Abstract
Objectives
Assessment of deep (>50%) myometrial invasion by dual-energy CT (DECT) and Trans-Vaginal US (TVUS) in patients with endometrial cancer.
Methods
We retrospectively enrolled patients with endometrial cancer who underwent DECT and TVUS for pre-surgical staging. Three sets of images were evaluated: 70 keV (routine CT images), 50 keV, and iodine-water reconstructions. The gold standard was pathology after surgery. The agreement between the different imaging modalities and the gold standard was estimated. Sensitivity, specificity and accuracy for each imaging modality were evaluated with 95% confidence intervals (CI).
Results
Thirty-nine patients were included. Median time from CT and TVUS to surgery was 23 and 18 days, respectively. The best agreement between evaluation of myometrial infiltration and the gold standard was 0.88 (0.72, 1.00) for the 50 keV images; the worst agreement was 0.43 (0.00, 0.88) for the 70 keV images. CT iodine reconstructions and US agreement were comparable. Specificity, sensitivity and accuracy were 0.91, 1.00, 0.94; 0.57, 0.86, 0.71; 0.82, 1.00, 0.87; 0.91, 0.77, 0.86 for 50 keV, 70 keV, iodine reconstructions and ultrasound, respectively.
Conclusions
DECT is a promising tool for assessment of myometrial invasion in endometrial cancer patients, with a special focus on 50 keV images.
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Acknowledgements
The English text has been edited by Anne Prudence Collins (Editor and Translator, Medical and Scientific Publications; Member AITI—FIT UNESCO; Member European Medical Writers Association).
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No funding was received for this study.
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The other authors declare that they have no conflict of interest. Alberto Mauro, an employee of GE Healthcare, helped the authors in setting up the CT protocol and had no influence on the data collected for this study.
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This article does not contain any studies with animals performed by any of the authors. All procedures performed in this study involving human participants, were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Rizzo, S., Femia, M., Radice, D. et al. Evaluation of deep myometrial invasion in endometrial cancer patients: is dual-energy CT an option?. Radiol med 123, 13–19 (2018). https://doi.org/10.1007/s11547-017-0810-2
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DOI: https://doi.org/10.1007/s11547-017-0810-2