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. 2016:2016:3561324.
doi: 10.1155/2016/3561324. Epub 2016 Nov 24.

Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

Mohamed Laban  1 , Sherif H Hussain  1 , Alaa S Hassanin  1 , Waleed M Khalaf  1 , Mohamed K Etman  2 , Mohammed S E Elsafty  1 , Ahmed M Bahaa Eldin  1 , Ahmad S Hasanien  3 , Noha A Sakna  1 , Mohammed Taema  1 , Mohammed H Mostafa  1 , Marwa M Eisa  1
Affiliations

Endometrial Volume Measured by VOCAL Compared to Office Hysteroscopy for Diagnosis of Endometrial Polyps in Premenopausal Women with Abnormal Uterine Bleeding

Mohamed Laban et al. Obstet Gynecol Int. 2016.

Abstract

The aim is to compare hysteroscopy, two-dimensional transvaginal ultrasound (2D TVUS), and three-dimensional (3D) Virtual Organ Computer-aided AnaLysis™ (VOCAL) to detect endometrial polyps (EPs) in premenopausal women with abnormal uterine bleeding (AUB). This prospective study was done at Ain Shams Maternity Hospital, Egypt, from March 5, 2015, to December 30, 2015, enrolling 118 premenopausal women with AUB. 2D TVUS, 3D VOCAL, and hysteroscopy were done. 109 patients reached final analysis. 36 women (33%) were diagnosed with EP by 2D TVUS. 50 (45.9%) had EP by hysteroscopy. Endometrial thickness was 10.1 mm by 2D TVUS and endometrial volume was 4.92 mL by VOCAL in women with EP by hysteroscopy compared to 9.9 mm and 3.50 mL in women with no EP, respectively (P = 0.223; P = 0.06). 2D TVUS has sensitivity, specificity, and positive and negative predictive values of 54%, 84.7%, 75%, and 68.5%, respectively. Endometrial thickness of >7.5 mm has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 82%, 37.3%, 52.6%, 71%, and 57.8%, respectively. Endometrial volume of >1.2 mL has sensitivity, specificity, positive and negative predictive values, and overall accuracy of 90%, 42.4%, 57%, 83.3%, and 64.2%, respectively. 3D VOCAL may be used as a noninvasive method for the diagnosis of EP in premenopausal women with AUB.

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Conflict of interest statement

All authors declare no competing interests.

Figures

Figure 1
Figure 1
Endometrial polyp identified by 2D TVUS in one of the participants.
Figure 2
Figure 2
Box plot showing the distribution of values of endometrial thickness of the participants measured by 2D TVUS. Markers represent individual observations. Box represents the interquartile range. Line inside the box represents the median. Whiskers represent the minimum and maximum values excluding outliers and extreme observations.
Figure 3
Figure 3
Endometrial volume measured by VOCAL for one of the participants.
Figure 4
Figure 4
Box plot showing the distribution of the values of endometrial volume of the participants measured by VOCAL. Markers represent individual observations. Box represents the interquartile range. Line inside the box represents the median. Whiskers represent the minimum and maximum values excluding outliers and extreme observations.
Figure 5
Figure 5
Box plot showing values of endometrial thickness measured by 2D TVUS in patients with or without endometrial polyps. Box represents the interquartile range. Line inside the box represents the median. Whiskers represent the minimum and maximum values excluding outliers (rounded markers) and extreme observations (asterisks).
Figure 6
Figure 6
Box plot showing values of endometrial volume measured by VOCAL in patients with or without endometrial polyps. Box represents the interquartile range. Line inside the box represents the median. Whiskers represent the minimum and maximum values excluding outliers (rounded markers) and extreme observations (asterisks).
Figure 7
Figure 7
Receiver-operating characteristic (ROC) curve for differentiating between patients with or without endometrial polyps using endometrial thickness measured by 2D TVUS.
Figure 8
Figure 8
Receiver-operating characteristic (ROC) curve for differentiating between patients with or without endometrial polyps using the endometrial volume measured by VOCAL.
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