Transvaginal Ultrasonography and Saline Infusion Sonography Compared to Hysteroscopy for Diagnosis of Intracavity Lesion: A 4-Year Experience in Suburban Referral Hospital

2020 ◽  
Vol 103 (6) ◽  
pp. 585-593
Keyword(s):  
Predictive Value ◽  
Final Diagnosis ◽  
Saline Infusion ◽  
Transvaginal Ultrasonography ◽  
Histopathological Diagnosis ◽  
Endometrial Polyps ◽  
Saline Infusion Sonography ◽  
Submucous Myoma ◽  
Kappa Value ◽  
Sensitivity Specificity

Objective: To evaluate the accuracy of transvaginal ultrasonography (TVS) and saline infusion sonography (SIS) in use for the diagnosis of endometrial polyps and submucous myoma compared to hysteroscopy. Histopathology was considered as the gold standard for final diagnosis. Materials and Methods: The present retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2014 and December 2017. Medical records of 150 patients who attended for hysteroscopy and histopathological diagnosis were reviewed. The accuracy of TVS and SIS for the diagnosis of endometrial polyps and submucous myoma were determined. Results: Out of 150 enrolled cases, endometrial polyp was the most frequent hysteroscopic finding in participants of the present study (92/150). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TVS, SIS, and hysteroscopy compared to pathologic reports for detection endometrial polyps were 71.7% versus 93.5% versus 97.8%, 38.5% versus 52.2% versus 68.2%, 80.5% versus 88.7% versus 92.8%, 27.8% versus 66.7% versus 88.2%, and 64.4% versus 85.2% versus 92.1%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of TVS, SIS, and hysteroscopy for detection of submucous myoma were 81.6% versus 92.1% versus 94.7%, 66.7% versus 86.9% versus 100%, 77.5% versus 92.1% versus 100%, 72.0% versus 86.9% versus 90.9%, and 75.4% versus 90.2% versus 96.6%, respectively. The kappa value from TVS, SIS, and hysteroscopy when the histopathologic reports were overall intrauterine abnormalities, endometrial polyps and submucous myoma were 0.45/0.43/0.72, 0.77/0.76/0.89, and 0.92/0.92/1.00, respectively. Conclusion: Sensitivity, specificity, PPV, NPV, accuracy, and kappa value of SIS for detecting endometrial polyps and submucous myoma were better than TVS. Keywords: Ultrasonography, Saline infusion sonography, Hysteroscopy, Accuracy

scholarly journals Clinicopathological and Radiological Profile of Multinodular Goitre – A Prospective Study

2021 ◽  
Vol 29 (2) ◽  
pp. 164-168
Author(s):  
Koustav Mondal ◽  
Chiranjib Das
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Multinodular Goitre ◽  
Sensitivity Specificity

Introduction Multinodular goitre (MNG) is defined as multiple palpable distinct nodules in the enlarged thyroid gland. MNG can harbour malignancy in 1-10% cases. We undertook the present study to correlate the clinical, radiological and cytological features of MNG with that of final histopathological diagnosis. Materials and Methods A prospective cohort study was done in a tertiary care hospital in northern part of West Bengal from January 2018 to December 2019. Patients aged between 12 years and 75 years, presenting with MNG on clinical examination, were included in the study. We compared the pre-operative ultrasonography (USG) of neck and fine needle aspiration cytology (FNAC) reports with post-operative histopathological examination (HPE) report. Results Among 100 patients 80 were female and 20 were male. Most patients were in 41-50 years age group. For detection of malignancy in MNG, USG had 40% sensitivity, 97.78% specificity, 66.67% positive predictive value (PPV), 93.62% negative predictive value (NPV), and 92% diagnostic accuracy. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNAC for detection of malignancy in MNG were 20%, 93.33%, 25%, 91.3% and 86% respectively. When USG features were combined with FNAC features non-diagnostic result decreased from 6% to 2% and diagnostic accuracy for detecting malignancy in MNG increased from 86% to 90%. Conclusion USG and FNAC are complementary to each other in the diagnostic workup of MNG. USG guided FNAC is still better for reaching final diagnosis and exclusion of malignancy.

scholarly journals Hysteroscopy versus transvaginal ultrasonography: finding the better modality for evaluation of postmenopausal bleeding

