OC19.02: International and multicentre prospective diagnostic accuracy of ultrasound for endometriosis using the IDEA consensus

To evaluate the diagnostic accuracy of transvaginal ultrasound (TVS) to predict overall deep endometriosis (DE) and DE locations by applying the IDEA terminology. This was an international, multicentre prospective diagnostic accuracy study involving 9 centres across 6 countries (Aug 2018-Nov 2019). Consecutive participants were enrolled. Only participants with suspected endometriosis based on clinical symptoms or historical diagnosis of endometriosis were included. The index test was TVS performed pre-operatively in accordance with the IDEA consensus statement. At each centre, the index test was interpreted by a single sonologist. The reference standard was direct visualisation of endometriosis at laparoscopy as determined by a non-blinded surgeon with expertise in endometriosis surgery. All surgeries were performed within 12 months of the index test TVS. Accuracy, sensitivity, specificity, positive and negative predictive values (PPV/NPV), and positive and negative likelihood ratios (LR+/LR-) of TVS were measured. 276 participants were included in the study with complete clinical, TVS, laparoscopic, and histologic data. 258/276 (93.5%) participants were confirmed to have endometriosis histologically. Based on surgical visualisation, 139/276 (50.4%) had an ovarian endometrioma (OE) and 209/276 (75.7%) had DE. For overall DE, diagnostic performance was as follows: Accuracy 85.9%; Sensitivity 88.5%; Specificity 77.6%; PPV 92.5%; NPV 68.4%; LR+ 3.95; LR- 0.15. Diagnostic performance for OE, specific DE sites, and rectouterine pouch obliteration can be found in Table 1. This study has found a higher TVS detection rate of overall DE than reported by the most recent meta-analysis on the topic (79%) but a lower specificity. Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.