Three-dimensional power Doppler ultrasound scanning for the prediction of endometrial cancer in women with postmenopausal bleeding and thickened endometrium

Objective The purpose of this study was to evaluate the role of 3-dimensional power Doppler angiography (3D-PDA) to discriminate between benign and malignant endometrial disease in women with postmenopausal bleeding and thickened endometrium. Study Design Ninety-nine postmenopausal women (median age, 63.1 years; range, 48-84 years) with uterine bleeding and a thickened endometrium (≥ 5 mm) at baseline transvaginal sonography were assessed by 3D-PDA before endometrial biopsy. Endometrial volume, vascularity index (VI), flow index, and vascularity-flow index were calculated with the virtual organ computer-aided analysis method. Results Histologic diagnoses were endometrial cancer (44 cases), hyperplasia (13 cases), polyp (23 cases), cystic atrophy (14 cases), and submucous myoma (5 cases). Endometrial volume, VI, and vascularity-flow index were significantly higher in malignant vs benign conditions. Receiver operating characteristic analysis revealed that VI was the best parameter for the prediction of endometrial cancer. Conclusion The findings show that 3D-PDA may be useful for the prediction of endometrial cancer in women with postmenopausal bleeding and thickened endometrium at baseline sonography.