Accuracy of endomyometrial biopsy in diagnosis of adenomyosis: A prospective study

Laban M, Mohamed Laban, Alaa S. Hassanin, Hussain SH, Sherif Hanafi Hussain, Jilan Tarek Elsayed, Elsayed JT, Maya M Abdelrazek
International Journal of Gynecology & Obstetrics · 2025 · vol. 171(2) , pp. 705–710 · doi:10.1002/ijgo.70253 · PMID:40421701
other OA: bronze public-domain-us
🔓 Open OA copy Full text JSON View on PubMed View at publisher
⚙ AI-generated deep summary by claude@2026-06, 2026-06-14 · read from full text ⓘ

This prospective observational study (n=60) evaluated the diagnostic accuracy of office hysteroscopy-guided endomyometrial biopsy using a Spirotome in patients with abnormal uterine bleeding, with results compared against final pathology after hysterectomy. Participants also underwent transvaginal ultrasound (TVUS) and MRI, and biopsy performance (sensitivity 86.36%, specificity 90%, accuracy 87.5%) was reported alongside imaging metrics (TVUS sensitivity 100% but lower positive predictive value, and MRI sensitivity 87.5% with specificity 75%). The study concludes that a sequential diagnostic approach combining hysteroscopic biopsy with TVUS and MRI improves detection rates, though it does not provide detailed limitations beyond its methodology and the lack of conflicts of interest. This paper is centrally about adenomyosis — it specifically assesses the diagnostic efficacy of Spirotome-based hysteroscopic endomyometrial biopsy for adenomyosis.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

OBJECTIVE: To evaluate the diagnostic accuracy of hysteroscopic endomyometrial biopsy using Spirotome,complemented by transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI), for diagnosis of adenomyosis in patients with abnormal uterine bleeding. METHODS: A prospective observational study (n = 60) was conducted at Ain Shams University Maternity Hospital. Patients underwent TVUS, MRI, and office hysteroscopy-guided biopsy using the Spirotome before hysterectomy. Biopsy results were compared with final pathology. RESULTS: Biopsy sensitivity (86.36%), specificity (90%), and overall accuracy (87.5%) were recorded. TVUS demonstrated high sensitivity (100%) but low positive predictive value (66.66%). MRI showed sensitivity of 87.5% and specificity of 75%. CONCLUSION: This study demonstrates the diagnostic efficacy of hysteroscopic endomyometrial biopsy using a Spirotome, complemented by TVUS and MRI, in adenomyosis diagnosis. A sequential diagnostic approach enhances detection rates, improving patient outcomes. Integrating office hysteroscopy-guided biopsy into diagnostic protocols will provide accurate diagnoses and targeted treatments.
Full text 1,454 characters · extracted from oa-html · 4 sections · click to expand

Abstract

Objective To evaluate the diagnostic accuracy of hysteroscopic endomyometrial biopsy using Spirotome,complemented by transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI), for diagnosis of adenomyosis in patients with abnormal uterine bleeding.

Methods

A prospective observational study (n = 60) was conducted at Ain Shams University Maternity Hospital. Patients underwent TVUS, MRI, and office hysteroscopy-guided biopsy using the Spirotome before hysterectomy. Biopsy results were compared with final pathology.

Results

Biopsy sensitivity (86.36%), specificity (90%), and overall accuracy (87.5%) were recorded. TVUS demonstrated high sensitivity (100%) but low positive predictive value (66.66%). MRI showed sensitivity of 87.5% and specificity of 75%.

Conclusion

This study demonstrates the diagnostic efficacy of hysteroscopic endomyometrial biopsy using a Spirotome, complemented by TVUS and MRI, in adenomyosis diagnosis. A sequential diagnostic approach enhances detection rates, improving patient outcomes. Integrating office hysteroscopy-guided biopsy into diagnostic protocols will provide accurate diagnoses and targeted treatments. CONFLICT OF INTEREST STATEMENT The authors have no conflicts of interest. DATA AVAILABILITY STATEMENT Data sharing is not applicable to this article as no new data were created or analyzed in this study.

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-html ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis

Citation neighborhood (no data yet)

We don't have any in-corpus citations linked to this paper yet. This is a recent paper (2025) — citers typically take a year or two to land, and the OpenAlex reference graph may still be filling in.

Source provenance

europepmc
last seen: 2026-07-16T06:15:11.481547+00:00
pubmed
last seen: 2026-07-16T06:11:37.320618+00:00
unpaywall
last seen: 2026-05-11T08:34:28.763810+00:00
License: public-domain-us · commercial use OK · attribution required
Courtesy of the U.S. National Library of Medicine