Assessing myometrial infiltration by endometrial cancer: uterine virtual navigation with three-dimensional US.

Purpose: To describe and analyze the diagnostic performance of uterine virtual navigation with three-dimensional (3D) ultrasonography (US) for the assessment of the depth of myometrial infiltration by endometrial cancer. Materials and Methods: Institutional review board approval was obtained; patients gave oral informed consent. Women with endometrial cancer were evaluated by using 3D US prior to surgical staging. A 3D volume of the whole uterus was obtained and analyzed by using software. Virtual navigation through three orthogonal planes was performed to identify the shortest myometrial tumor-free distance to serosa (TDS) by analyzing the lateral, anterior, posterior, and fundal portions of the myometrium. Myometrial infiltration was also assessed by subjective impression of an examiner. Histologic findings of myometrial infiltration and TDS measured by a pathologist were used as the reference standard. A receiver operating characteristic curve was plotted to identify the best cutoff for TDS for identif...