PMID- 16715466 OWN - NLM STAT- MEDLINE DCOM- 20070216 LR - 20191210 IS - 0960-7692 (Print) IS - 0960-7692 (Linking) VI - 27 IP - 6 DP - 2006 Jun TI - New models to predict depth of infiltration in endometrial carcinoma based on transvaginal sonography. PG - 664-71 AB - OBJECTIVES: Preoperative knowledge of the depth of myometrial infiltration is important in patients with endometrial carcinoma. This study aimed at assessing the value of histopathological parameters obtained from an endometrial biopsy (Pipelle de Cornier; results available preoperatively) and ultrasound measurements obtained after transvaginal sonography with color Doppler imaging in the preoperative prediction of the depth of myometrial invasion, as determined by the final histopathological examination of the hysterectomy specimen (the gold standard). METHODS: We first collected ultrasound and histopathological data from 97 consecutive women with endometrial carcinoma and divided them into two groups according to surgical stage (Stages Ia and Ib vs. Stages Ic and higher). The areas (AUC) under the receiver-operating characteristics curves of the subjective assessment of depth of invasion by an experienced gynecologist and of the individual ultrasound parameters were calculated. Subsequently, we used these variables to train a logistic regression model and least squares support vector machines (LS-SVM) with linear and RBF (radial basis function) kernels. Finally, these models were validated prospectively on data from 76 new patients in order to make a preoperative prediction of the depth of invasion. RESULTS: Of all ultrasound parameters, the ratio of the endometrial and uterine volumes had the largest AUC (78%), while that of the subjective assessment was 79%. The AUCs of the blood flow indices were low (range, 51-64%). Stepwise logistic regression selected the degree of differentiation, the number of fibroids, the endometrial thickness and the volume of the tumor. Compared with the AUC of the subjective assessment (72%), prospective evaluation of the mathematical models resulted in a higher AUC for the LS-SVM model with an RBF kernel (77%), but this difference was not significant. CONCLUSIONS: Single morphological parameters do not improve the predictive power when compared with the subjective assessment of depth of myometrial invasion of endometrial cancer, and blood flow indices do not contribute to the prediction of stage. In this study an LS-SVM model with an RBF kernel gave the best prediction; while this might be more reliable than subjective assessment, confirmation by larger prospective studies is required. CI - Copyright 2006 ISUOG. Published by John Wiley & Sons, Ltd. FAU - De Smet, F AU - De Smet F AD - Department of Electrical Engineering ESAT-SCD, Katholieke Universiteit Leuven, Leuven, Belgium. FAU - De Brabanter, J AU - De Brabanter J FAU - Van den Bosch, T AU - Van den Bosch T FAU - Pochet, N AU - Pochet N FAU - Amant, F AU - Amant F FAU - Van Holsbeke, C AU - Van Holsbeke C FAU - Moerman, P AU - Moerman P FAU - De Moor, B AU - De Moor B FAU - Vergote, I AU - Vergote I FAU - Timmerman, D AU - Timmerman D LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Validation Study PL - England TA - Ultrasound Obstet Gynecol JT - Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology JID - 9108340 SB - IM MH - Aged MH - Aged, 80 and over MH - Biopsy MH - Carcinoma, Endometrioid/diagnostic imaging/*pathology/surgery MH - Endometrial Neoplasms/diagnostic imaging/*pathology/surgery MH - Female MH - Humans MH - Middle Aged MH - *Models, Statistical MH - Neoplasm Invasiveness MH - Neoplasm Staging MH - Prospective Studies MH - Ultrasonography, Doppler, Color/methods EDAT- 2006/05/23 09:00 MHDA- 2007/02/17 09:00 CRDT- 2006/05/23 09:00 PHST- 2006/05/23 09:00 [pubmed] PHST- 2007/02/17 09:00 [medline] PHST- 2006/05/23 09:00 [entrez] AID - 10.1002/uog.2806 [doi] PST - ppublish SO - Ultrasound Obstet Gynecol. 2006 Jun;27(6):664-71. doi: 10.1002/uog.2806.