New Ultrasound-Driven Model Boosts Accuracy in Diagnosing Endometrial Malignancy: Study Shows

The research, led by Dr. Xiu Yun Dong and her team at the Jinan Maternal and Child Health Hospital Affiliated with Shandong First Medical University, emphasizes a more personalized approach to evaluating endometrial thickening. The study aims to evaluate the diagnostic effectiveness of transvaginal ultrasound (TVUS) and to develop a multivariable risk stratification model for identifying endometrial malignancy and precursor lesions in postmenopausal women presenting with asymptomatic endometrial thickening.

For this purpose, the researchers analyzed retrospective data from 587 postmenopausal women who had asymptomatic endometrial thickening detected during routine transvaginal ultrasound examinations. Participants were categorized based on histopathological results—221 women were found to have malignant or precursor lesions, while 366 had benign outcomes.

By developing a multivariable risk stratification model, the researchers aimed to better distinguish which women were more likely to have underlying malignancies. The model incorporated ultrasound findings—such as endometrial thickness, border irregularities, and heterogeneous texture—alongside clinical data like age, BMI, and diabetes status.

The key findings of the study were as follows:

• Women with malignant or pre-malignant findings had a significantly thicker endometrium (average 14.2 mm) than those with benign lesions (10.1 mm).
• Ultrasound abnormalities were more commonly observed among women in the positive group.
• Independent predictors of malignancy included increased endometrial thickness (OR 2.94), abnormal ultrasound features (OR 4.12), presence of diabetes (OR 1.98), and obesity with a BMI ≥ 30 kg/m² (OR 1.82).
• The predictive model showed strong diagnostic performance, achieving an area under the curve (AUC) of 0.81, reflecting good accuracy in identifying high-risk cases.

According to the researchers, incorporating clinical and imaging data enables a more holistic understanding of a patient’s risk profile. “This model provides a practical method for identifying high-risk postmenopausal women,” the authors noted, highlighting the potential to reduce unnecessary invasive tests while ensuring timely intervention for those who need it.

They also stressed the importance of future research to validate this model across broader populations and explore new imaging techniques that may further refine diagnostic capabilities.

By aligning with personalized medicine principles, the study marks a step forward in enhancing care pathways for postmenopausal women with endometrial abnormalities.

Reference:

Qiu, S., Wu, S., Song, Y., Wang, B., & Dong, X. Y. (2025). Endometrial thickness and its diagnostic utility in postmenopausal women: A retrospective analysis of ultrasound and histopathological findings. Journal of Radiation Research and Applied Sciences, 18(2), 101509. https://doi.org/10.1016/j.jrras.2025.101509