EP23.10: Comparing handheld point of care ultrasound with high specification ultrasound in gynecology

Point of Care Ultrasound is being increasingly used in all settings of healthcare. This study aims to evaluate the performance of handheld point of care ultrasound (POCUS) in comparison to standard care with high-specification ultrasound in gynecology. 155 consecutive patients in gynecology at a London teaching hospital were recruited to this cross-sectional study. One sonologist conducted an assessment with a handheld POCUS. Following this a second sonologist conducted the standard care with a high specification machine which may include both transabdominal and transvaginal ultrasound. The operators were blinded to each other's findings and measurements. There was moderate correlation in uterine measurements (R=0.44 for longitudinal measurement) There was fair agreement for endometrial thickness (R= 0.32). There was slight agreement on ovary visualisation (k= 0.171) however where there was a cyst present, POCUS had improved performance with moderate concordance (k=0.481), where a cyst was seen there was significant correlation looking at maximum cyst diameter (R=0.870). IOTA Benign cyst descriptors were applied which showed substantial concordance (k=0.679). Point of Care Ultrasound may be a useful adjunct within the gynecology setting especially where there is a lack of access to ultrasound. At this point we would only recommend its use within research or triage. Although its performance was limited at seeing normal ovaries, concordance was much better when an adnexal mass was present, as well as looking at its measurements and contents. More data is needed to assess the endometrial thickness in the postmenopausal population.