The high-risk of endometrial cancer (HIREC) scoring method was successful in predicting high-risk cancers preoperatively, according to a recent study published in the Journal of Ultrasound in Medicine.
The authors developed the HIREC score to predict high-risk endometrial cancer, focusing on patient age and ultrasound characteristics, including endometrial thickness (ET) and Doppler imaging. Current treatments for high-risk endometrial cancer involve surgery and, when necessary, lymphadenectomy.
“The HIREC score, which includes age, Doppler score and endometrial thickness, provides a reliable method for predicting high-risk endometrial cancer,” the authors wrote.
The authors aimed to evaluate the use of a transvaginal ultrasound-based (TVS) scoring system to predict high-risk endometrial cancer, improving early detection and preoperative planning.
The study involved almost 270 women diagnosed with either endometrial cancer or atypical hyperplasia, who were examined using TVS to assess endometrial characteristics.
The researchers performed multivariate logistic regression to correlate these imaging and clinical factors with high-risk endometrial cancer, defined as FIGO stage Ib-IV, high-grade tumors (grade 3 or non-endometrioid), and lympho-vascular space invasion (LVSI).
The resulting HIREC score demonstrated a sensitivity of 72%, specificity of 88%, and an overall accuracy of 81%, indicating that it effectively predicted high-risk cancers. Also, with low-risk cancers, the sensitivity was at 91%, although its specificity was lower (46%).
Despite these promising results, the authors emphasized that further validation in larger and more diverse populations is necessary to fully establish the reliability and clinical utility of the HIREC score across different healthcare settings.
Additionally, the authors suggest that while the HIREC score is valuable, its performance could be enhanced by using more experienced sonographers or additional imaging methods for intermediate scores (5-6), where predictive accuracy is lower.
“Low and high HIREC scores effectively predicted low- and high-risk endometrial cancer. The score is a simple point system suitable for the first ultrasound assessment. It may be used in preoperative work-up to select treatment and additional imaging, but it needs to be validated in further studies,” the authors concluded.
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