2022-RA-1601-ESGO Ultrasound Versus Magnetic Resonance Imaging in the Assessment of Parametrial Invasion in Cervical Cancer

Introduction/Background Transvaginal/trans rectal ultrasound (TVS/TRS) when performed at experienced centers, typically performed by the treating gynecologist has the advantage of being readily available at low cost. The reported diagnostic performance of TVS/TRS for the assessment of tumor size > 4 cm, deep Stromal invasion and parametrial invasion is overall quite good with reported sensitivities (specificities) [accuracies] of 78% (99%) [95%], 88–91% (93–97%) [91–93%], and 60–83% (89–100%) [87–99%] respectively. This study aimed to compare the accuracy of ultrasound in relation to magnetic resonance imaging (MRI) in detection of parametrial infiltration in cases of cervical cancer Methodology A prospective comparative cohort study was conducted after ethical commitee approval on 50 newly diagnosed patients with cervical cancer at El Shatby University Hospital gyne-oncology unit in Alexandria, Egypt. the patients had no contraindications for MRI .They did not receive any radiotherapy .pelvic ultrasound (Trans abdominal/transvaginal) evaluation were done by expert ultra-sonographer to all patients with the aim to evaluate the parametrial infiltration before MRI evaluation .The ultrasound examination was compared to the results of the MRI examination for each patient. Results The sensitivity of TVS for detecting parametrium invasion was 92.86 and the specificity was 93.75 in comparison to MRI as gold standard.positive predictive value (PPV) was 82.35 and negative predictive value (NPV) is 96.30 where κ value is 0.855 Conclusion TVS is in a very good agreement with MRI in detection of parametrial invasion.