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

Abstract

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.