2019 ◽  
Vol 8 (4) ◽  
pp. 1568
Author(s):  
Mishika Bhoj ◽  
Shakti Kumar Yadav
Keyword(s):  
Screening Method ◽  
Disease Free Survival ◽  
Endometrial Biopsy ◽  
Transvaginal Ultrasonography ◽  
Transvaginal Sonography ◽  
Histopathological Diagnosis ◽  
Postmenopausal Bleeding ◽  
Current Standard ◽  
Endometrial Polyps ◽  
Sensitivity Specificity

Background: The most common cause of postmenopausal bleeding is benign pathology, but likelihood of malignancy must be promptly excluded. As excision of localized lesion has higher disease-free survival rate and lower morbidity as opposed to treatment for regional-stage disease. Commonly employed blind dilatation and curettage followed by histopathology is the current standard. A screening method with high sensitivity and specificity can help to prevent the invasive procedure and can also improve the accuracy of the biopsy. The objective of the present study was to study and compare the diagnostic accuracy of hysteroscopy and transvaginal ultrasonography in diagnosis of postmenopausal bleeding.Methods: 80 female patients with complaints of postmenopausal bleeding were enrolled and followed up for a period of 10 months. Each patient underwent transvaginal ultrasonography and hysteroscopy followed by endometrial biopsy. Result were analyzed to find sensitivity, specificity, accuracy, PPV and NPV taking histopathological diagnosis as gold standard.Results: Authors found that in 40 patients (50%), the cause of post-menopausal bleeding was caused atrophic endometrium followed by endometrial hyperplasia seen in 14 patients (17.5%). Hysteroscopy had higher overall sensitivity, specificity, NPV and accuracy as compared to transvaginal ultrasonography. Hysteroscopy was found to be highly accurate in diagnosing endometrial carcinoma (100%) and endometrial polyps (100%). However, both methods showed similar accuracy (97.5%) in diagnosis of proliferative endometrium and hyperplasia.Conclusions: Hysteroscopy is comparable to histopathology and superior to transvaginal sonography in the diagnosis of intrauterine causes for postmenopausal bleeding, it also offers the possibility of visualizing macroscopic or focal intra-uterine abnormalities.

scholarly journals Evaluation of endometrial pathology in women with postmenopausal bleeding by saline infusion sonography and hysteroscopy

2020 ◽  
Vol 9 (5) ◽  
pp. 2068
Author(s):  
Shikha Bharti ◽  
Rupali Dewan
Keyword(s):  
Diagnostic Accuracy ◽  
Postmenopausal Women ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Saline Infusion ◽  
New Delhi ◽  
Postmenopausal Bleeding ◽  
Cross Sectional ◽  
Saline Infusion Sonography ◽  
Sensitivity Specificity

Background: Postmenopausal bleeding (PMB) is a common problem representing 5% of all gynaecological outpatient attendance. Objective of this study was to determine diagnostic performance of saline infusion sonography and hysteroscopy for evaluation of endometrial lesions in postmenopausal bleeding.Methods: Being a prospective cross-sectional study, the present study was conducted on 46 postmenopausal women with bleeding, admitted to department of obstetrics and gynecology VMMC and Safdarjang Hospital, New Delhi, India. After TVS, all patients with ET >4 mm underwent SIS and then scheduled for hysteroscopy when there was no active bleeding. Sensitivity, specificity, positive predictive value and negative predictive value were calculated to compare the diagnostic accuracy of SIS and hysteroscopy.Results: Most commonly found endometrial lesions were polyp (39.13%) and endometrial hyperplasia (28.26%) among our study population consisting of 46 postmenopausal women (mean age 56.72±6.6 years). Overall sensitivity rates were 86.84% for SIS and 97.37% for hysteroscopy, while the overall specificity rates were 50% for both SIS and hysteroscopy. Hysteroscopy had PPV and NPV of 90.24% and 80% respectively whereas PPV and NPV were 89.19% and 44.44% for SIS.Conclusions: As an easy to perform, safe and well tolerated procedure yielding high diagnostic accuracy, SIS seems to be comparable to hysteroscopy for endometrial evaluation.

scholarly journals Clinical application of three-dimensional transvaginal ultrasonography in the diagnosis of intrauterine adhesions

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110245
Author(s):  
Xinkui Jiang ◽  
Xiaofeng Chen ◽  
Jiangtao Li ◽  
Weiqi Wang ◽  
Jing Li
Keyword(s):  
Predictive Value ◽  
3D Imaging ◽  
Three Dimensional ◽  
Definitive Diagnosis ◽  
Transvaginal Ultrasonography ◽  
Therapeutic Effects ◽  
Intrauterine Adhesions ◽  
Endometrial Polyps ◽  
Before And After ◽  
Sensitivity Specificity

