Endometrial volume as predictor of malignancy in women with postmenopausal bleeding

OBJECTIVE: To assess endometrial volume as a predictor of endometrial malignancy in women with postmenopausal bleeding. METHODS: Endometrial volume was measured by virtual organ computer-aided analysis in 170 women with postmenopausal bleeding, and histopathologic results of endometrial biopsies were obtained for all. A group of 100 women without postmenopausal bleeding was used for control. RESULTS: There were 90 cases of benign disease, 53 cases of atypia, and 27 cases of endometrial cancers in the study group. Whereas endometrial thickness was 9.61+/-5.12 mm (range, 5-20 mm) and endometrial volume was 3+/-1.1 mL (range, 1.8-5.4 mL) in women with atypia or cancer, they were 4.87+/-3.43 mm (range, 2-8 mm) and 1.52+/-0.82 (range, 0.6-2.2 mL), respectively, in women with benign disease. In the control group, endometrial volume was 1.15+/-0.14 mL (range, 0.6-1.3 mL). Volume was more sensitive than thickness for predicting malignancy, and a cutoff value of 1.35 mL was found to provide the best sensitivity. CONCLUSION: An endometrial volume of 1.35 mL or greater may predict malignancy in women with postmenopausal bleeding.