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Diagnostic utility of three-dimensional power Doppler ultrasound for postmenopausal bleeding compared with sonohysterography
Taiwanese Journal of Obstetrics & Gynecology 55 (2016) 306
Contents lists available at ScienceDirect
Taiwanese Journal of Obstetrics & Gynecology journal homepage: www.tjog-online.com
Correspondence
Diagnostic utility of three-dimensional power Doppler ultrasound for postmenopausal bleeding compared with sonohysterography
Dear Editor, We respond to the great comment of Coccia et al. [1], who explained the high diagnostic accuracy of sonohysterography in the identification of endometrial pathology. They also suggested the diagnostic value of endometrial liquid-based cytology compared with endometrial biopsy. According to their investigation, biopsy may provide inadequate results, therefore, the combination of sonohysterography and endometrial liquid-based cytology might be considered a reliable outpatient procedure in the management of patients with abnormal postmenopausal endometrial bleeding. There are variable diagnostic methods that can detect or assess postmenopausal endometrial bleeding, and this can be done not only with invasive tools but also in a noninvasive manner. There is an opinion that the best way to diagnose endometrial pathology is to use hysteroscopic biopsy [2]. However, to diagnose the malignancy condition, biopsy of endometrial tissue and pathologic review of cells are tentative and acceptable [3]. Their suggestion is to use another novel method to detect the malignancy in patients with postmenopausal endometrial bleeding. Similarly, our findings suggest a new approach to estimate the possibility of endometrial cancer using three-dimensional power Doppler ultrasound as a noninvasive initial method before the patients undergo invasive and painful endometrial biopsy. As Coccia et al [1] noted, further studies should be conducted involving larger numbers of cases with postmenopausal endometrial bleeding in various diagnostic options. Therefore, with integration or
combination of various diagnostic methods, we can find the most effective way to overcome the limitation(s) of each method. Conflicts of interest The authors have no conflicts of interest relevant to this article. References [1] Coccia ME, Rizzello F, Cammilli F, Berloco P, Castellacci E. Sonohysterography and liquid-based cytology in menopausal patients with abnormal endometrium. Taiwan J Obstet Gynecol 2016;55:150e1. [2] Guruwadayarhalli B, Jones SE, Srinivasan V. Hysteroscopy in the diagnosis of postmenopausal bleeding. Menopause Int 2007;13:132e4. [3] Bani Irshaid I, Al Sumadi A. Histological findings in women with postmenopausal bleeding: Jordanian figures. East Mediterr Health J 2011;17:582e6.
Heung Yeol Kim* Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, South Korea Ari Kim Department of Obstetrics and Gynecology, Institute of Wonkwang Medical Science, College of Medicine, Wonkwang University, Iksan, South Korea *
Corresponding author. Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, South Korea. E-mail address: [email protected] (H.Y. Kim).
http://dx.doi.org/10.1016/j.tjog.2016.02.017 1028-4559/Copyright © 2016, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Contents lists available at ScienceDirect
Taiwanese Journal of Obstetrics & Gynecology journal homepage: www.tjog-online.com
Correspondence
Diagnostic utility of three-dimensional power Doppler ultrasound for postmenopausal bleeding compared with sonohysterography
Dear Editor, We respond to the great comment of Coccia et al. [1], who explained the high diagnostic accuracy of sonohysterography in the identification of endometrial pathology. They also suggested the diagnostic value of endometrial liquid-based cytology compared with endometrial biopsy. According to their investigation, biopsy may provide inadequate results, therefore, the combination of sonohysterography and endometrial liquid-based cytology might be considered a reliable outpatient procedure in the management of patients with abnormal postmenopausal endometrial bleeding. There are variable diagnostic methods that can detect or assess postmenopausal endometrial bleeding, and this can be done not only with invasive tools but also in a noninvasive manner. There is an opinion that the best way to diagnose endometrial pathology is to use hysteroscopic biopsy [2]. However, to diagnose the malignancy condition, biopsy of endometrial tissue and pathologic review of cells are tentative and acceptable [3]. Their suggestion is to use another novel method to detect the malignancy in patients with postmenopausal endometrial bleeding. Similarly, our findings suggest a new approach to estimate the possibility of endometrial cancer using three-dimensional power Doppler ultrasound as a noninvasive initial method before the patients undergo invasive and painful endometrial biopsy. As Coccia et al [1] noted, further studies should be conducted involving larger numbers of cases with postmenopausal endometrial bleeding in various diagnostic options. Therefore, with integration or
combination of various diagnostic methods, we can find the most effective way to overcome the limitation(s) of each method. Conflicts of interest The authors have no conflicts of interest relevant to this article. References [1] Coccia ME, Rizzello F, Cammilli F, Berloco P, Castellacci E. Sonohysterography and liquid-based cytology in menopausal patients with abnormal endometrium. Taiwan J Obstet Gynecol 2016;55:150e1. [2] Guruwadayarhalli B, Jones SE, Srinivasan V. Hysteroscopy in the diagnosis of postmenopausal bleeding. Menopause Int 2007;13:132e4. [3] Bani Irshaid I, Al Sumadi A. Histological findings in women with postmenopausal bleeding: Jordanian figures. East Mediterr Health J 2011;17:582e6.
Heung Yeol Kim* Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, South Korea Ari Kim Department of Obstetrics and Gynecology, Institute of Wonkwang Medical Science, College of Medicine, Wonkwang University, Iksan, South Korea *
Corresponding author. Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, South Korea. E-mail address: [email protected] (H.Y. Kim).
http://dx.doi.org/10.1016/j.tjog.2016.02.017 1028-4559/Copyright © 2016, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).