Modern methods of diagnostics of endometrial pathology: extended comparative analysis of ultrasound, hysteroscopy, magnetic resonance imaging and spectroscopy

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Endometrial pathologies, including polyps, hyperplasia, and cancer, are a significant problem in gynecological practice. Despite advances in diagnostics, the choice of the optimal method remains a subject of debate. This article provides a detailed analysis of modern imaging methods and their role in differential diagnostics. Technical aspects, diagnostic accuracy (sensitivity, specificity), clinical limitations, cost-effectiveness, and prospects for technology development are considered. Based on systematized data from 180 studies, an algorithm for choosing a method depending on the clinical scenario is proposed.

全文:

受限制的访问

作者简介

D. Lystsev

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

Email: rtchilova@gmail.com
ORCID iD: 0009-0006-3826-3174
俄罗斯联邦, Moscow

V. Kaptilnyy

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

Email: rtchilova@gmail.com
ORCID iD: 0000-0002-2656-132X
SPIN 代码: 4312-3455

Associate Professor, Candidate of Medical Sciences

俄罗斯联邦, Moscow

V. Zuev

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

Email: rtchilova@gmail.com
ORCID iD: 0000-0001-8715-2020
SPIN 代码: 2857-0309

Professor, MD

俄罗斯联邦, Moscow

R. Chilova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

编辑信件的主要联系方式.
Email: rtchilova@gmail.com
ORCID iD: 0000-0001-6331-3109
SPIN 代码: 4137-4848

