Comparative study between preoperative and operative staging in endometrial cancer patients

Background: endometrial cancer is the most common gynecological cancer in developed countries and is primarily treated surgically. This study aimed to compare between preoperative findings by Vaginal U/S & MRI with postoperative pathological data regarding Endometrial thickening, Myometrial Invasion Depth and Lymph Node Metastasis. Methods: It is a prospective cohort study of 20 consecutive patients with endometrial cancer, in the Department of General Surgery at Al-Azhar University Hospitals. To assess the depth of myometrial invasion, we performed a pelvic MR. Subsequently; myometrial invasion was detected with MRI by the recognition of the disruption, whilst transvaginal sonography was performed by experienced sonographers who used a 5.0- to 7.5-MHz curvilinear-array transducer probe. Results: Our results showed that the employment of magnetic resonance imaging to detect the myocardial invasion established that the sensitivity, specificity, positive and negative predicted values of MRI was 92.3%, 76.5%, 60.0% and 96.3% subsets, respectively. US was accurate in 12 of 20 cases and overestimated the depth of invasion in 2 cases. In comparison with histopathological findings; the results of MRI images were accurate in 13 patients whilst TVUS images were accurate in 12 patients (60%) with 3 patients underestimated and two patients over estimated. Conclusion: MRI and TVUS detect myocardial invasion with accurate results that help the surgeon to make the appropriate decision. Brings to light that, MRI and TVUS perform best in the pretreatment evaluation of endometrial cancer and differentiating deep from superficial myometrial invasion.