AI Insight
This retrospective comparative study evaluated transvaginal ultrasound-guided tru-cut biopsy against ascitic fluid cytology in 104 women with gynaecologic tumours at a single university hospital in the Czech Republic. Tru-cut biopsy demonstrated superior diagnostic accuracy (93.3% vs. 83.9%), sensitivity (93.3% vs. 79.2%), and negative predictive value (82.4% vs. 58.3%), while both methods showed comparable adequacy, specificity, and positive predictive value. The overall complication rate for tru-cut biopsy was low at 1%, with no complications recorded for ascitic fluid cytology.
Why it matters
For clinicians managing gynaecologic tumours, these findings support ultrasound-guided tru-cut biopsy as the preferred diagnostic approach when tissue characterisation is needed, while affirming that ascitic fluid cytology remains a viable, safe alternative when biopsy is not feasible, which may influence clinical decision-making and diagnostic protocols.
by Munachiso Iheme Ndukwe, Petra Bretova, Ivan Praznovec, Denisa Pohanková, Dominik Karasek, Martin Stepan, Dominik Habes, Jan Laco, Eva Hovorkova, Akaninyene Eseme Ubom, Milan Vosmik, Igor Sirak
Objective
To compare the diagnostic performance- including adequacy, accuracy, safety, sensitivity, specificity, and predicitve values- of transvaginal tru-cut biopsy and ascitic fluid cytology in women with gynaecologic tumours.
Methods
A retrospective review was conducted of women with gynaecologic tumours who underwent ultrasound-guided transvaginal tru-cut biopsy and ascitic fluid cytology at the Department of Obstetrics and Gynaecology, University Hospital Hradec Kralove, between January 2018 and December 2021.
Results
A total of 104 women with gynaecologic tumours underwent transvaginal tru-cut biopsy, of whom 47 also had ascitic fluid cytology. The diagnostic accuracy [93.3% (95% CI: 84.1%−97.4%) vs. 83.9% (95% CI: 67.4%−92.9%)], sensitivity [93.3% (95% CI: 82.1%−97.7%) vs. 79.2% (95% CI: 59.5%−90.8%)], and negative predictive value [82.4% (95% CI: 59.0%−93.8%) vs. 58.3% (95% CI: 32.0%−80.7%)] were higher for transvaginal tru-cut biopsy compared to ascitic fluid cytology. Adequacy [93.3% (95% CI: 86.8%−96.7%) vs. 93.6% (95% CI: 82.8%−97.8%)], specificity [93.3% (95% CI: 70.2%−98.8%) vs. 100.0% (95% CI: 64.6%−100.0%)], and positive predictive value [97.7% (95% CI: 88.2%−99.6%) vs. 100.0% (95% CI: 83.2%−100.0%)] were similar for the two methods. Only one tru-cut biopsy was complicated by bleeding, giving an overall complication rate of 1% (95% CI: 0.2%−5.3%). There was no complication with ascitic fluid cytology. Concordance of tru-cut histopathological diagnoses with ascitic fluid cytological diagnoses was 78% (95% CI: 63.6%−87.5%).
Conclusion
Ultrasound-guided tru-cut biopsy provides more diagnostic information than ascitic fluid cytology and is the preferred method when feasible. However, ascitic fluid cytology remains a safe and practical option when biopsy is unavailable.