OP08.04: Accuracy of the sonography for the diagnosis of endometriotic parametrial involvement: a systematic review and meta‐analysis

The aim of this meta-analysis is to evaluate the diagnostic accuracy of transvaginal ultrasonography (TVS) to detect parametrial endometriosis, using laparoscopy as the reference standard. A search for studies evaluating the TVS for assessing parametrial endometriosis compared to surgery from January 2000 to December 2020 was performed in PubMed/MEDLINE and Web of Science. The Quality Assessment of Diagnostic Accuracy Studies 2 evaluated the quality of the studies (QUADAS-2). All analyses were performed using MIDAS and METANDI commands. We identified 133 citations. Finally, four studies comprising 560 patients were included. Mean prevalence of parametrial endometriosis was 17%. Overall, the pooled estimated sensitivity, specificity, positive likelihood, and negative likelihood ratio of TVS for detecting parametrial endometriosis were 31% (95% confidence interval [CI] = 10% -64%), 98% (95% CI = 95%-99%), 18.5 (95% CI = 8.8-38.9), 0.70 (95% CI =0.46-1.06), respectively. Diagnostic odds ratio (DOR) was 26 (95% CI =10-68). Heterogeneity was high. The visualisation of a lesion suspected to be parametrial endometriosis increases significantly the pretest probability of parametrial endometriosis at laparoscopy. The use of TVS for the detection of parametrial endometriosis have a high specificity but a low sensitivity. This study was partly supported by Fondazione di Sardegna grant F74I19001010007.