ArticleJournal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine2026
Concordance of Preoperative Transvaginal Ultrasound and Intraoperative Findings in Fibroid Ablation Using Transcervical Ultrasound: A Two-Center Cohort Study.
Article in Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate concordance between the number of uterine fibroids deemed clinically significant on preoperative transvaginal sonography (TVS) and the number of fibroids treated intraoperatively during transcervical radiofrequency ablation (RFA) under intrauterine ultrasound guidance.
methodsThis is a retrospective, paired-sample cohort study that is conducted in two tertiary care centers. Sixty-seven women underwent transcervical RFA for symptomatic uterine fibroids. This study compares TVS-significant with intraoperatively treated fibroid counts.
resultsTVS identified a mean of 1.60 ± 0.94 clinically significant fibroids, whereas 1.90 ± 1.23 were treated intraoperatively (mean paired difference + 0.30; 95% CI 0.11-0.49, P = .0036). Intraoperative counts exceeded TVS in 28%, were identical in 66%, and were lower in 6% of patients. Categorized exact agreement was 73.1% with substantial concordance (weighted κ = 0.61; 95% CI 0.42-0.76). In the a priori multifibroid subgroup (≥2 clinically significant fibroids on TVS; n = 23), the mean paired difference (+0.26) was not statistically significant (P = .266). Treated fibroid count correlated strongly with TVS count (ρ = 0.72, P < .001) and modestly with ablation time (ρ = 0.26, P = .033), but not with postoperative changes in hemoglobin or inflammatory markers (all P > .10).
conclusionPreoperative TVS demonstrates substantial diagnostic agreement with the fibroid burden treated during transcervical RFA. While TVS may numerically underrepresent the actionable fibroid count in a subset, systematic underestimation is not confirmed in multifibroid disease. The potential for intraoperative expansion should be considered during procedural planning.
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