Advances in ultrasound-based imaging for diagnosis of endometrial cancer

Table 2 Diagnostic performance summary

Modality	Sensitivity	Specificity	Area under the curve	Primary indication	Strengths	Weaknesses
Transvaginal US	76%–96%	61%–86%	0.88	Initial screening; endometrial thickness measurement	Widely available; cost-effective; high sensitivity	Operator-dependent; reduced accuracy in obesity/retroversion
MRI	79%–92%	84%–95%	0.89–0.91	Staging (myometrial/cervical invasion, lymph nodes)	High soft tissue contrast; reliable staging	Expensive; limited availability
Three-dimensional US	75%–88%	75%–91%	0.86–0.90	Volumetric analysis; preoperative planning	Similar accuracy to MRI; enhanced resolution	Requires advanced equipment and training
Contrast-enhanced US	82%–90%	78%–89%	0.85–0.88	Vascular characterization; benign vs malignant differentiation	Real-time microvascular imaging	Contrast contraindications; standardization needed
Elastography	78%–85%	70%–88%	0.83–0.87	Tissue stiffness evaluation; adjunct diagnostic tool	Non-invasive characterization	Limited operator experience; fewer studies
Artificial intelligence (radiomics/machine learning)	80%–90%	78%–92%	0.88–0.91	Risk prediction; segmentation; decision support	High potential for automation; promising accuracy	Data bias; hardware demands; limited external validation

MRI: Magnetic resonance imaging; US: Ultrasound.