Objective The present study aimed to evaluate the diagnostic accuracy of three-dimensional transvaginal ultrasonography (3D-TVS) for intrauterine adhesions (IUA). Methods We performed a retrospective cohort study. A total of 500 women aged 19 to 46 years with uterine lesions who received treatment from the Department of Obstetrics and Gynecology were enrolled. Endometrial 3D imaging was conducted to obtain the display plane and 3D-TVS parameters. Patients also underwent hysteroscopy for a definitive diagnosis. Results For diagnosing IUA, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of 3D-TVS were 98.8%, 90.8%, 91.4%, 98.7%, and 94.8%, respectively. For diagnosing a submucosal myoma, the sensitivity, specificity, PPV, NPV, and overall accuracy of 3D-TVS were 88.2%, 97.9%, 88.2%, 97.9%, and 96.4%, respectively. For diagnosing endometrial polyps, the sensitivity, specificity, PPV, NPV, and overall accuracy of 3D-TVS were 94.7%, 96.8%, 92.9%, 97.7%, and 96.2%, respectively. Conclusions Before hysteroscopy, 3D-TVS, as a method of screening, has great value for comparing differences before and after treatment, and for evaluating therapeutic effects.

Classification of Male Breast Lesions According to the IAC Yokohama System for Reporting Breast Cytopathology

2020 ◽  
pp. 1-8
Author(s):  
Melissa Oosthuizen ◽  
Rubina Razack ◽  
Jenny Edge ◽  
Pawel Tomasz Schubert
Keyword(s):  
Predictive Value ◽  
Best Practice ◽  
Internal Audit ◽  
Needle Aspiration ◽  
Male Breast ◽  
Histopathological Diagnosis ◽  
Breast Lesions ◽  
Risk Of Malignancy ◽  
Sensitivity Specificity

<b><i>Objective:</i></b> This study aims to determine the diagnostic utility of the International Academy of Cytology (IAC) Yokohama System for reporting breast cytopathology in lesions of the male breast. <b><i>Study Design:</i></b> Fine-needle aspiration biopsy (FNAB) reports between 2015 and 2019 were retrospectively recategorized according to the 5-tiered IAC Yokohama Reporting System. Our database yielded a total of 1,532 FNAB reports from breast lesions, obtained from 1,350 male patients. The risk of malignancy (ROM) and diagnostic performance of FNAB were determined using follow-up histopathological diagnosis and/or clinical follow-up, where available, for each category. <b><i>Results:</i></b> The category distribution were as follows: inadequate, 40%; benign, 57%; atypical, 0.6%; suspicious for malignancy, 0.7%; and malignant, 1.6%. The ROM in each category was nondiagnostic, 11%; benign, 3%; atypical, 28%; suspicious for malignancy, 56%; and malignant, 100%. The sensitivity, specificity, positive predictive value, and negative predictive value were recorded as 63, 100, 100, and 84.6% respectively, when only malignant cases were considered as positive tests. <b><i>Conclusion:</i></b> This study validates the IAC Yokohama System for reporting male breast cytopathology. In accordance with the aim of the Yokohama System to establish best practice guidelines for reporting breast cytopathology, this comprehensive scheme facilitates comparisons between local and international institutions. The ROM acts as an internal audit for quality assurance within one’s own laboratory and provides guidance for clinical management. It highlights inefficiencies such as high inadequacy rates for category 1 and also features strengths with impressive specificity for categories 4 and 5.

scholarly journals Role of transvaginal sonography in the detection of endometrial carcinoma

2014 ◽  
Vol 39 (2) ◽  
pp. 80-85
Author(s):  
MS Showkat ◽  
S Nabi ◽  
L Khondker ◽  
B Bhowmik ◽  
SN Tushar ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Transvaginal Sonography ◽  
Histopathological Diagnosis ◽  
Cross Sectional ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Sensitivity Specificity ◽  
Transabdominal Sonography

