Douha Abdalla
Hywel Dda University Health Board, UKPresentation Title:
The impact of ordering MRI before histopathology report on timely medical management
Abstract
Background: Endometrial cancer is the most common gynecological malignancy in developed countries, with rising incidence linked to obesity and aging. Timely diagnosis and treatment are crucial. In current practice, MRI is often requested after histopathological confirmation of malignancy. However, this audit explores whether earlier MRI imaging could enhance care without compromising cost-effectiveness or efficiency.
Methods: A retrospective cross-sectional audit was conducted across three hospitals in the Hywel Dda University Health Board (June 2022 – June 2023), reviewing the records of postmenopausal women presenting with bleeding who underwent hysteroscopy and MRI. Data collected included timing of investigations, CA125 levels, MRI results, and treatment initiation intervals. Statistical comparison was made between patients who received MRI before versus after histopathology reports.
Results: 57.1% of patients received MRI prior to histopathology, and 42.9% after. Median time from hysteroscopy to first definitive treatment (FDT) was 87 days, with no significant difference in FDT timing between groups (p=0.480). A higher proportion of early MRI patients had confirmed cancer (75% vs. 66.7%), though not statistically significant. Most patients had Stage 1A disease, and CA125 was elevated in only one case.
Conclusion: Ordering MRI prior to histopathology in postmenopausal bleeding cases does not significantly expedite treatment and may not be justified without strong clinical suspicion. The audit supports updating local policies to delay MRI requests until histopathological confirmation, thereby optimizing resource use without affecting patient outcomes.
Recommendations:
• Update local guidelines to recommend MRI after histopathology unless urgent imaging is clinically justified.
• Deliver training to relevant teams on revised protocols.
• Implement quarterly audits to monitor compliance and impact.
Biography
Douha Abdalla is a specialty registrar in obstetrics and gynaecology currently training in the UK. She previously worked as a registrar in Saudi Arabia before joining the UK healthcare system through the Medical Training Initiative (MTI) programme. She brings a wealth of international expertise to patient care and clinical education. She has a strong interest in oncology and urogynaecology. In addition to her clinical work, she is actively involved in medical education, leading regular case-based teaching sessions for medical students in Cardiff and Swansea. She has completed leadership and teaching qualifications and has contributed to the academic field through research publications and case reports. She is currently conducting several audit in her trust. Her professional focus is on evidence-based care, service improvement, and training the next generation of clinicians.
Organization Location
1309 Coffeen Avenue, STE 1200, Sheridan, Wyoming 82801, USA
Mail us at
Program Enquiry
gynecologysummit@scientexconference.org
General Enquiry
contact@scientexconferences.com
Registration Enquiry
finance@scientexconferences.com
gynecologysummit@scientexevents.org
Our Social Presence
Call us at
USA : (+1) 217 291 7151