Role of endometrial power Doppler ultrasound using the international endometrial tumor analysis group classification in predicting intrauterine pathology

Kucur, Suna Kabil; Temizkan, Osman; Atis, Alev; Gözükara, İlay; Uludag, Eda Ulku; Agar, Sema; Davas, İnci

doi:10.1007/s00404-013-2813-0

Cited by 21 publications

(14 citation statements)

References 23 publications

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“…Endometrial hyperplasia was more frequently assigned a color score of 2. Certainly, as did Kabul Kucur et al, we found that virtually all cases of myoma (only 3 cases, in fact) were assigned a color score of 3 of 4 by all examiners.…”

Section: Discussionsupporting

confidence: 62%

“…One single study prospectively evaluated the power Doppler criteria proposed by the IETA group for assessing endometrial vascularization in women with suspected endometrial disorders. Kabil Kucur et al evaluated 97 women with clinical suspicion of endometrial lesions. Histologically, of the 97 women, 39 had endometrial polyps; 9 had endometrial hyperplasia; 10 had submucous myoma; 7 had endometrial cancer; and 32 had “other nonspecific pathologies.” They did not find statistically significant differences in the color score among different pathologic types.…”

Section: Discussionmentioning

confidence: 99%

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Reproducibility of the International Endometrial Analysis Group Color Score for Assigning the Amount of Flow Within the Endometrium Using Stored 3-Dimensional Volumes

et al. 2017

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Reproducibility of the International Endometrial Analysis Group Color Score for Assigning the Amount of Flow Within the Endometrium Using Stored 3-Dimensional Volumes

et al. 2017

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“…It allows the evaluation of the number, size, echogenicity of the myomas, as well as the detection of any comorbidities (whether uterine or adnexal); the use of color Doppler and power Doppler modalities allows to analyze the vascularization of the masses (27). Moreover, TVUS provides the parameter of myometrial-free margin (MFM: the thickness of myometrium between the deepest pole and the perimeter of the myoma) (28), that delivers a safety margin for hysteroscopic-guided surgical maneuvers and aims at preventing the risk of perforation.…”

Section: Scientific Evidencementioning

confidence: 99%

Is Hysteroscopy Better than Ultrasonography for Uterine Cavity Evaluation? An Evidence-Based and Patient-Oriented Approach

Sardo

Calagna

Laganà

et al. 2016

Journal of Endometriosis and Pelvic Pain Disorders

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PROS AND CONS also considering that gynecologists are familiar with the technique since it is included in the basic training in obstetrics and gynecology. Certainly, TVUS is an easy, fast and cheap method widely used; moreover, the develop of high-frequency and 3D transvaginal probes really increased its diagnostic accuracy, adding such tremendous value to sonographic examination (1). In this sense, it restricts the use of computed tomography (CT) scanning and magnetic resonance imaging (MRI), mainly for evaluation of complex congenital abnormalities and diagnosis/staging of gynecological tumors. However, many disadvantages of TVUS have to be considered. First, the diagnostic accuracy of 2D TVUS being dynamic examinations, is highly dependent on the experience of the examiner and on the correct method of performing; it is not always feasible to have the required planes due to the patient's anatomical characteristics. The 3D TVUS is not as widely available as the 2D (up to now) and it needs experienced sonographers with special and adequate training in 3D image acquisition and post-processing techniques. Furthermore, it

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“…Therefore, the International Endometrial Tumor Analysis (IETA) group published a consensus opinion in 2010 on the terms, definitions and measurements of the endometrium 16 . Using the IETA terminology, the most commonly reported features of EC are endometrium with heterogeneous echogenicity, irregular or ill‐defined endometrial‐myometrial junction and multiple vessels with focal or multifocal origin on Doppler ultrasound 17–20 . Assessment of the presence of these ultrasound features, in addition to measurement of ET, may improve the diagnosis of EC.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound diagnosis of endometrial cancer by subjective pattern recognition in women with postmenopausal bleeding: prospective inter‐rater agreement and reliability study

Wong

Thanatsis

Amin

et al. 2021

Ultrasound in Obstet & Gyne

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Objectives To assess the inter‐rater agreement and reliability of using subjective pattern recognition for diagnosing endometrial cancer (EC) on ultrasound in women with postmenopausal bleeding (PMB). Methods This was a prospective cross‐sectional study conducted at a gynecological rapid‐access clinic, between October 2016 and December 2017, in which consecutive women with PMB and endometrial thickness of ≥ 4.5 mm on transvaginal ultrasound examination were included. Women on hormone replacement therapy or tamoxifen and those with a history of primary gynecological malignancy were excluded. Two raters independently performed ultrasound examinations, blinded to each other's findings, and classified women as having uniformly thickened endometrium, benign endometrial polyp or EC, using subjective pattern recognition. Inter‐rater reliability of ultrasound diagnosis was assessed using Cohen's kappa (κ) statistic. All women subsequently underwent either outpatient endometrial biopsy, hysteroscopy or hysterectomy. Results Forty women were included in the study, with a median age of 61 (interquartile range (IQR), 57–69) years and a median endometrial thickness of 11.0 (IQR, 6.2–20.3) mm. Final histological analysis confirmed 16 (40%) women with EC, 16 (40%) with benign endometrial polyp, four (10%) with atrophic endometrium, three (8%) with proliferative endometrium and one (3%) with endometrial hyperplasia. Inter‐rater agreement for the ultrasound diagnoses of uniformly thickened endometrium, benign endometrial polyp and EC was 14/16 (87.5%), 22/30 (73.3%) and 28/34 (82.4%), respectively; inter‐rater reliability was good (κ = 0.69; 95% CI, 0.49–0.88). When the ultrasound diagnoses were grouped as either cancer or no cancer, inter‐rater agreement was 85% and inter‐rater reliability was good (κ = 0.78; 95% CI, 0.61–0.95). Rater A correctly identified 14/16 cases of EC and Rater B identified 15/16. EC was misdiagnosed as benign polyps on ultrasound in two women by Rater A and in one woman by Rater B. The overall accuracies of Rater A and Rater B in differentiating between benign endometrial pathologies and malignancy were 90% and 90%, respectively. Conclusions Our results show good inter‐rater reliability of subjective pattern recognition in diagnosing uniformly thickened endometrium, benign endometrial polyp and EC on ultrasound in women with PMB. Our findings should facilitate wider use of subjective pattern recognition in routine clinical practice. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.

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Role of endometrial power Doppler ultrasound using the international endometrial tumor analysis group classification in predicting intrauterine pathology

Abstract: The nomenclature described by IETA group for power Doppler assessment of the endometrium is clinically valuable and reasonable. Using this terminology, it will be easier to compare results of different studies on endometrial Doppler sonography in the future.

Cited by 21 publications

References 23 publications

Reproducibility of the International Endometrial Analysis Group Color Score for Assigning the Amount of Flow Within the Endometrium Using Stored 3-Dimensional Volumes

Reproducibility of the International Endometrial Analysis Group Color Score for Assigning the Amount of Flow Within the Endometrium Using Stored 3-Dimensional Volumes

Is Hysteroscopy Better than Ultrasonography for Uterine Cavity Evaluation? An Evidence-Based and Patient-Oriented Approach

Ultrasound diagnosis of endometrial cancer by subjective pattern recognition in women with postmenopausal bleeding: prospective inter‐rater agreement and reliability study

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