OP34.04: Accuracy of different imaging techniques to assess POD obliteration: a systematic review and meta‐analysis

Pouch of Douglas (POD) obliteration in women with potential endometriosis will warrant referral to a specialised endosurgery unit. Advanced laparoscopic skills are required to manage women with complex endometriosis and underlying POD obliteration. Imaging modalities such as transvaginal ultrasound (TVS) and magnetic resonance imaging (MRI) have been utilised to pre-operatively predict POD obliteration. The purpose of this meta-analysis is to assess the performance of these imaging modalities in the prediction of POD obliteration. This was a systematic review conducted in accordance with the PRISMA statement. We searched MEDLINE, Embase, PubMed and Goggle scholar from database inception to March 2016. Studies included compared imaging prediction of POD obliteration with laparoscopic gold standard confirmation with at least 10 affected and 10 unaffected participants were considered eligible. The electronic searches retrieved 3881 records. We excluded 3780 by reading titles/abstracts and more 82 after reading the full text as they were clearly not eligible. Regarding the other 19 records we excluded more 1 record because it evaluated the same population of other included study and more 8 records because they were related to studies that included less than 10 affected/unaffected women. We included 10 studies in the meta-analysis, four evaluating MRI and the other six evaluating TVS. The main results are summarised on table 1. MRI and TVS demonstrated high sensitivity and specificity to diagnose POD obliteration. As TVS is more readily available and cost less this should be the first line diagnostic tool for the women with suspected POD obliteration.