Diagnostic accuracy of TVUS and MRI in the preoperative evaluation of myometrial infiltration in patients with endometrial cancer: A meta-analysis
The incidence of endometrial cancer is on the rise worldwide. Accurate preoperative evaluation of myometrial infiltration is crucial for developing treatment strategies. This study compares the diagnostic accuracy of transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) for myometrial infiltration (MI) in endometrial cancer (EC). We performed a systematic review and meta-analysis of observational studies, identified by screening Web of Science, SCOPUS, MEDLINE, PubMed, Google Scholar, and EMBASE databases. Studies published between January 1964 and June 2024 comparing the diagnostic accuracy of TVUS and MRI for MI were included. The data analysis focused on sensitivity, specificity, and overall diagnostic accuracy. Twenty-two studies in EC patients were included. The diagnostic odds ratio (OR) for TVUS and for MRI was 18 (95% CI: 22-26) and 20 (95% CI: 14-28), respectively. TVUS was associated with a sensitivity and specificity of 76% (95% CI: 72-82%) and 84% (95% CI: 79-88%), respectively, while MRI had a sensitivity and specificity of 79% (95% CI: 73-84%) and 84% (95% CI: 80-88%), respectively. The area under the receiver operating characteristic curve (AUCROC) was 0.88 for TVUS and 0.89 for MRI. No significant publication bias was detected. Both TVUS and MRI demonstrated comparable diagnostic accuracy for the preoperative evaluation of MI in EC.