P15.02: How accurate is ultrasound imaging in the diagnosis of deep infiltrating endometriosis?

To determine the sensitivity, specificity, positive and negative predictive values of ultrasound in the diagnosis of DIE at our institution. This was an observational cohort study comparing the pre-operative ultrasound findings (US) with the surgical findings in women with presumed DIE and /or women who underwent diagnostic laparoscopies for the investigation of pelvic pain or infertility. In particular, we examined pouch of Douglas (POD) obliteration, presence of uterosacral disease (USL) and presence of rectal nodules. A total of 214 women were evaluated, of which 159 had suspected DIE on ultrasound findings. 81 of these women underwent surgery. 55 women have not undergone surgery. The sensitivity of predicting POD obliteration was 82%, USL disease 53% and rectal nodules 93%. The specificity of POD obliteration was 97%, USL disease 78% and rectal nodules 95%. In this cohort US has a high accuracy for detecting DIE. There is an excellent sensitivity and specificity for the detection of rectal nodules and POD obliteration. The accuracy for detecting USL disease is lower. These findings may reduce the number of diagnostic laparoscopies being performed prior to definitive surgery. This has significant benefits for women and health service providers. We conclude that TVUS significantly improves the pre-operative diagnosis of DIE.