Diagnostic Accuracy of Ultrasonography Versus Magnetic Resonance Imaging in the Detection of Endometrial Carcinoma Keeping Histopathology as Gold Standard

Abstract

Objective: To calculate the diagnostic accuracy of Ultrasonography versus Magnetic Resonance Imaging in detecting endometrial carcinoma with histopathology kept as a gold standard. Study Design: Cross-sectional study. Place and Duration of Study: Department of Diagnostic Radiology, Pakistan Institute of Medical Sciences Hospital, Islamabad Pakistan, from Apr 2019 to Apr 2020. Methodology: This study included patients of perimenopausal and post-menopausal age groups with abnormal uterine bleeding having a high index of suspicion for endometrial malignancy referred from the Gynecology department for an ultrasound examination. Patients having high suspicion for malignancy or inconclusive evidence on ultrasound were considered for Magnetic Resonance Imaging(MRI). All of them were followed for histopathological reports after surgical exploration. Clinical, sonological and Magnetic Resonance Imaging (MRI) findings, along with histopathological diagnosis, were documented. Results: Mean age of the patients was 56.58±10.28. Of these eight patients, 8(21.1%) did not have carcinoma upon histopathology. The most common type of carcinoma was poorly differentiated endometrial adenocarcinoma. The diagnostic accuracy of ultrasound was found to be 47.35%, while that for Magnetic Resonance Imaging (MRI) was 71.05%. Sensitivity and specificity for Ultrasound versus Magnetic Resonance Imaging (MRI) were 53.33% versus 66.67% and 75% versus 87.50%, respectively. The mean endometrial thickness on ultrasound was 15.97±5.64 mm, while on MRI was 15.42±6.9 mm. Conclusion: Magnetic Resonance Imaging (MRI) is a more accurate and sensitive modality in detecting endometrial carcinoma in patients with abnormal uterine bleeding.

Keywords

• Abnormal uterine bleeding
• Endometrial carcinoma
• Magnetic resonance imaging (MRI)