DIAGNOSTIC ACCURACY OF TRANSVAGINAL ULTRASOUND IN ETECTION OF ENDOMETRIAL CARCINOMA IN PATIENTS RESENTING WITH POST MENOPAUSAL BLEED KEEPING HISTOPATHOLOGY AS GOLD STANDARD

Abstract

Objectives:
To determine the diagnostic accuracy of transvaginal ultrasound (TVUS) in detecting endometrial carcinoma in patients presenting with postmenopausal bleeding, using histopathology as the gold standard.

Methodology:
This cross-sectional analytical study was conducted at a tertiary care hospital on 150 postmenopausal women presenting with bleeding. Patients with at least 12 months of natural menopause were included using a consecutive non-probability sampling technique. All participants underwent TVUS to assess endometrial thickness and morphology, followed by endometrial sampling for histopathological confirmation. Qualitative variables included TVUS findings, histopathological diagnosis, parity, and comorbidities, while quantitative variables included age, endometrial thickness, and duration since menopause. Data were analyzed using statistical software, and diagnostic accuracy measures including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated.

Results:
The mean age of patients was 58.4 ± 7.6 years, and the mean duration since menopause was 9.2 ± 5.1 years. Endometrial carcinoma was confirmed in 48 (32.0%) patients on histopathology. TVUS showed 42 true positives, 78 true negatives, 18 false positives, and 12 false negatives. The sensitivity, specificity, PPV, NPV, and overall diagnostic accuracy of TVUS were 87.5%, 81.2%, 70.0%, 86.7%, and 80.0%, respectively. Increased endometrial thickness (>10 mm) showed a significant association with malignancy (p ≤ 0.05).

Conclusion:
TVUS is an effective, non-invasive diagnostic tool with good sensitivity and specificity for detecting endometrial carcinoma in postmenopausal bleeding..