Contrast‑enhanced ultrasound in the diagnosis of endometrial carcinoma: A meta‑analysis

  • Authors:
    • Jing Geng
    • Jun Tang
  • View Affiliations

  • Published online on: October 22, 2018     https://doi.org/10.3892/etm.2018.6889
  • Pages: 5310-5314
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

The present study evaluated the diagnostic value of contrast‑enhanced ultrasound (CEUS) in endometrial carcinoma (EC). Articles published until 31 January 2017 were retrieved from PubMed, EMBASE, Elsevier, Springer and Google scholar, with the following inclusion criteria: i) The accuracy (sensitivity and specificity) of CEUS in the diagnosis of EC was evaluated; ii) a gold standard was adopted to treat and confirm EC, including surgery, histopathology and appropriate follow‑up (as included in the meta‑analysis); iii) the data allowed for construction of a 2x2 table of positives, false‑positives, negatives and false‑negatives. Pooled estimates of sensitivity, specificity, risk ratios and diagnostic odds ratios (DOR) were calculated in the present meta‑analysis of the accuracy of CEUS in diagnosing EC. The summary receiver‑operating characteristics (sROC) curve was also constructed. Among the 93 relevant articles, 7 studies were finally selected according to the inclusion criteria with a sample size of n=275. The pooled sensitivity of CEUS in the diagnosis of EC was 84% [95% confidence interval (CI), 0.78‑0.88], while the pooled specificity was 90% (95% CI, 0.86‑0.92). The positive likelihood ratio (+LR) of CEUS was 8.0 (95% CI, 5.9‑10.8) and the negative likelihood ratio (‑LR) was 0.18 (95% CI, 0.13‑0.25). The DOR was 44 (95% CI, 26‑77). The area under the sROC curve was 0.93 with specificity of 0.90 (0.86‑0.92) and sensitivity of 0.84 (0.78‑0.88) for the summary operating point. Moderate heterogeneity was observed for sensitivity, specificity and DOR with I2 values of 32.56, 34.68 and 41.2%, respectively. No significant publication bias was observed for the DOR of CEUS. In conclusion, the present meta‑analysis indicates that CEUS is valuable in the diagnosis of EC. Additional clinical data and studies are still required to confirm these results and to further develop the diagnostic application of CEUS in EC.

References

1 

Dal Maso L, Augustin LS, Karalis A, Talamini R, Franceschi S, Trichopoulos D, Mantzoros CS and La Vecchia C: Circulating adiponectin and endometrial cancer risk. J Clin Endocrinol Metab. 89:1160–1163. 2014. View Article : Google Scholar

2 

Wright JD, Barrena Medel NI, Sehouli J, Fujiwara K and Herzog TJ: Contemporary management of endometrial cancer. Lancet. 379:1352–1360. 2012. View Article : Google Scholar : PubMed/NCBI

3 

Siegel RL, Miller KD and Jemal A: Cancer statistics, 2015. CA Cancer J Clin. 65:5–29. 2015. View Article : Google Scholar : PubMed/NCBI

4 

de Boer SM, Nout RA, Jürgenliemk-Schulz IM, Jobsen JJ, Lutgens LC, van der Steen-Banasik EM, Mens JW, Slot A, Stenfert Kroese MC, Oerlemans S, et al: Long-term impact of endometrial cancer diagnosis and treatment on health-related quality of life and cancer survivorship: Results from the randomized PORTEC-2 trial. Int J Radiat Oncol Biol Phys. 93:797–809. 2015. View Article : Google Scholar : PubMed/NCBI

5 

Kurosawa H, Ito K, Nikura H, Takano T, Nagase S, Utsunomiya H, Otsuki T, Toyoshima M, Nagai T, Tanaka S, et al: Hysteroscopic inspection and total curettage are insufficient for discriminating endometrial cancer from atypical endometrial hyperplasia. Tohoku J Exp Med. 228:365–70. 2012. View Article : Google Scholar : PubMed/NCBI

6 

Crispi CP, Vanin CM, Dibi RP, Kato SK and Pesssini SA: Postmenopausal bleeding: Findings and accuracy of hysteroscopy and histopathologic in the diagnosis of endometrial cancer. J Minimal Invasive Gynecol. 18:S832011. View Article : Google Scholar

7 

Bakir B, Sanli S, Bakir VL, Ayas S, Yildiz SO, Iyibozkurt AC, Kartal MG and Yavuz E: Role of diffusion weighted MRI in the differential diagnosis of endometrial cancer, polyp, hyperplasia, and physiological thickening. Clin Imaging. 41:86–94. 2017. View Article : Google Scholar : PubMed/NCBI

8 

Bollineni VR, Ytrehauge S, Bollinenibalabay O, Salvesen HB and Haldorsen IS: High diagnostic value of FDG-PET/CT in endometrial cancer: Systematic review and meta-analysis of the literature. J Nucl Med. 57:879–885. 2016. View Article : Google Scholar : PubMed/NCBI

9 

Jacobs I, Gentry-Maharaj A, Burnell M, Manchanda R, Singh N, Sharma A, Ryan A, Seif MW, Amso NN, Turner G, et al: Sensitivity of transvaginal ultrasound screening for endometrial cancer in postmenopausal women: A case-control study within the UKCTOCS cohort. Lancet Oncol. 12:38–48. 2011. View Article : Google Scholar : PubMed/NCBI

10 

Palmieri VO, Santovito D, Marano G, Minerva F, Ricci L, D'Alitto F, Angelelli G and Palasciano G: Contrast-enhanced ultrasound in the diagnosis of hepatocellular carcinoma. Radiol Med. 120:627–633. 2015. View Article : Google Scholar : PubMed/NCBI

