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Three‐dimensional power D oppler and endometrial volume as predictors of malignancy in patients with postmenopausal bleeding
Author(s) -
Makled Ahmed K.,
Elmekkawi Sherif F.,
ElRefaie Tamer A.,
ElSherbiny Mohammed A.
Publication year - 2013
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2012.02066.x
Subject(s) - medicine , vascularity , endometrial cancer , carcinoma , endometrium , receiver operating characteristic , malignancy , postmenopausal bleeding , radiology , area under the curve , urology , gynecology , cancer
Aim The aim of this study was to evaluate the efficacy of 3 D power D oppler angiography ( 3D‐PDA ) for distinguishing between benign endometrial lesions and endometrial carcinoma in patients with postmenopausal bleeding ( PMB ). Material and Methods One‐hundred and fifty women with PMB and an endometrial thickness ( ET ) of ≥4 mm on 2D sonography were assessed by 3D‐PDA before endometrial sampling to obtain definitive histological diagnosis of endometrial pathology. Endometrial volume ( EV ), vascularity index ( VI ), flow index ( FI ) and vascularity‐flow index ( VFI ) were calculated by computer‐aided analysis. Results Of the 150 women, 114 (76%) had benign endometrial lesions and 36 (24%) had endometrial carcinoma. Patients with endometrial carcinoma had significantly thicker endometrium (15.8 ± 7.7 vs 9.9 ± 5.9 mm; P < 0.001), larger EV (9.1 ± 4.7 vs 2.6 ± 3.5 mL, P < 0.001) and higher 3D‐PDA indices ( P < 0.001) than patients with benign endometrial lesions. The best variable for distinguishing between benign and malignant endometrium was VI , with an area under the receiver operating characteristic curve ( AUC ) of 0.86. In contrast, the ET had an AUC of only 0.62. The best‐fit logistic regression model for the diagnosis malignancy contained only VI as an independent factor ( P = 0.002). Conclusion 3D‐PDA measurements may be useful for distinguishing between benign endometrial lesions and endometrial carcinoma in patients with postmenopausal bleeding.