P15.05: Vascularity measurements in predicting deep invasion in endometrial carcinoma: uterine artery color Doppler and uterine 3D‐power Doppler angiography

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To evaluate the performance of uterine artery color Doppler assessment and uterine three-dimensional power Doppler angiography (3D-PDA) in predicting deep (≥ 50%) myometrial tumor invasion and the presence of metastases in patients with endometrial carcinoma. Sonographic and histological data of 66 consecutive patients presenting with Grade 1 or Grade 2 endometrial carcinoma were analyzed. The uterine artery colour Doppler indices RI (resistance index), PI (pulsatility index), PSV (peak systolic velocity) and uterine and 10 mm shell myometrial 3D-PDA indices VI (vascularization index), FI (flow index) and VFI (vascularization flow index) were calculated. Signal attenuation in 3D-PDA was evaluated by categorizing the patients into two subgroups according to the distance to the center of the endometrium. The results were compared with a complete surgical staging. A deep myometrial invasion was present in 23 patients. Of the color Doppler indices, the uterine artery RI and PI were statistically significantly lower in the group with deep invasion (P = 0.014 and 0.013, respectively). The uterine and myometrial 3D-PDA indices VI and VFI were statistically significantly higher in the group with deep invasion (P = 0.014 and 0.014; P = 0.013 and 0.022, respectively). No correlation was found between any of the measured indices and the presence of metastases. The subgroup analysis indicated that the uterine and myometrial VI was affected by distance, being statistically significantly higher in the group closer to the probe (P = 0.021 and 0.012, respectively). The multivariable analysis left the mean uterine artery RI as the only independent factor for the presence of deep invasion (OR 0.0003, 95%CI 0.00008–0.143, P = 0.010). The uterine artery RI correlates with the presence of deep invasion in endometrial carcinoma. 3D-PDA has potential in the preoperative assessment of endometrial carcinoma, but signal attenuation may bias the results.

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