Do we need more than ultrasound endometrial thickness to predict malignancy?

Adly N. Al Fattah; Tricia D. Anggraeni; Bella Aprilia; Muhammad Ikhsan

doi:10.18203/2320-1770.ijrcog20180852

Authors

Adly N. Al Fattah Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
Tricia D. Anggraeni Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
Bella Aprilia Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
Muhammad Ikhsan Department of Obstetrics and Gynecology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20180852

Keywords:

Clinical, Doppler, Endometrial cancer, Ultrasound

Abstract

Endometrial thickness (ET) ultrasound measurement has high diagnostic performance for detection of endometrial cancer in symptomatic postmenopausal women. Identified clinical risk factors, Doppler or 3D ultrasound parameters to predict endometrial malignancy had been proposed in several studies. We compared the accuracy of ultrasound endometrial thickness with scoring system/index involving both of clinical and ultrasound parameters to predict endometrial malignancy. Eight eligible diagnostic studies were appraised to assess the accuracy of ultrasound ET and/or ultrasound-based index to predict malignancy. The incidence of endometrial malignancy confirmed by histopathology examination was ranging from 10.5 to 58% from 8 studies. Ultrasound-based index to predict endometrial malignancy had good accuracy (AUC 75% - 98%). The addition of endometrial volume/uterine corpus volume ratio (EV/UCV) and Doppler to clinical parameters had increased the prediction accuracy of the index. While ultrasound ET alone has also high sensitivity, respectively 90.6% and 96.9% using the cut-off 4 mm and 3 mm with low accuracy. Ultrasound-based index to predict endometrial malignancy had better accuracy compared to ultrasound ET alone. Combination of ultrasound including Doppler parameters and clinical parameters had increased the prediction accuracy of the endometrial malignancy prediction index.

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