Diagnostic performance of transvaginal sonography vs. magnetic resonance imaging for rectovaginal septum deep in filtrating endometriosis: a head-to-head comparative meta-analysis

AIM: We aimed to compare the diagnostic performance of transvaginal sonography (TVS) versus magnetic resonance imaging (MRI) in identifying deep in filtrating endometriosis (DIE) in the rectovaginal septum (RVS) of affected patients. MATERIALS AND METHODS: An extensive search was conducted in the PubMed, Embase databases to identify available publications up to November 2023. Studies evaluating the diagnostic perfor-mance of TVS and MRI for DIE in patients with rectovaginal septum involvement were all included. Sensitivity and speci ficity analyses employed the DerSi-monian and Laird method, complemented by the Freeman-Tukey double arc-sine trans-formation. Additionally, the study quality was rigorously evaluated using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) method. RESULTS: The meta-analysis encompassed 8 articles with a total of 721 patients. It revealed that the overall sensitivity of TVS was 0.51 (95% CI: 0.31-0.72), contrasted with 0.74 (95% CI: 0.66-0.82) for MRI. This finding suggests a higher sensitivity of MRI compared to TVS ( P =0.04). Conversely, the overall speci ficity was 0.97 (95%CI: 0.94-1.00) for TVS and 0.93 (95% CI: 0.84-0.99) for MRI, indicating a comparable level of speci ficity between the two modalities ( P =0.22). CONCLUSION: Our meta-analysis reveals that MRI exhibits higher sensitivity and comparable speci ficity to TVS in patients with DIE of the RVS. However, the limited number of articles included may affect the evidence of these results. Therefore, further d number of articles included may affect the evidence of these results. Therefore, further research with larger sample sizes and prospective designs is essential to validate these findings. (c) 2024 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.