Transvaginal Sonography (TVS) in Evaluation of Endometrial Carcinoma and Its Correlation with Histopathology: A Retrospective Analysis

Purpose: To study the TVS findings in endometrial carcinoma and correlate with postoperative findings. Method: This is a retrospective observational study which included 192 cases of histopathologically proven cases of endometrial malignancy (either preoperatively or postoperatively) who had undergone a prior transvaginal ultrasonographic examination. The TVS data were analyzed with regard to endometrial thickness, echogenicity, presence of cystic areas, myometrial invasion, cervical extension and adnexal involvement. The TVS findings and endometrial thickness were correlated with postoperative histopathological types and grades. Results: Out of total 192 cases, TVS findings were normal in 11 (6%) cases. One hundred and eighty-one (94%) cases demonstrated abnormal TVS findings. Well-defined/smooth endometrial thickening was seen in 59 (31%) cases, whereas ill-defined/irregular endometrial thickening was seen in 87 (45%) cases. Frank mass formation was noted in 27 (14%) cases. Cystic changes were seen in 48 (25%) cases. The commonest histological type was endometrioid adenocarcinoma which accounted for 153 (80%) cases. Forty-six (24%) cases had grade I malignancy, 104 (54%) grade II and 42 (22%) cases had grade III malignancy. The sensitivity of TVS in detecting endometrial pathology was 90%. The sensitivity of TVS in detecting myometrial invasion was found to be 53%, and cervical invasion was found to be 70%. 62% of the endometrioid types are moderately differentiated, whereas other histological types 55% are poorly differentiated. Conclusion: TVS is a fairly good imaging tool in endometrial carcinoma. © 2017, Association of Gynecologic Oncologists of India.