The Diagnostic Accuracy of Ultrasound in Assessment of Myometrial Invasion in Endometrial Cancer: Subjective Assessment versus Objective Techniques

Table 4

Characteristics and results of the studies assessing diagnostic performance of ultrasound in preoperative local staging of endometrial cancer.

Reference	Consecutive recruitment		Myometrial invasion							Cervical stromal invasion
			Subjective assessment		Karlsson’s ratio		Gordon’s ratio		Cases with MI ≥ 50% ()	Subjective assessment		Cases with cervical stromal invasion ()
			Sensitivity	Specificity	Sensitivity	Specificity	Sensitivity	Specificity		Sensitivity	Specificity
Weber (1995) [20]	Unclear	80	—	—	90.0	85.5	—	—	27	—	—	—
Gabrielli (1996) [21]	Unclear	67	—	—	88.0	71.0	—	—	26	54.0	87.0	11
Olaya (1998) [22]	Yes	50	—	—	94.1	84.8	—	—	17	—	—	—
Alcázar (1999) [23]	Yes	50	—	—	86.7	94.3	—	—	15	—	—	—
Arko (2000) [24]	Unclear	120	—	—	—	—	79.0	69.0	48	—	—	—
Fishman (2000) [25]	Yes	91	—	—	87.8	82.7	—	—	33	—	—	—
Szánthó (2001) [26]	Unclear	52	—	—	86.0	90.0	—	—	28	—	—	—
Van Doorn (2002) [27]	Unclear	93	79.0	72.0	—	—	—	—	33	—	—	—
Sawicki (2003) [11]	Unclear	90	—	—	88.9	92.6	—	—	36	86.4	85.3	22
De Smet (2006) [15]	Yes	97	61.0	86.0	72.0	71.0	—	—	59	—	—	—
Takač (2007) [28]	Unclear	53	—	—	—	—	85.7	76.0	28	—	—	—
Yahata (2007) [29]	Unclear	177	—	—	—	—	64.3	97.5	58	—	—	—
Savelli (2008) [7]	Yes	74	84.0	83.0	—	—	—	—	32	93.0	92.0	12
Alcázar (2009) [13]	Yes	96	92.6	82.3	—	—	—	—	27	—	—	—
Ӧzdemir (2009) [30]	Unclear	64	85.0	75.0	—	—	—	—	20	—	—	—
Akbayir (2011) [10]	Yes	298	—	—	68.4	82.0	—	—	98	76.5	99.3	17
Akbayir (2012) [31]	Yes	219	62.0	81.0	—	—	—	—	69	—	—	—
Savelli (2012) [32]	Unclear	155	75.0	89.0	—	—	—	—	76	—	—	—
Ørtoft (2013) [33]	Yes	156	—	—	—	—	77.0	72.0	66	38.0	89.0	26
Mascilini (2013) [12]	Yes	144	77.0	81.0	72.0	76.0	—	—	60	54.0	93.0	26
Antonsen (2013) [6]	Yes	318	71.0	72.0	—	—	—	—	82	29.0	92.0	63
Van Holsbeke (2014) [16]	Unclear	211	83.0	71.0	66.0	74.0	—	—	77	—	—	—
Alcázar (2015) [14]	Yes	169	79.5	89.6	31.8	94.3	—	—	44	—	—	—
Christensen (2015) [34]	Yes	110	—	—	—	—	62.0	83.0	47	25.0	90.0	18
Frühauf (2017)	Yes	210	79.3	73.2	56.3	76.4	69.6	65.9	87	40.5	94.2	37

In all studies, the index test was transvaginal ultrasound and reference standard was final histological finding after hysterectomy.