The Diagnostic Accuracy of Ultrasound in Assessment of Myometrial Invasion in Endometrial Cancer: Subjective Assessment versus Objective Techniques
Table 3
Diagnostic performance of ultrasound in local staging of endometrial cancer in relation to final histological results as reference standard: subjective assessment and objective methods.
Assessment of myometrial invasion
Sensitivity (95% CI)
Specificity (95% CI)
PPV (95% CI)
NPV (95% CI)
Accuracy (95% CI)
AUC (95% CI)
value
(1) Subjective evaluation of myometrial invasion
79.3 (69.3–87.3)
73.2 (64.4–80.8)
67.6 (57.7–76.6)
83.3 (74.9–89.9)
75.7 (69.3–81.4)
0.712 (0.649–0.768)
<0.001
(2) Deepest invasion/normal myometrium width
69.6 (58.2–79.5)
65.9 (56.8–74.2)
56.7 (46.3–66.7)
77.1 (67.9–84.8)
67.3 (60.3–73.5)
0.677 (0.608–0.741)
<0.001
(3) Tumor/uterine AP diameter
56.3 (45.3–66.9)
76.4 (67.9–83.6)
62.8 (51.1–73.6)
71.2 (62.7–78.8)
68.1 (61.3–74.3)
0.664 (0.595–0.727)
<0.001
Assessment of cervical stromal invasion
(4) Subjective evaluation of cervical stromal invasion
40.5 (24.8–57.9)
94.2 (89.6–97.2)
60.0 (38.2–79.2)
88.1 (82.5–92.4)
84.8 (79.2–89.3)
0.694 (0.626–0.757)
<0.001
Statistical test
Statistical comparison (1) versus (2)
0.023
0.105
—
—
0.047
0.437
Statistical comparison (1) versus (3)
<0.001
0.651
—
—
0.084
0.309
Statistical comparison (1) versus (4)
<0.001
<0.001
—
—
0.019
0.687
of predictive power of subjective evaluation versus objective methods in assessment of myometrial invasion and comparison of subjective evaluation of myometrial and cervical stromal invasion (chi-square test); estimates of NPV and PPV were not compared due to their dependence on the prevalence of endpoint; NPV, negative predictive value; PPV, positive predictive value; AUC, area under the curve (Receiver Operating Characteristics curves) with corresponding confidence interval and statistical significance ( value).