Professor, MD

俄罗斯联邦, Moscow

M. Poznyak

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

Email: rtchilova@gmail.com
ORCID iD: 0009-0006-8217-0784
俄罗斯联邦, Moscow

G. Sevastyanov

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

Email: rtchilova@gmail.com
ORCID iD: 0009-0000-4823-9510
俄罗斯联邦, Moscow

参考

  1. Guidelines for Management of Endometrial Hyperplasia. American College of Obstetricians and Gynecologists (ACOG), 2021.
  2. Consensus on Endometrial Cancer Staging. European Society of Gynaecological Oncology (ESGO), 2022.
  3. Classification of Endometrial Pathology. World Health Organization (WHO), 2020.
  4. Best Practices in Hysteroscopy. Royal College of Obstetricians and Gynaecologists (RCOG). 2019.
  5. WHO Classification of Tumours Editorial Board. Female Genital Tumours. 5th ed. WHO 2020.
  6. Sanderson P.A., Critchley H.O.D., Williams A.R.W. et al. New concepts for an old problem: the diagnosis of endometrial hyperplasia. Hum Reprod Update. 2017; 23 (2): 232–54. doi: 10.1093/humupd/dmw042
  7. Lacey J.V. Jr., Ioffe O.B., Ronnett B.M. et al. Endometrial carcinoma risk among women diagnosed with endometrial hyperplasia: the 34-year experience in a large health plan. Br J Cancer. 2008; 98 (1): 45–53. doi: 10.1038/sj.bjc.6604102
  8. Schultz N., Cherniack A.D. et al. Integrated genomic characterization of endometrial carcinoma. Nature. 2013; 497 (7447): 67–73. doi: 10.1038/nature12113
  9. Endometrial cancer management. ESGO-ESTRO-ESP Guidelines, 2021.
  10. Cabrera S., de la Calle I., Baulies S. et al. Screening Strategies to Improve Early Diagnosis in Endometrial Cancer. J Clin Med. 2024; 13 (18): 5445. doi: 10.3390/jcm13185445
  11. Salim S., Won H., Nesbitt-Hawes E. et al. Diagnosis and management of endometrial polyps: a critical review of the literature. J Minim Invasive Gynecol. 2011; 18 (5): 569–81. doi: 10.1016/j.jmig.2011.05.018
  12. Nijkang N.P., Anderson L., Markham R. et al. Endometrial polyps: Pathogenesis, sequelae and treatment. SAGE Open Med. 2019; 7: 2050312119848247. doi: 10.1177/2050312119848247
  13. Wolman I., Sagi J., Ginat S. et al. The sensitivity and specificity of vaginal sonography in detecting endometrial abnormalities in women with postmenopausal bleeding. J Clin Ultrasound. 1996; 24 (2): 79–82. doi: 10.1002/(SICI)1097-0096(199602)24:2<79::AID-JCU5>3.0.CO;2-H
  14. Christiansen F., Konuk E., Ganeshan A.R. et al. International multicenter validation of AI-driven ultrasound detection of ovarian cancer. Nat Med. 2025; 31 (1): 189–96. doi: 10.1038/s41591-024-03329-4
  15. de Kroon C.D., Jansen F.W. Saline infusion sonography in women with abnormal uterine bleeding: an update of recent findings. Curr Opin Obstet Gynecol. 2006; 18 (6): 653–7. doi: 10.1097/01.gco.0000247395.32711.68
  16. Xia Z., Jin H. Diagnostic Value of Ultrasonography Combined with Hysteroscopy in Intrauterine Space-Occupying Abnormalities. Contrast Media Mol Imaging. 2022; 2022: 6192311. doi: 10.1155/2022/6192311
  17. Liu M.-J., Liu Z.-F., Yin W.-H. et al. Application of transvaginal three-dimensional power Doppler ultrasound in benign and malignant endometrial diseases. Medicine (Baltimore). 2019; 98 (46): e17965. doi: 10.1097/MD.0000000000017965
  18. Alcazar J.L., Galvan R. Three-dimensional power Doppler ultrasound scanning for the prediction of endometrial cancer in women with postmenopausal bleeding and thickened endometrium. Am J Obstet Gynecol. 2009; 200 (1): 44.e1-6. doi: 10.1016/j.ajog.2008.08.027
  19. Butt S.R., Soulat A., Lal P.M. et al. Impact of artificial intelligence on the diagnosis, treatment and prognosis of endometrial cancer. Ann Med Surg (Lond). 2024; 86 (3): 1531–9. doi: 10.1097/MS9.0000000000001733
  20. Use of Advanced Imaging Tests and the Not-So-Incidental Harms of Incidental Findings. JAMA Intern Med. 2018; 178 (2): 227–8. doi: 10.1001/jamainternmed.2017.7557
  21. Guida M., Di Spiezio Sardo A., Acunzo G. et al. Vaginoscopic versus traditional office hysteroscopy: a randomized controlled study. Hum Reprod. 2006; 21 (12): 3253–7. doi: 10.1093/humrep/del298
  22. Loverro G., Bettocchi S., Cormio G. et al. Diagnostic accuracy of hysteroscopy in endometrial hyperplasia. Maturitas. 1996; 25 (3): 187–91. doi: 10.1016/s0378-5122(96)01064-x
