{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:08:55Z","timestamp":1791896935073,"version":"4.3.4"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,5,2]],"date-time":"2014-05-02T00:00:00Z","timestamp":1398988800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To develop and validate strategies, using new ultrasound\u2010based mathematical models, for the prediction of high\u2010risk endometrial cancer and compare them with strategies using previously developed models or the use of preoperative grading only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women with endometrial cancer were prospectively examined using two\u2010dimensional (<jats:styled-content style=\"fixed-case\">2D<\/jats:styled-content>) and three\u2010dimensional (<jats:styled-content style=\"fixed-case\">3D<\/jats:styled-content>) gray\u2010scale and color Doppler ultrasound imaging. More than 25 ultrasound, demographic and histological variables were analyzed. Two logistic regression models were developed: one \u2018objective\u2019 model using mainly objective variables; and one \u2018subjective\u2019 model including subjective variables (i.e. subjective impression of myometrial and cervical invasion, preoperative grade and demographic variables). The following strategies were validated: a one\u2010step strategy using only preoperative grading and two\u2010step strategies using preoperative grading as the first step and one of the new models, subjective assessment or previously developed models as a second step.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One\u2010hundred and twenty\u2010five patients were included in the development set and 211 were included in the validation set. The \u2018objective\u2019 model retained preoperative grade and minimal tumor\u2010free myometrium as variables. The \u2018subjective\u2019 model retained preoperative grade and subjective assessment of myometrial invasion. On external validation, the performance of the new models was similar to that on the development set. Sensitivity for the two\u2010step strategy with the \u2018objective\u2019 model was 78% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 69\u201384%) at a cut\u2010off of 0.50, 82% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 74\u201388%) for the strategy with the \u2018subjective\u2019 model and 83% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 75\u201388%) for that with subjective assessment. Specificity was 68% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 58\u201377%), 72% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 62\u201380%) and 71% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 61\u201379%) respectively. The two\u2010step strategies detected up to twice as many high\u2010risk cases as preoperative grading only. The new models had a significantly higher sensitivity than did previously developed models, at the same specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Two\u2010step strategies with \u2018new\u2019 ultrasound\u2010based models predict high\u2010risk endometrial cancers with good accuracy and do this better than do previously developed models. Copyright \u00a9 2013 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.13216","type":"journal-article","created":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T02:26:26Z","timestamp":1381544786000},"page":"586-595","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Development and external validation of new ultrasound\u2010based mathematical models for preoperative prediction of high\u2010risk endometrial cancer"],"prefix":"10.1002","volume":"43","author":[{"given":"C.","family":"Van Holsbeke","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University Hospitals Leuven Leuven Belgium"},{"name":"Department of Obstetrics and Gynaecology Ziekenhuis Oost\u2010Limburg Genk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Ameye","sequence":"additional","affiliation":[{"name":"Department of Development and Regeneration KU Leuven \u2010 University of Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. C.","family":"Testa","sequence":"additional","affiliation":[{"name":"Istituto di Clinica Ostetrica e Ginecologica, Universit\u00e0 Cattolica del Sacro Cuore Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Mascilini","sequence":"additional","affiliation":[{"name":"Istituto di Clinica Ostetrica e Ginecologica, Universit\u00e0 Cattolica del Sacro Cuore Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Lindqvist","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Fischerova","sequence":"additional","affiliation":[{"name":"Gynecological Oncology Center, Department of Obstetrics and Gynecology First Faculty of Medicine and General University Hospital, Charles University Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Fr\u00fchauf","sequence":"additional","affiliation":[{"name":"Gynecological Oncology Center, Department of Obstetrics and Gynecology First Faculty of Medicine and General University Hospital, Charles University Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Fransis","sequence":"additional","affiliation":[{"name":"Department of Pathology Ziekenhuis Oost\u2010Limburg Genk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"de Jonge","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Ziekenhuis Oost\u2010Limburg Genk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Timmerman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University Hospitals Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Epstein","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.20107"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181f39849"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(91)90086-K"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2006.10.058"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(00)00689-1"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61766-3"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61767-5"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2011.05.041"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2503080877"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5295"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2012.01.051"},{"key":"e_1_2_6_13_1","first-page":"293","article-title":"The value of ultrasonography in preoperative assessment of selected prognostic factors in endometrial cancer","volume":"24","author":"Sawicki W","year":"2003","journal-title":"Eur J Gynaecol Oncol"},{"key":"e_1_2_6_14_1","first-page":"517","article-title":"Prediction of cervical infiltration in Stage II endometrial cancer by different preoperative evaluation techniques (D&C, US, CT, MRI)","volume":"24","author":"Pete I","year":"2003","journal-title":"Eur J Gynaecol Oncol"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2012.05.009"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5295"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12120315"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.1992.02010035.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2806"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7487"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2000.00287.x"},{"key":"e_1_2_6_22_1","first-page":"217","volume-title":"Pathology and Genetics. 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