LAUSR

Demer et al reported on an interesting study comparing the accuracy of transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) for local staging in women with endometrial cancer. 1 This study concluded that both techniques have a similar diagnostic accuracy for detecting deep myometrial infiltration and cervical invasion. The main strength of this study is its prospective design with gynecologist and radiologist blinded each other to their respective assessment. The results of this study are relevant for they confirm data from two previous meta-analyses analyzing studies comparing TVS and MRI for detecting myometrial infiltration 2 and cervical invasion 3 in patients with endometrial cancer. These findings are clinically important since, as the authors state in their manuscript, TVS is cheaper and worldwide available than MRI. This fact is very important when considering the preoperative assessment of women with endometrial cancer in low- and mid-income countries, where financial and facility resources are scanty. Interestingly, this study observed that TVS and MRI have similar diagnostic performance for identifying those women with no myometrial infiltration. This is very relevant from the clinical point of view since no myometrial infiltration is a crucial issue for selecting women for fertility sparing treatment. 4 Additionally, the authors assessed the correlation of tumor volume, as measured by 2D TVS, 3D, TVS and MRI, with some poor prognostic histological factors such as tumor histological grade, lympho-vascular invasion and myometrial infiltration. They found out that tumor volume correlated with these factors. These findings agree with some previous reports, 5 highlighting the potential clinical value of this parameter. Furthermore, this study showed that tumor volume estimation performed by 2D