{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T18:15:58Z","timestamp":1778782558347,"version":"3.51.4"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Grant Agency of Charles University","award":["246125"],"award-info":[{"award-number":["246125"]}]},{"name":"MH CZ\u00e2\u20ac\u201cDRO","award":["UHHK, 00179906"],"award-info":[{"award-number":["UHHK, 00179906"]}]},{"name":"Cooperatio Program of Charles University","award":["BBMRI-CZ LM2023033"],"award-info":[{"award-number":["BBMRI-CZ LM2023033"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the\u00a0diagnostic performance- including adequacy, accuracy, safety, sensitivity, specificity, and predicitve values-\u00a0 of transvaginal tru-cut biopsy and ascitic fluid cytology in women with gynaecologic tumours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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%\u221297.4%) vs. 83.9% (95% CI: 67.4%\u221292.9%)], sensitivity [93.3% (95% CI: 82.1%\u221297.7%) vs. 79.2% (95% CI: 59.5%\u221290.8%)], and negative predictive value [82.4% (95% CI: 59.0%\u221293.8%) vs. 58.3% (95% CI: 32.0%\u221280.7%)] were higher for transvaginal tru-cut biopsy compared to ascitic fluid cytology. Adequacy [93.3% (95% CI: 86.8%\u221296.7%) vs. 93.6% (95% CI: 82.8%\u221297.8%)], specificity [93.3% (95% CI: 70.2%\u221298.8%) vs. 100.0% (95% CI: 64.6%\u2212100.0%)], and positive predictive value [97.7% (95% CI: 88.2%\u221299.6%) vs. 100.0% (95% CI: 83.2%\u2212100.0%)] 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%\u22125.3%). 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%\u221287.5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0349602","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T17:49:13Z","timestamp":1778780953000},"page":"e0349602","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transvaginal tru-cut biopsy versus ascitic fluid cytology in gynaecologic tumours: A comparative diagnostic study"],"prefix":"10.1371","volume":"21","author":[{"given":"Munachiso Iheme","family":"Ndukwe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"Bretova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Praznovec","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denisa","family":"Pohankov\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Karasek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Stepan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3316-9801","authenticated-orcid":true,"given":"Dominik","family":"Habes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Laco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Hovorkova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7543-0510","authenticated-orcid":true,"given":"Akaninyene Eseme","family":"Ubom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6497-7505","authenticated-orcid":true,"given":"Milan","family":"Vosmik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Sirak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"issue":"12","key":"pone.0349602.ref001","doi-asserted-by":"crossref","first-page":"5227","DOI":"10.18203\/2320-6012.ijrms20175382","article-title":"Study of ascitic fluid cytology in ovarian tumours","volume":"5","author":"C Janagam","year":"2017","journal-title":"Int J Res Med Sci"},{"issue":"931","key":"pone.0349602.ref002","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1136\/pmj.79.931.292","article-title":"How valuable is ascitic cytology in the detection and management of malignancy?","volume":"79","author":"RO Karoo","year":"2003","journal-title":"Postgrad Med J"},{"issue":"1","key":"pone.0349602.ref003","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1177\/104990910201900101","article-title":"Malignant ascites","volume":"19","author":"RE Enck","year":"2002","journal-title":"Am J Hosp Palliat Care"},{"key":"pone.0349602.ref004","first-page":"25","article-title":"Diagnostic value of ascitic fluid cytology in malignancy","volume":"20","author":"YH Chavan","year":"2021","journal-title":"IOSR-JDMS"},{"issue":"4","key":"pone.0349602.ref005","article-title":"Negative Serum Ascites Albumin Gradient (SAAG) in the setting of cholangiocarcinoma: a case report","volume":"15","author":"E Shilakis","year":"2023","journal-title":"Cureus"},{"issue":"7","key":"pone.0349602.ref006","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1515\/cclm-2023-1112","article-title":"Differential diagnosis of ascites: etiologies, ascitic fluid analysis, diagnostic algorithm","volume":"62","author":"L Du","year":"2023","journal-title":"Clin Chem Lab Med"},{"key":"pone.0349602.ref007","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.2147\/JMDH.S396788","article-title":"Tru-cut biopsy in gynecological cancer: adequacy, accuracy, safety and clinical applicability","volume":"16","author":"M Asp","year":"2023","journal-title":"J Multidiscip Healthc"},{"issue":"9","key":"pone.0349602.ref008","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.3390\/diagnostics15091133","article-title":"Safety, adequacy, and accuracy of