Diagnostic utility of three-dimensional power Doppler ultrasound for postmenopausal bleeding

Kim, Ari; Lee, Ji Young; Chun, Sungwook; Kim, Heung Yeol

doi:10.1016/j.tjog.2013.10.043

Cited by 16 publications

(12 citation statements)

References 26 publications

(25 reference statements)

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“…Another prospective observational study that agreed was our study conducted by [14] regarding the prediction value of the endometrial thickness and vascular indices in predicting malignancy in postmenopausal women with vaginal bleeding. Although they used in their study over the 174 women they chose, the 2D/3D power Doppler the final conclusion of that the increased endometrial vascularity can positively predict endometrial malignancy still can support the results of our study.…”

Section: Discussionmentioning

confidence: 75%

The Prognostic Value of BMI, Serum Glucose, Endometrial Echo Pattern and Uterine Artery Doppler Velocimetry as a Predictor for Endometrial Pathology in Women with Postmenopausal Bleeding (Prospective Observational Study)

Wafa¹,

Alfattah²,

Korany³

2020

OJOG

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Background: Post-menopausal bleeding is a warning sign that accounts for about 5% of all outpatient gynaecologic visits and is a common indication for referral to rapid access clinics because of the fear of underlying malignancy. Endometrial malignancies differ from other malignancies in that early symptomization is common, allowing early cure. Patients and Methods: During the study period, 100 women with post-menopausal bleeding having inclusion criteria were evaluated in Al-Hussein University Hospital. For each patient full history, general, abdominal and pelvic examination was performed. Routine pre-operative investigations were done. Patients were divided into four groups: Group 1 included 29 patients with endometrial polyp. Group 2 included 34 patients with endometrial hyperplasia. Group 3 included 21 patients with atrophic endometrium. Group 4 included 16 patients with endometrial carcinoma. Results: As regards the predictive value of BMI, in the study there was a high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. When discussing the predictive value of blood glucose level, in the study there was a high statistical significance in comparison between the endometrial carcinoma group and all other benign groups. It is worth to mention that the predictive value of endometrial thickness, in the study, was with high statistical significance in comparison between the endometrial carcinoma group and all other benign groups providing the highest specificity and sensitivity. At the last the predic

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Section: Discussionmentioning

confidence: 75%

The Prognostic Value of BMI, Serum Glucose, Endometrial Echo Pattern and Uterine Artery Doppler Velocimetry as a Predictor for Endometrial Pathology in Women with Postmenopausal Bleeding (Prospective Observational Study)

Wafa¹,

Alfattah²,

Korany³

2020

OJOG

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“…A statistical power analysis was performed for sample size estimation. Considering an estimated prevalence of EC or AH in postmenopausal asymptomatic patients with ET ≥ 4 mm of about 3% and an estimated prevalence of about 15% in postmenopausal patients with AUB, applying an alpha = 0.05 and a power = 0.80 with a 1:1 ratio, we calculated that a minimum sample size of 86 per group could be adequate for the main endpoint of the study; considering a possible drop out of about 10%, we decided to set a minimum sample size of 95 patients per group [19,20].…”

Section: Discussionmentioning

confidence: 99%

Endometrial Cancer Risk Prediction According to Indication of Diagnostic Hysteroscopy in Post-Menopausal Women

