Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women
Abstract Objective: Dilatation and curettage have been replaced by ultrasound measurement of uterine endometrial thickness (ET) especially by Transvaginal ultrasound (TVS) as a first step in the workup of women with postmenopausal bleeding for many years. Still, there is no unanimity for endometr...
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Rawalpindi Medical University
2023-12-01
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| Series: | Journal of Rawalpindi Medical College |
| Online Access: | https://www.journalrmc.com/index.php/JRMC/article/view/2292 |
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| author | Ayesha Bibi Noreen Majeed Irum Mushtaq Shabana Kalsoom Ruqya Azhar Mehreen Mehdi |
| author_facet | Ayesha Bibi Noreen Majeed Irum Mushtaq Shabana Kalsoom Ruqya Azhar Mehreen Mehdi |
| author_sort | Ayesha Bibi |
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Abstract
Objective: Dilatation and curettage have been replaced by ultrasound measurement of uterine endometrial thickness (ET) especially by Transvaginal ultrasound (TVS) as a first step in the workup of women with postmenopausal bleeding for many years. Still, there is no unanimity for endometrial thickness cut-off value to define abnormality. We used an endometrial thickness of 4mm as a cut-off value in this study.
Methods: This cross-sectional validation study included 120 patients who presented with postmenopausal bleeding in OPD of POF hospital from 01-12-2017 to 1-06-2018.TVS measured endometrial thickness ≥4mm was assumed positive for malignancy and ˂ 4 mm was taken negative for malignancy. The TVS findings of patients were compared with the histopathology report of endometrial sampling, which was performed in OPD by manual vacuum aspirator (MVA). Histopathology report was taken as a reference standard to confirm or refute the diagnosis of transvaginal ultrasound.
Results: On TVS, 54 patients had ≥ 4mm endometrial thickness (taken positive for malignancy) while 66 patients had <4 mm endometrial thickness (taken negative for malignancy). Histopathology of the endometrium (reference standard) revealed that 47 (39.17%) patients had malignancy and 73(60.83%) patients did not have malignancy. The reliability of transvaginal ultrasound (TVS) using 4mm cut-off point ET in detecting endometrial malignancy in patients presenting with uterine bleeding after menopause, keeping histopathological findings as a reference standard showed 89.36% sensitivity, 83.56%, specificity, 92.42% negative predictive value and 77.78% positive predictive value & 85.83% accuracy rate.
Conclusion: We concluded that there was a low probability of endometrial malignancy in women with ˂ 4 mm transvaginal ultrasound (TVS)measured endometrial thickness (ET).TVS may replace invasive endometrial sampling in cases of postmenopausal bleeding with ˂ 4mm ET.
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| format | Article |
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| institution | Kabale University |
| issn | 1683-3562 1683-3570 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Rawalpindi Medical University |
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| series | Journal of Rawalpindi Medical College |
| spelling | doaj-art-9acddd7f8e894c27bba1d80dc35717ab2025-02-06T08:40:37ZengRawalpindi Medical UniversityJournal of Rawalpindi Medical College1683-35621683-35702023-12-0127410.37939/jrmc.v27i4.2292Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal WomenAyesha Bibi0Noreen Majeed1Irum Mushtaq2Shabana Kalsoom3Ruqya Azhar4Mehreen Mehdi5POF HospitalPOF, WMC, NUMS universityWMCPOF,WMC WMCPOF, WMC Abstract Objective: Dilatation and curettage have been replaced by ultrasound measurement of uterine endometrial thickness (ET) especially by Transvaginal ultrasound (TVS) as a first step in the workup of women with postmenopausal bleeding for many years. Still, there is no unanimity for endometrial thickness cut-off value to define abnormality. We used an endometrial thickness of 4mm as a cut-off value in this study. Methods: This cross-sectional validation study included 120 patients who presented with postmenopausal bleeding in OPD of POF hospital from 01-12-2017 to 1-06-2018.TVS measured endometrial thickness ≥4mm was assumed positive for malignancy and ˂ 4 mm was taken negative for malignancy. The TVS findings of patients were compared with the histopathology report of endometrial sampling, which was performed in OPD by manual vacuum aspirator (MVA). Histopathology report was taken as a reference standard to confirm or refute the diagnosis of transvaginal ultrasound. Results: On TVS, 54 patients had ≥ 4mm endometrial thickness (taken positive for malignancy) while 66 patients had <4 mm endometrial thickness (taken negative for malignancy). Histopathology of the endometrium (reference standard) revealed that 47 (39.17%) patients had malignancy and 73(60.83%) patients did not have malignancy. The reliability of transvaginal ultrasound (TVS) using 4mm cut-off point ET in detecting endometrial malignancy in patients presenting with uterine bleeding after menopause, keeping histopathological findings as a reference standard showed 89.36% sensitivity, 83.56%, specificity, 92.42% negative predictive value and 77.78% positive predictive value & 85.83% accuracy rate. Conclusion: We concluded that there was a low probability of endometrial malignancy in women with ˂ 4 mm transvaginal ultrasound (TVS)measured endometrial thickness (ET).TVS may replace invasive endometrial sampling in cases of postmenopausal bleeding with ˂ 4mm ET. https://www.journalrmc.com/index.php/JRMC/article/view/2292 |
| spellingShingle | Ayesha Bibi Noreen Majeed Irum Mushtaq Shabana Kalsoom Ruqya Azhar Mehreen Mehdi Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women Journal of Rawalpindi Medical College |
| title | Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women |
| title_full | Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women |
| title_fullStr | Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women |
| title_full_unstemmed | Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women |
| title_short | Reliability Of Transvaginal Ultrasound Measured Endometrial Thickness In Diagnosis Of Endometrial Cancer In Postmenopausal Women |
| title_sort | reliability of transvaginal ultrasound measured endometrial thickness in diagnosis of endometrial cancer in postmenopausal women |
| url | https://www.journalrmc.com/index.php/JRMC/article/view/2292 |
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