Power Doppler data may aid endometrial Ca Dx: postmenopausal bleeding.(Gynecology)

PARIS -- Objective quantification of power Doppler signals can contribute to the diagnosis of endometrial cancer in women with postmenopausal bleeding, Dr. Elisabeth Epstein reported at the 13th World Congress on Ultrasound in Obstetrics and Gynecology.

However, the qualitative evaluation of vascular morphology via current Doppler technique may be of more limited value, said Dr. Epstein of the department of obstetrics and gynecology at Malmo (Sweden) University.

Current evidence suggests that ultrasound measurement of endometrial thickness can select women with postmenopausal bleeding who are at low (endometrium less than or equal to 4 mm) or high (endometrium greater than or equal to 5 mm) risk for endometrial cancer, and that hydrosonography can be used in women at high risk to rule out focal lesions.

Power Doppler, which allows greater visualization of blood vessels, can potentially contribute further to the risk assessment, particularly in elderly women who have endometrium thickness of 5 mm or greater who are at high operative risk and who have failed biopsy/hydrosonography.

"A reliable risk estimation of endometrial cancer could help us to optimize the timing of endometrial biopsy, or even allow us to refrain from further diagnostic procedures," Dr. Epstein noted.

In a study published last year, Dr. Epstein and her associates prospectively evaluated 83 women who had postmenopausal bleeding and an endometrium that was greater than or equal to 5 mm.

They first assessed for suspicion of malignancy using gray-scale Doppler, then used power Doppler to locate the most vascularized area, and finally calculated the vascularity within the endometrial area via computer program.