Diagnostic performance of ultrasound compared with clinical examination, for measuring primary tumor size in patients with cervical cancer

The purpose of this study was to compare the diagnostic value of ultrasound and clinical examination for measuring primary tumor size in patients with cervical cancer. This was a retrospective, cross-sectional study for patients with cervical cancer (stage IB) in Cipto Mangunkusumo Hospital from 2009 to 2014. We calculated the diagnostic value of both examinations according to sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. We also tested agreement with gold-standard macroscopic size measures. There were 92 patients who fulfilled the inclusion criteria. These consisted of 65 (70%) patients with stage IB 1 and 27 (30%) patients stage IB2 cervical cancer. Diagnostic values for ultrasonography were: sensitivity 92%; specificity 96%; positive predictive value 92%; negative predictive value 96%; and accuracy 95%. Meanwhile, clinical examination diagnostic values were: sensitivity 51%; specificity 92%; positive predictive value 73%; negative predictive value 82%; and accuracy 80%. Comparing ultrasound and macroscopic size revealed an average difference of approximately 0.56 cm, whereas clinical examination and macroscopic size produced an average difference of approximately 0.97 cm. Ultrasound appears to have superior diagnostic value, compared with clinical examination, for determining primary tumor size in patients with cervical cancer.