11 

Dietrich CF, Averkiou MA, Correas JM, Lassau N, Leen E and Piscaglia F: An EFSUMB introduction into dynamic contrast-enhanced ultrasound (DCE-US) for quantification of tumour perfusion. Ultraschall Med. 33:344–351. 2012. View Article : Google Scholar : PubMed/NCBI

12 

Wang J, Lv F, Fei X, Cui Q, Wang L, Gao X, Yuan Z, Lin Q, Lv Y and Liu A: Study on the characteristics of contrast-enhanced ultrasound and its utility in assessing the microvessel density in ovarian tumors or tumor-like lesions. Int J Biol Sci. 7:600–606. 2011. View Article : Google Scholar : PubMed/NCBI

13 

Moher D, Liberati A, Tetzlaff J, Altman DG and PRISMA Group: Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann Intern Med. 151:264–269. 2009. View Article : Google Scholar : PubMed/NCBI

14 

Puli SR, Kalva N, Bechtold ML, Pamulaparthy SR, Cashman MD, Estes NC, Pearl RH, Volmar FH, Dillon S, Shekleton MF and Forcione D: Diagnostic accuracy of endoscopic ultrasound in pancreatic neuroendocrine tumors: A systematic review and meta-analysis. World J Gastroenterol. 19:3678–3684. 2013. View Article : Google Scholar : PubMed/NCBI

15 

Wang AZ, Liu CY, Xie Q and Wu XP: Contrast-enhanced ultrasound and magnetic resonance imaging diagnosis value and differential diagnosis for myometrial invasion of stage I endometrial carcinoma. Shaanxi Yi Xue Za Zhi. 41:80–83. 2012.(In Chinese).

16 

Zhou HL, Xiang H, Duan L, Shahai G, Liu H, Li XH and Mou RX: Application of combined two-dimensional and three-dimensional transvaginal contrast enhanced ultrasound in the diagnosis of endometrial carcinoma. Biomed Res Int. 2015:2927432015. View Article : Google Scholar : PubMed/NCBI

17 

Song Y, Yang J, Liu Z and Shen K: Preoperative evaluation of endometrial carcinoma by contrast-enhanced ultrasonography. BJOG. 116:298–299. 2009. View Article : Google Scholar

18 

Ding Y, Guo Y, Guan L, Wang H, Zhang D and Wang Y: Application value of contrast-enhanced ultrasound for stage of endometrial carcinoma. Chongqing Med J. 42:2103–2106. 2013.

19 

Liu CY, Wang XF, Xie Q, Wan BB, Sheng X, Wang M and Zhao LH: Diagnostic value of contrast-enhanced ultrasound for myometrial invasion of stage I endometrial carcinoma. Chinese J Med Image Technol. 27:1443–1446. 2011.

20 

Sun ZJ, Yang JX, Shen K, et al: Contrast-enhanced ultrasound in the evaluation of myometrial invasion in endometrial carcinoma. J Reproduct Med. 2008.

21 

Zhang XZ, Zhao HY, Peng M and Wei WB: Application of contrast-enhanced ultrasound in the myometrial invasion of endometrial carcinoma. J Bengbu Med Col. 36((3)): 285–287. 2011.

22 

Lencioni R, Piscaglia F and Bolondi L: Contrast-enhanced ultrasound in the diagnosis of hepatocellular carcinoma. J Hepatol. 48:848–857. 2008. View Article : Google Scholar : PubMed/NCBI

23 

Zhou XD, Ren XL, Zhang J, He GB, Zheng MJ, Tian X, Li L, Zhu T, Zhang M, Wang L and Luo W: Therapeutic response assessment of high intensity focused ultrasound therapy for uterine fibroid: Utility of contrast-enhanced ultrasonography. Eur J Radiol. 62:289–294. 2007. View Article : Google Scholar : PubMed/NCBI

24 

Sconfienza LM, Lacelli F, Gazzo P, Gandolfo N, Gravano M and Serafini G: Is contrast-enhanced ultrasound (CEUS) effective in the assessment of outcomes and in the follow up of uterine fibroids after superselective uterine fibroids embolization (SUFE) when compared to dynamic magnetic resonance (MR)? Ultraschall in Der Medizin. 29((S1))2008.

25 

Seitz K and Strobel D: A Milestone: Approval of CEUS for diagnostic liver imaging in adults and children in the USA. Ultraschall Med. 37:229–232. 2016. View Article : Google Scholar : PubMed/NCBI

26 

Whiting P, Rutjes AW, Reitsma JB, Bossuyt PM and Kleijnen J: The development of QUADAS: A tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 3:252003. View Article : Google Scholar : PubMed/NCBI

Related Articles

Journal Cover

December 2018
Volume 16 Issue 6

Print ISSN: 1792-0981
Online ISSN:1792-1015

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
APA
Geng, J., & Geng, J. (2018). Contrast‑enhanced ultrasound in the diagnosis of endometrial carcinoma: A meta‑analysis. Experimental and Therapeutic Medicine, 16, 5310-5314. https://doi.org/10.3892/etm.2018.6889
MLA
Geng, J., Tang, J."Contrast‑enhanced ultrasound in the diagnosis of endometrial carcinoma: A meta‑analysis". Experimental and Therapeutic Medicine 16.6 (2018): 5310-5314.
Chicago
Geng, J., Tang, J."Contrast‑enhanced ultrasound in the diagnosis of endometrial carcinoma: A meta‑analysis". Experimental and Therapeutic Medicine 16, no. 6 (2018): 5310-5314. https://doi.org/10.3892/etm.2018.6889