Power Doppler Area in the Diagnosis of Endometrial Cancer

Objective: To evaluate the diagnostic accuracy of power Doppler area (PDA) in the detection of endometrial cancer in women with postmenopausal bleeding. Design: Prospective diagnostic study. Setting: University hospital. Population: Seventy-four consecutive women presenting with postmenopausal bleeding and a total endometrial thickness of more than 4 mm. Methods: The PDA was measured by pelvic ultrasound. Endometrial cancer and hyperplasia with complex atypia were considered abnormal. Main Outcome Measures: A receiver operating characteristic curve was constructed and area under curve (AUC) calculated as well as positive and negative likelihood ratios (LR+ and LR-). Results: Eighteen women (24%) had abnormal results of their histological specimen. The AUC of the PDA was 0.88(95% confidence interval [CI], 0.80-0.98). The LR+ and LR- of the PDA were, respectively, 14.5 (95% CI, 4.69-44.9) and 0.23 (95% CI, 0.09-0.55). In women with total endometrial thickness of 4 to 10 mm, the AUC, LR+, and LR- were, respectively, 0.91 (95% CI, 0.78-1.00), 23.9 (95% CI, 3.29-175.0), and 0.34 (95% CI, 0.13-0.86). Conclusions: The PDA is an effective measure in the diagnosis and exclusion of endometrial cancer.