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Multicenter Study
. 2018 Jun;51(6):818-828.
doi: 10.1002/uog.18909.

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

E Epstein  1 , D Fischerova  2 , L Valentin  3 , A C Testa  4 , D Franchi  5 , P Sladkevicius  3 , F Frühauf  2 , P G Lindqvist  6 , F Mascilini  4 , R Fruscio  7 , L A Haak  8 , G Opolskiene  9 , M A Pascual  10 , J L Alcazar  11 , V Chiappa  12 , S Guerriero  13 , J W Carlson  14 , C Van Holsbeke  15 , F P G Leone  16 , B De Moor  17 , T Bourne  18   19 , B van Calster  19 , A Installe  17 , D Timmerman  19   20 , J Y Verbakel  19   21 , T Van den Bosch  20
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Free article
Multicenter Study

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

E Epstein et al. Ultrasound Obstet Gynecol. 2018 Jun.
Free article

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] Ultrasound Obstet Gynecol. 2018 Nov;52(5):684. doi: 10.1002/uog.20133. Ultrasound Obstet Gynecol. 2018. PMID: 30394630 No abstract available.

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.

Keywords: Doppler; diagnostic imaging; endometrial neoplasm; neoplasm staging; ultrasonography.

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