title: Performance of multidetector CT in the evaluation of the endometrium: Measurement of endometrial thickness and detection of disease.
abstract: OBJECTIVE
  To evaluate the performance of multidetector computed tomography (MDCT) in the measurement of endometrial thickness and assessment for endometrial disease.
  
  
  METHODS
  Seventy-nine MDCT examinations, including sagittal reformats from isotropic data, were retrospectively evaluated for the presence of endometrial abnormality, endometrial thickness, and recommendation for transvaginal ultrasound (TVUS) after CT. The endometrial thickness was measured on sagittal images using two different methods, between the inner-to-inner hypoattenuating stripe, and when visible, between the outer-to-outer hyperattenuating stripe. TVUS performed within 48 h of CT in premenopausal and 1 month in postmenopausal patients served as reference standard. Interobserver agreement for endometrial thickness and abnormalities was assessed using concordance correlation (CC) and kappa statistics.
  
  
  RESULTS
  Interobserver agreement for endometrial thickness on sagittal CT images was excellent (CC 0.98), and highly accurate using the inner-to-inner measurement. For determination of abnormal thickening, the positive predictive value and negative predictive value were 67-100% and 99.5-100%. For detection of any endometrial abnormality, the positive predictive value and negative predictive value were 79-90% and 84-95%, respectively. False-negative missed abnormalities included small volume hydrometra, a polyp, and endometrial distortion by a fibroid.
  
  
  CONCLUSIONS
  At MDCT, sagittal reformatted images provide reliable endometrial measurement using the inner-to-inner hypoattenuating stripe and are accurately categorized as normal or abnormal thickness using the same numerical criteria as at sonography.
authors: Department of Radiology, New York University Langone Medical Center, 660 First Ave, New York, NY 10016, USA. Electronic address: stella.kang@nyumc.org.
authors: S K
authors: SK
authors: Kang
authors: Department of Radiology, New York University Langone Medical Center, 660 First Ave, New York, NY 10016, USA.
authors: G
authors: G
authors: Giovanniello
authors: Department of Radiology, New York University Langone Medical Center, 660 First Ave, New York, NY 10016, USA.
authors: S
authors: S
authors: Kim
authors: New York University School of Medicine, 550 First Ave, New York, NY 10016, USA.
authors: S
authors: S
authors: Bedell
authors: Department of Radiology, New York University Langone Medical Center, 660 First Ave, New York, NY 10016, USA.
authors: J S
authors: JS
authors: Babb
authors: Department of Radiology, New York University Langone Medical Center, 660 First Ave, New York, NY 10016, USA.
authors: G L
authors: GL
authors: Bennett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014591:Uterine Diseases / Q000000981:diagnostic imaging* / Q000473:pathology