  23. Marchetti M., Litta P., Lanza P. et al. The role of hysteroscopy in early diagnosis of endometrial cancer. Eur J Gynaecol Oncol. 2002; 23 (2): 151–3.
  24. del Valle C., Solano J.A., Rodriguez A. et al. Pain management in outpatient hysteroscopy. Gynecology and Minimally Invasive Therapy. 2016; 5 (4): 141–7. doi: 10.1016/j.gmit.2016.08.001
  25. Madár I., Szabó A., Vleskó G. et al. Diagnostic Accuracy of Transvaginal Ultrasound and Magnetic Resonance Imaging for the Detection of Myometrial Infiltration in Endometrial Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel). 2024; 16 (5): 907. doi: 10.3390/cancers16050907
  26. Peitsidis P., Vrachnis N., Sifakis S. et al. Improving tissue characterization, differentiation and diagnosis in gynecology with the narrow-band imaging technique: A systematic review. Exp Ther Med. 2021; 23 (1): 36. doi: 10.3892/etm.2021.10958
  27. Takeuchi M., Matsuzaki K., Harada M. Evaluating Myometrial Invasion in Endometrial Cancer: Comparison of Reduced Field-of-view Diffusion-weighted Imaging and Dynamic Contrast-enhanced MR Imaging. Magn Reson Med Sci. 2017; 17 (1): 28–34. doi: 10.2463/mrms.mp.2016-0128
  28. Hylton N. Dynamic contrast-enhanced magnetic resonance imaging as an imaging biomarker. J Clin Oncol. 2006; 24 (20): 3293–8. doi: 10.1200/JCO.2006.06.8080
  29. Takeuchi M., Matsuzaki K., Nishitani H. Diffusion-weighted magnetic resonance imaging of endometrial cancer: differentiation from benign endometrial lesions and preoperative assessment of myometrial invasion. Acta Radiol. 2009; 50 (8): 947–53. doi: 10.1080/02841850903099981
  30. Chen J., Fan W., Gu H. et al. Preoperative MRI and immunohistochemical examination for the prediction of high-risk endometrial cancer. Gland Surg. 2021; 10 (7): 2180–91. doi: 10.21037/gs-21-38
  31. Guo W., Wang T., Lv B. et al. Advances in Radiomics Research for Endometrial Cancer: A Comprehensive Review. J Cancer. 2023; 14 (18): 3523–31. doi: 10.7150/jca.89347
  32. Luo Y., Mei D., Gong J. et al. Multiparametric MRI-Based Radiomics Nomogram for Predicting Lymphovascular Space Invasion in Endometrial Carcinoma. J Magn Reson Imaging. 2020; 52 (4): 1257–62. doi: 10.1002/jmri.27142
  33. Maheedhar K., Bhat R.A., Malini R. et al. Diagnosis of ovarian cancer by Raman spectroscopy: a pilot study. Photomed Laser Surg. 2008; 26 (2): 83–90. doi: 10.1089/pho.2007.2128
  34. Chen X., Shen J., Liu C. et al. Applications of Data Characteristic AI-Assisted Raman Spectroscopy in Pathological Classification. Anal Chem. 2024; 96 (16): 6158–69. doi: 10.1021/acs.analchem.3c04930
  35. Buda A., Di Martino G., Vecchione F. et al. Optimizing Strategies for Sentinel Lymph Node Mapping in Early-Stage Cervical and Endometrial Cancer: Comparison of Real-Time Fluorescence With Indocyanine Green and Methylene Blue. Int J Gynecol Cancer. 2015; 25 (8): 1513–8. doi: 10.1097/IGC.0000000000000526
  36. Alfano R.R. Advances in Optical Biopsy for Cancer Diagnosis. Technol Cancer Res Treat. 2011; 10 (2): 101. doi: 10.7785/tcrt.2012.500184
  37. Gupta J.K., Chien P.F.W., Voit D. et al. Ultrasonographic endometrial thickness for diagnosing endometrial pathology in women with postmenopausal bleeding: a meta-analysis. Acta Obstet Gynecol Scand. 2002; 81 (9): 799–816. doi: 10.1034/j.1600-0412.2001.810902.x
  38. Yang S.Y., Chon S.-J., Lee S.H. The effects of diagnostic hysteroscopy on the reproductive outcomes of infertile women without intrauterine pathologies: a systematic review and meta-analysis. Korean J Women Health Nurs. 2020; 26 (4): 300–17. doi: 10.4069/kjwhn.2020.12.13
  39. Bi Q., Chen Y., Wu K. et al. The Diagnostic Value of MRI for Preoperative Staging in Patients with Endometrial Cancer: A Meta-Analysis. Acad Radiol. 2020; 27 (7): 960–8. doi: 10.1016/j.acra.2019.09.018
  40. Kirillin M., Motovilova T., Shakhova N. Optical coherence tomography in gynecology: a narrative review. J Biomed Opt. 2017; 22 (12): 121709. doi: 10.1117/1.JBO.22.12.121709
  41. Zheng Z., Liu Y., Feng L. et al. Multimodal MRI Image Fusion for Early Automatic Staging of Endometrial Cancer. Sensors (Basel). 2025; 25 (9): 2932. doi: 10.3390/s25092932

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © Russkiy Vrach Publishing House, 2025