ImageJ Analysis for Transabdominal Endometrial Sonography of Single Saudi Females: A Cohort Study

Gynecological assessment of single females in some countries, where transvaginal ultrasound can not be performed, presents a challenge. This study proposed using computer-assisted analysis (ImageJ software) to assess its feasibility for endometrial analysis and consequently enhance the diagnostic value of transabdominal ultrasound.

This pilot normative cohort study was conducted among 20 single healthy volunteers recruited at Princess Nourah University (PNU) ultrasound lab from November 2022 to April 2023. Participants were followed throughout their entire menstrual cycle and underwent a transabdominal ultrasound in the 4 menstrual phases. Sonographs were analyzed using the ImageJ program, and the data were analyzed with SPSS software.

The mean age of the participants was 21 years (± 0.9), and the average menstrual cycle length was 29.65 days (±2.18). The endometrium measured 0.33 cm (±0.137), 0.63 cm (±0.172), 0.89 cm (±0.167), and 1.06 cm (±0.19) in the menstrual, early proliferative, late proliferative, and secretory phases, respectively. At the same time, the intensity score was 96.735 (±26.24), 117.4 (±27.8), 145.37 (±30.0137), and 157.3 (±21.3) in these phases. Endometrial thickness also showed a moderate positive correlation with the intensity score (r=0.545, p=0.000).

These findings, which demonstrate a correlation between the intensity score and endometrial thickness, underscore the importance of this study in providing a basis for using ImageJ software to analyze transabdominal ultrasound.

This pilot study generated preliminary reference values for endometrial thickness and intensity score using transabdominal ultrasound. It also demonstrated a correlation between these measurements, underscoring the potential utility of ImageJ analysis.