What is the accuracy of transvaginal ultrasound for endometriosis mapping prior to surgery when performed by a sonographer within an outpatient women's imaging centre?
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Experienced sonographers accurately mapped deep endometriosis via transvaginal ultrasound in an outpatient setting, though soft markers showed poor detection of superficial endometriosis.
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Abstract
INTRODUCTION: This study aimed to assess the accuracy of transvaginal ultrasound (TVUS) for the mapping of endometriosis before surgery when performed by sonographers in an outpatient women's imaging centre.
METHODS: A prospective longitudinal cohort study was performed. The study group comprised of 201 women who underwent a comprehensive TVUS assessment, performed by a sonographer. Laparoscopy was performed as the reference standard. Complete TVUS and surgical data were available for 53 women who were included in the final analysis.
RESULTS: Endometriosis was confirmed at a surgery in 50/53 (94.3%) participants, with 25/53 (47.2%) having deep endometriosis (DE) nodules and/or endometriomas present. TVUS for mapping of DE had an overall sensitivity of 84.0%, specificity of 89.3%, PPV of 87.5%, NPV of 86.2%, LR+ of 7.85, LR- of 0.18, and accuracy of 86.8% (P < 0.001). Ovarian immobility had poor sensitivity for detecting localised superficial endometriosis, DE, adhesions, and/or endometriomas (Left = 61.9% and right = 13.3%) but high specificities (left = 87.5% and right = 94.7%). Site-specific tenderness had low sensitivities and moderate specificities for the same. All soft markers of endometriosis failed to reach statistical significance except for left ovarian immobility (P = <0.001).
CONCLUSION: Sonographers well experienced in obstetric and gynaecological imaging, working in an outpatient women's imaging setting can accurately map DE; however, the performance of soft markers for detection of SE was poor.
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Cited by (8)
- Transvaginal Ultrasound for the Diagnosis of Endometriosis: Current Practices and Barriers in Australian Sonographers 2025
- Best Practices: Ultrasound Versus MRI in the Assessment of Pelvic Endometriosis 2024
- Guideline No. 449: Diagnosis and Impact of Endometriosis - A Canadian Guideline 2024
- Proposed simplified protocol for initial assessment of endometriosis with transvaginal ultrasound 2024
- Are sonographers the future ‘gold standard’ in the diagnosis of endometriosis? 2024
- Directive clinique no 449 : Directive canadienne sur le diagnostic et les impacts de l’endométriose 2024
- CAR Practice Statement on Advanced Pelvic Ultrasound for Endometriosis 2023
- Predictive Value of Ultrasound Imaging for Diagnosis and Surgery of Deep Endometriosis: A Systematic Review 2023
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