Transvagival sonography is superior to transabdominal sonography in most cases of pelvic pathology. Objective of this study is to evaluate the clinical usefulness of transvaginal ultrasonography (TVS) in pre, peri and post menopausal women suspected to have endometrial carcinoma. This cross sectional study was done with 40 patients who are clinically suspected having thickened endometrium. The study was carried out January 2007 to November 2008 for a period of two years. The patients having endometrial carcinoma diagnosed by TVS was correlated with histopathological diagnosis following collection of the report from the respective cases. Of total 40 cases, 2(5.0%) cases were endometrial carcinoma and 38(95.0%) were negative for endometrial carcinoma respectively in TVS findings. On the other hand 3(7.5%) cases were endometrial carcinoma and 37 (92.5%) cases were negative for endometrial carcinoma in histopathological findings. The validity of TVS in diagnosis of endometrial carcinoma were studied by calculating sensitivity, specificity, accuracy, positive predictive value and negative predictive value, which were 67 percent, 100 percent, 98 percent, 100 percent and 97 percent respectively. As the TVS findings of the present study correlated well with the histopathology findings and the validity test values were higher than observed by others, it can be concluded that TVS is sensitive and accurate modality in the evaluation of endometrial carcinoma. DOI: http://dx.doi.org/10.3329/bmrcb.v39i2.19647 Bangladesh Med Res Counc Bull 2013; 39: 80-85

scholarly journals Correlation of colposcopy with biopsy in cases of abnormal cervical cytology

2019 ◽  
Vol 14 (1) ◽  
pp. 36-39
Author(s):  
Kirtipal Subedi
Keyword(s):  
Predictive Value ◽  
Prospective Observational Study ◽  
Accurate Diagnosis ◽  
Cervical Cytology ◽  
Histopathological Diagnosis ◽  
Cervical Biopsy ◽  
Abnormal Cervical Cytology ◽  
Disease Threshold ◽  
Sensitivity Specificity

Aims: This study aims to find out the role of colposcopy and its correlation with cervical biopsy in detection of pre malignant cervical lesion. Methodology: This is hospital based prospective observational study on 60 cases with abnormal cervical cytology reports conducted in the Department of Obstetrics and Gynecology, PMWH, Thapathali, Kathmandu. Colposcopy guided biopsies were done and findings noted. Results: Among 60 cases enrolled in the study the most common cervical cytology finding was ASCUS, LSIL, HSIL and ASC-H present in 46.6%, 31.6%, 15% and 6.6% respectively.  The colposcopy finding among these cases was normal, CIN1, CIN 2 and CIN 3 in 45%, 23.3%, 16.7% and 9% respectively. Among these cases the most common biopsy finding was normal, CIN 1, CIN 2, CIN 3 and squamous cell carcinoma in 55%, 18.3%, 8.3%, 15% and 3.3% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of colposcopy with CIN 1 as disease threshold was calculated to be 80.6%, 93.1%, 81.8% and 92.6% respectively. While evaluating the validity of colposcopy with histopathology, colposcopy seems to make an accurate diagnosis in 75% of cases, overestimating in 15% and underestimating in 8% of cases. Conclusions: There is a good correlation of colposcopy with histopathological diagnosis of cervical cancer. Keywords: colposcopy, cytology, diagnosis, premalignant  

scholarly journals Accuracy of High Resolution Sonography in Diagnosis of Fibroadenosis Compared with Histopathological Diagnosis

2018 ◽  
Vol 8 (3) ◽  
pp. 139-142
Author(s):  
Mashah Binte Amin ◽  
Tarana Yasmin ◽  
Khaleda Parvin Rekha ◽  
Rushaida Haque Leeba ◽  
Nasima Akhter ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Linear Array ◽  
Histopathological Diagnosis ◽  
Fibrocystic Disease ◽  
Medical College ◽  
Breast Condition ◽  
Sensitivity Specificity ◽  
Test Result

Background: Fibrocystic breast condition is a common, non-cancerous condition that affects premenopausal woman between 20 and 50 years of age. Because of non-specific nature of clinical presentation, diagnosis is not that easy. Linear array sonography has been helpful for detection of mammary dysplasia.Objective: The purpose of this study was to determine the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of superficial sonography in the diagnosis of chronic cystic mastitis.Materials and Methods: This study was carried out in department of Radiology & Imaging of Enam Medical College and Hospital during June 2013 to October 2017. Sonography was done in 1350 women suspected of having fibrocystic disease. Among them FNAC was done only in 1020 cases. Ultrasonographic findings and histopathological reports were analyzed using SPSS 13.0.Results: According to our study the sensitivity of superficial sonography was 92.4%, specificity 88.8%, positive predictive value 93.8%, negative predictive value 86.4% and accuracy 91% in the diagnosis of fibrocystic changes.Conclusion: With the validity test result, it can be concluded that high frequency sonography provides an accurate diagnosis of fibroadenosis.J Enam Med Col 2018; 8(3): 139-143

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