Abstract：
To evaluate and compare the diagnostic test accuracy (DTA) of three-dimensional transvaginal ultrasound (3D-TVS) and magnetic resonance imaging (MRI) for deep myometrial infiltration (DMI) and cervical invasion for preoperative staging and surgery planning in patients with endometrial cancer (EC).
This systematic review and meta-analysis investigated the DTA of MRI and 3D-TVS for DMI and cervical invasion in patients with EC. A literature search was performed using MEDLINE, Scopus, EMBASE, ScienceDirect, The Cochrane library, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, EU Clinical Trials Register and World Health Organization International Clinical Trials Registry Platform to identify relevant studies published between January 2000 and December 2021. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.
Five studies, including a total of 450 patients, were included in the systematic review. All five studies compared the DTA of 3D-TVS vs MRI for DMI, and three studies compared the DTA of 3D-TVS vs MRI for cervical invasion. Pooled sensitivity, positive likelihood ratio and negative likelihood ratio for detecting DMI using 3D-TVS were 77% (95% CI, 66-85%), 4.57 and 0.31, respectively. The respective values for detecting DMI on MRI were 80% (95% CI, 73-86%), 4.22 and 0.24. Bivariate metaregression indicated a similar DTA of 3D-TVS and MRI (P = 0.80) for the correct identification of DMI. Pooled ln diagnostic odds ratio for detecting cervical invasion was 3.11 (95% CI, 2.09-4.14) for 3D-TVS and 2.36 (95% CI, 0.90-3.83) for MRI. The risk of bias was low for most of the four domains assessed in QUADAS-2.
3D-TVS demonstrated good diagnostic accuracy in terms of sensitivity and specificity for the evaluation of DMI and cervical invasion, with results comparable with those of MRI. Thus, we confirmed the potential role of 3D-TVS in the preoperative staging and surgery planning in patients with EC. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
This systematic review and meta-analysis investigated the DTA of MRI and 3D-TVS for DMI and cervical invasion in patients with EC. A literature search was performed using MEDLINE, Scopus, EMBASE, ScienceDirect, The Cochrane library, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, EU Clinical Trials Register and World Health Organization International Clinical Trials Registry Platform to identify relevant studies published between January 2000 and December 2021. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.
Five studies, including a total of 450 patients, were included in the systematic review. All five studies compared the DTA of 3D-TVS vs MRI for DMI, and three studies compared the DTA of 3D-TVS vs MRI for cervical invasion. Pooled sensitivity, positive likelihood ratio and negative likelihood ratio for detecting DMI using 3D-TVS were 77% (95% CI, 66-85%), 4.57 and 0.31, respectively. The respective values for detecting DMI on MRI were 80% (95% CI, 73-86%), 4.22 and 0.24. Bivariate metaregression indicated a similar DTA of 3D-TVS and MRI (P = 0.80) for the correct identification of DMI. Pooled ln diagnostic odds ratio for detecting cervical invasion was 3.11 (95% CI, 2.09-4.14) for 3D-TVS and 2.36 (95% CI, 0.90-3.83) for MRI. The risk of bias was low for most of the four domains assessed in QUADAS-2.
3D-TVS demonstrated good diagnostic accuracy in terms of sensitivity and specificity for the evaluation of DMI and cervical invasion, with results comparable with those of MRI. Thus, we confirmed the potential role of 3D-TVS in the preoperative staging and surgery planning in patients with EC. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
摘要：
评价并比较经阴道三维超声(3D-TVS)和磁共振成像(MRI)对子宫内膜癌(EC)患者深肌层浸润(DMI)和宫颈浸润的诊断试验(DTA)准确性及手术计划。
本系统综述和荟萃分析研究了EC患者的MRI和3D-TVS的DTA对DMI和宫颈侵犯的影响。使用MEDLINE进行文献检索，Scopus,EMBASE,ScienceDirect,科克伦图书馆,ClinicalTrials.gov,Cochrane中央控制试验登记册,欧盟临床试验注册和世界卫生组织国际临床试验注册平台，以确定2000年1月至2021年12月之间发表的相关研究。使用诊断准确性研究质量评估-2（QUADAS-2）工具评估研究质量。
五项研究,包括450名患者，包括在系统审查中。所有五项研究都比较了3D-TVS与MRI的DTA，三项研究比较了3D-TVS与MRI对宫颈侵犯的DTA。汇集灵敏度,使用3D-TVS检测MI的正似然比和负似然比为77%（95%CI，66-85%），分别为4.57和0.31。MRI上的MI检测值分别为80％（95％CI，73-86％），4.22和0.24。双变量回归表明3D-TVS和MRI的DTA相似（P=0.80），可以正确识别DMA。3D-TVS检测宫颈侵犯的合并诊断比值比为3.11（95％CI，2.09-4.14），MRI为2.36（95％CI，0.90-3.83）。在QUADAS-2中评估的四个领域中，大多数领域的偏倚风险较低。
3D-TVS在评估STI和宫颈侵犯的敏感性和特异性方面表现出良好的诊断准确性。结果与MRI相当。因此，我们证实了3D-TVS在EC患者的术前分期和手术计划中的潜在作用.©2022作者由JohnWiley&SonsLtd代表国际妇产科超声学会出版的妇产科超声。
本系统综述和荟萃分析研究了EC患者的MRI和3D-TVS的DTA对DMI和宫颈侵犯的影响。使用MEDLINE进行文献检索，Scopus,EMBASE,ScienceDirect,科克伦图书馆,ClinicalTrials.gov,Cochrane中央控制试验登记册,欧盟临床试验注册和世界卫生组织国际临床试验注册平台，以确定2000年1月至2021年12月之间发表的相关研究。使用诊断准确性研究质量评估-2（QUADAS-2）工具评估研究质量。
五项研究,包括450名患者，包括在系统审查中。所有五项研究都比较了3D-TVS与MRI的DTA，三项研究比较了3D-TVS与MRI对宫颈侵犯的DTA。汇集灵敏度,使用3D-TVS检测MI的正似然比和负似然比为77%（95%CI，66-85%），分别为4.57和0.31。MRI上的MI检测值分别为80％（95％CI，73-86％），4.22和0.24。双变量回归表明3D-TVS和MRI的DTA相似（P=0.80），可以正确识别DMA。3D-TVS检测宫颈侵犯的合并诊断比值比为3.11（95％CI，2.09-4.14），MRI为2.36（95％CI，0.90-3.83）。在QUADAS-2中评估的四个领域中，大多数领域的偏倚风险较低。
3D-TVS在评估STI和宫颈侵犯的敏感性和特异性方面表现出良好的诊断准确性。结果与MRI相当。因此，我们证实了3D-TVS在EC患者的术前分期和手术计划中的潜在作用.©2022作者由JohnWiley&SonsLtd代表国际妇产科超声学会出版的妇产科超声。