et al. 2020

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We conducted a prospective observational study investigating the clinical relevance of endometrial thickness (ET) and abnormal uterine bleeding (AUB) on endometrial cancer (EC) risk in a cohort of postmenopausal patients undergoing diagnostic hysteroscopy and endometrial biopsy. Patients were divided into two groups according to the indication of diagnostic hysteroscopy: ET_Group (asymptomatic patients with endometrial thickness ≥ 4 mm) and AUB_Group (patients with a history of abnormal uterine bleeding). We further divided the AUB_Group into two subgroups based on endometrial thickness (AUB_Subgroup1: ET < 4 mm; AUB_Subgroup2: ET ≥ 4 mm). The primary outcome was the risk of endometrial cancer and atypical hyperplasia according to the indications of diagnostic hysteroscopy (AUB, ET ≥ 4 mm or both). The secondary outcome was to determine the best cut-off value of endometrial thickness to predict endometrial cancer in asymptomatic postmenopausal women. The prevalence of endometrial cancer and atypical hyperplasia in AUB_Group and ET_Group was 21% and 6.7% respectively. As well as for EC alone, higher prevalence of both conditions was observed in AUB_Subgroup2 (29.3%) in comparison to AUB_Subgroup1 (10.6%; p < 0.001). In asymptomatic patients the cut-off of endometrial thickness that showed the best sensitivity and specificity to diagnose endometrial cancer (100% and 80% respectively) was 11 mm (AUC of 91.4%; Expβ: 1067; CI 95%). In conclusion, considering the high risk of neoplasia, diagnostic hysteroscopy with endometrial biopsy should be mandatory in cases of abnormal uterine bleeding in postmenopausal patients. Moreover, we want to emphasize the need for further evidence stating the clinical relevance of endometrial thickness value in asymptomatic patients and the impact of individual risk factors on endometrial cancer development.

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“…Out of these four studies, three have been included in this present meta-analysis 18,19,23 and one was not because, from this paper, 2x2 tables could not be extracted. 40 However, they did not perform an analysis about endometrial volume because of the small sample size.…”

Section: Sensitivity Specificitymentioning

confidence: 99%

The Value of Endometrial Volume as Estimated by Three-Dimensional Ultrasound for Detecting Endometrial Cancer in Postmenopausal Women: A Systematic Review and Meta-Analysis

2020

EMJ Radiol

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Objective: To analyse the diagnostic performance of endometrial volume calculated by three-dimensional (3D) ultrasound for diagnosing endometrial carcinoma in women with postmenopausal bleeding. Methods: An extensive search of papers analysing the role of endometrial volume calculated by 3D ultrasound for diagnosing endometrial carcinoma in women with postmenopausal bleeding was performed in MEDLINE/PubMed and Web of Science from January 1996 to January 2020. Quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool. Results: The extended search identified 318 citations but after exclusions, eight articles wereincluded in the meta-analysis. The risk of bias for most studies was high for the four domains assessed in QUADAS-2. Overall, after excluding three studies that contributed significantly to heterogeneity, pooled estimated sensitivity and specificity for diagnosing endometrial cancer were 87% (95% confidence interval: 80–92%) and 60% (95% confidence interval: 51–68%), respectively. Heterogeneity was low or moderate. Conclusion: Endometrial volume as estimated by 3D ultrasound using virtual organ computer-aided analysis (VOCALTM) software has a moderate diagnostic performance for detecting endometrial malignancy in women with postmenopausal bleeding.

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Diagnostic utility of three-dimensional power Doppler ultrasound for postmenopausal bleeding

Abstract: Endometrial vasculature and volume can be obtained using 3D PD-US. The diagnostic usefulness of 3D PD-US for endometrial diseases is promising in women with postmenopausal endometrial bleeding.

Cited by 16 publications

References 26 publications

The Prognostic Value of BMI, Serum Glucose, Endometrial Echo Pattern and Uterine Artery Doppler Velocimetry as a Predictor for Endometrial Pathology in Women with Postmenopausal Bleeding (Prospective Observational Study)

The Prognostic Value of BMI, Serum Glucose, Endometrial Echo Pattern and Uterine Artery Doppler Velocimetry as a Predictor for Endometrial Pathology in Women with Postmenopausal Bleeding (Prospective Observational Study)

Endometrial Cancer Risk Prediction According to Indication of Diagnostic Hysteroscopy in Post-Menopausal Women

The Value of Endometrial Volume as Estimated by Three-Dimensional Ultrasound for Detecting Endometrial Cancer in Postmenopausal Women: A Systematic Review and Meta-Analysis

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