{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T21:20:09Z","timestamp":1760908809141,"version":"3.40.4"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,3,19]],"date-time":"2013-03-19T00:00:00Z","timestamp":1363651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the accuracy of different preoperative modalities for staging of endometrial cancer to restrict extensive surgery to patients at high risk of metastatic disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Aarhus University Hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>156 women referred in 2006\u20132011 because of atypical endometrial hyperplasia (G0) or endometrial cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were offered preoperative transvaginal ultrasonography (<jats:styled-content style=\"fixed-case\">TVS<\/jats:styled-content>), magnetic resonance imaging (<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>), and hysteroscopic\u2010directed biopsies from the uterine tumor and cervix. Final pathology of the removed uterus was the reference standard. Patients were divided into low risk (&lt;50% myometrial invasion, and grades 0, 1, 2, and no cervical invasion) or high risk (all others).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Accuracy, sensitivity, specificity, positive\/negative predictive value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients were aged 32\u201388\u00a0years, with a mean body mass index of 29. At final pathology 81% had cancer and 19% G0 or no residual tumor; 54% were high risk. Hysteroscopy\u2010directed biopsies had a higher accuracy (92%) than endometrial biopsy (58%) for differentiating G0 from cancer (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001); grade 3 tumor identification had similar accuracy (93 vs. 92%). Deep myometrial invasion was estimated with higher accuracy by<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>(82%) than<jats:styled-content style=\"fixed-case\">TVS<\/jats:styled-content>(74%) (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.02). For cervical involvement, hysteroscopy\u2010directed biopsies had higher accuracy (94%) than<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>(84%,) and<jats:styled-content style=\"fixed-case\">TVS<\/jats:styled-content>(80%) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.02). Accuracy for identifying high\u2010risk women was highest (83%) using a combination of<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>and hysteroscopic\u2010directed biopsies, compared with<jats:styled-content style=\"fixed-case\">TVS<\/jats:styled-content>and endometrial biopsy (72%) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preoperative staging with<jats:styled-content style=\"fixed-case\">MRI<\/jats:styled-content>and hysteroscopy\u2010directed biopsy can identify eight of 10 women with high risk of lymph node metastases and spare eight of 10 low\u2010risk women extended surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12103","type":"journal-article","created":{"date-parts":[[2013,2,9]],"date-time":"2013-02-09T10:02:24Z","timestamp":1360404144000},"page":"536-545","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Preoperative staging of endometrial cancer using<scp>TVS<\/scp>,<scp>MRI<\/scp>, and hysteroscopy"],"prefix":"10.1111","volume":"92","author":[{"given":"Gitte","family":"\u00d8rtoft","sequence":"first","affiliation":[{"name":"Department ofGynecology and Obstetrics Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margit","family":"Dueholm","sequence":"additional","affiliation":[{"name":"Department ofGynecology and Obstetrics Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ole","family":"Mathiesen","sequence":"additional","affiliation":[{"name":"Department 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