Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature: prospective multicenter study

E Epstein, D Fischerova, L Valentin, A C Testa, D Franchi, P Sladkevicius, F Frühauf, P G Lindqvist, F Mascilini, R Fruscio, L A Haak, G Opolskiene, M A Pascual, J L Alcazar, V Chiappa, S Guerriero, J W Carlson, C Van Holsbeke, F P G Leone, B De MoorT Bourne, B van Calster, A Installe, D Timmerman, J Y Verbakel, T Van den Bosch

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To describe the sonographic features of endometrial cancer in relation to tumor stage, grade and histological type, using the International Endometrial Tumor Analysis (IETA) terminology.

METHODS: This was a prospective multicenter study of 1714 women with biopsy-confirmed endometrial cancer undergoing standardized transvaginal grayscale and Doppler ultrasound examination according to the IETA study protocol, by experienced ultrasound examiners using high-end ultrasound equipment. Clinical and sonographic data were entered into a web-based database. We assessed how strongly sonographic characteristics, according to IETA, were associated with outcome at hysterectomy, i.e. tumor stage, grade and histological type, using univariable logistic regression and the c-statistic.

RESULTS: In total, 1538 women were included in the final analysis. Median age was 65 (range, 27-98) years, median body mass index was 28.4 (range 16-67) kg/m2 , 1377 (89.5%) women were postmenopausal and 1296 (84.3%) reported abnormal vaginal bleeding. Grayscale and color Doppler features varied according to grade and stage of tumor. High-risk tumors, compared with low-risk tumors, were less likely to have regular endometrial-myometrial junction (difference of -23%; 95% CI, -27 to -18%), were larger (mean endometrial thickness; difference of +9%; 95% CI, +8 to +11%), and were more likely to have non-uniform echogenicity (difference of +7%; 95% CI, +1 to +13%), a multiple, multifocal vessel pattern (difference of +21%; 95% CI, +16 to +26%) and a moderate or high color score (difference of +22%; 95% CI, +18 to +27%).

CONCLUSION: Grayscale and color Doppler sonographic features are associated with grade and stage of tumor, and differ between high- and low-risk endometrial cancer. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

Original languageEnglish
Pages (from-to)818-828
Number of pages11
JournalUltrasound in Obstetrics and Gynecology
Volume51
Issue number6
DOIs
Publication statusPublished - Jun 2018

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Consensus Development Conferences as Topic
  • Cross-Sectional Studies
  • Endometrial Neoplasms/classification
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Grading
  • Prospective Studies
  • Reproducibility of Results
  • Terminology as Topic
  • Ultrasonography, Doppler, Color/standards

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