Dr Mª Angela Pascual, head of R&D&I at the Gynaecological Diagnostic Imaging Service of Dexeus Mujer, has participated in a large prospective multicentre European study performed in pre- and post-menopausal women in order to describe the ultrasound findings of uterine cavity and endometrial pathologies using the terminology of the International Endometrial Tumor Analysis group (IETA).

The database consisted of 2856 consecutive women presenting with abnormal uterine bleeding. In all cases a colour Doppler ultrasound was performed and in 1857 cases a saline contrast ultrasound was performed. Endometrial histology was available for 2216 women, which constituted the study population. The mean age of the patients was 49 years (range, 19-92 years). Endometrial sampling was performed according to the local protocol of each medical centre.

In total, endometrial polyps were diagnosed in 751 women (33.9%), submucosal fibroids in 223 women (10.1%), and 137 women (6.2%) were diagnosed with endometrial cancer. None (0% [95% CI, 0.0-5.5%])) of the 66 women with endometrial thickness under <3 mm had endometrial cancer or atypical hyperplasia/EIN. Endometrial cancer or atypical hyperplasia/EIN was found in three of 283 (1.1% [95% CI, 0.4-3.1%]) endometriums with a triple-line pattern, in three of 459 (0.7% [95% CI, 0.2-1.9%]) endometriums with a linear midline and in five of 337 (1.5% [95% CI, 0.6-3.4%]) cases with a single unbranched vessel on ultrasounds performed without saline contrast.

The authors concluded that detection of some easy-to-evaluate features of IETA (endometrial thickness under <3 mm, triple-line pattern, regular midline, and single unbranched vessel) is associated with low likelihood of endometrial cancer.