transvaginal ultrasound-guided tru-cut biopsy of gynaecologic tumours: a retrospective single-centre study","volume":"15","author":"MI Ndukwe","year":"2025","journal-title":"Diagnostics (Basel)"},{"issue":"9","key":"pone.0349602.ref009","doi-asserted-by":"crossref","first-page":"2534","DOI":"10.3390\/jcm11092534","article-title":"Ultrasound-guided tru-cut biopsy in gynecological and non-gynecological pelvic masses: a single-center experience","volume":"11","author":"F Buonomo","year":"2022","journal-title":"J Clin Med"},{"issue":"1","key":"pone.0349602.ref010","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1136\/ijgc-2019-000734","article-title":"Role of transvaginal ultrasound-guided biopsy in gynecology","volume":"30","author":"F Mascilini","year":"2020","journal-title":"Int J Gynecol Cancer"},{"issue":"2","key":"pone.0349602.ref011","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1136\/jcp.55.2.93","article-title":"Comparison of fine needle aspiration cytology and needle core biopsy in the diagnosis of radiologically detected abdominal lesions","volume":"55","author":"CJR Stewart","year":"2002","journal-title":"J Clin Pathol"},{"issue":"3","key":"pone.0349602.ref012","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.ygyno.2021.03.026","article-title":"Safety and efficiency of performing transvaginal ultrasound-guided tru-cut biopsy for pelvic masses","volume":"161","author":"H Verschuere","year":"2021","journal-title":"Gynecol Oncol"},{"issue":"6","key":"pone.0349602.ref013","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1002\/uog.8803","article-title":"Ultrasound-guided tru-cut biopsy of abdominal and pelvic tumors in gynecology","volume":"36","author":"M Zikan","year":"2010","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"6","key":"pone.0349602.ref014","first-page":"80","article-title":"Statistical evaluation of diagnostic tests (Part 1): sensitivity, specificity, positive and negative predictive values","volume":"65","author":"NJ Gogtay","year":"2017","journal-title":"J Assoc Physicians India"},{"issue":"5","key":"pone.0349602.ref015","doi-asserted-by":"crossref","first-page":"327","DOI":"10.4103\/sjg.SJG_547_18","article-title":"Determination of the optimal volume of ascitic fluid for the precise diagnosis of malignant ascites","volume":"25","author":"F Zhang","year":"2019","journal-title":"Saudi J Gastroenterol"},{"issue":"4","key":"pone.0349602.ref016","first-page":"418","article-title":"Diagnostic value of carcinoembryonic antigen in malignancy-related ascites: systematic review and meta-analysis","volume":"77","author":"M Ahadi","year":"2014","journal-title":"Acta Gastroenterol Belg"},{"issue":"10","key":"pone.0349602.ref017","first-page":"5655","article-title":"Diagnostic accuracy of tumor markers CYFRA21-1 and CA125 in the differential diagnosis of ascites","volume":"35","author":"J Trap\u00e9","year":"2015","journal-title":"Anticancer Res"},{"issue":"4","key":"pone.0349602.ref018","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1159\/000529855","article-title":"Number needed to diagnose in malignant ascites: effects of volume, repeating collection, and primary malignancy on diagnostic performance in peritoneal fluid cytology","volume":"67","author":"JK Ng","year":"2023","journal-title":"Acta Cytol"},{"issue":"6","key":"pone.0349602.ref019","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1002\/(SICI)1097-0339(199906)20:6<350::AID-DC5>3.0.CO;2-7","article-title":"Diagnostic accuracy of effusion cytology","volume":"20","author":"H Motherby","year":"1999","journal-title":"Diagn Cytopathol"},{"issue":"2","key":"pone.0349602.ref020","doi-asserted-by":"crossref","first-page":"125","DOI":"10.4314\/ejhs.v24i2.4","article-title":"Analysis of diagnostic value of cytological smear method versus cell block method in body fluid cytology: study of 150 cases","volume":"24","author":"VM Bhanvadia","year":"2014","journal-title":"Ethiop J Health Sci"},{"key":"pone.0349602.ref021","first-page":"2660","article-title":"Critical analysis of cell block versus smear examination in effusions","author":"M Thapar","year":"2009","journal-title":"J Cytol"},{"issue":"3","key":"pone.0349602.ref022","doi-asserted-by":"crossref","first-page":"380","DOI":"10.3390\/diagnostics13030380","article-title":"Contribution of outpatient ultrasound transvaginal biopsy and puncture in the diagnosis and treatment of pelvic lesions: a bicenter study","volume":"13","author":"I Pelayo-Delgado","year":"2023","journal-title":"Diagnostics (Basel)"},{"key":"pone.0349602.ref023","doi-asserted-by":"crossref","first-page":"2590","DOI":"10.3390\/cancers13112590","article-title":"Transvaginal ultrasound-guided core biopsy\u2014experiences in a comprehensive cancer centre","volume":"13","author":"D Lengyel","year":"2021","journal-title":"Cancers"},{"key":"pone.0349602.ref024","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1007\/s00404-018-4952-9","article-title":"Malignant ascites occurs most often in patients with high-grade serous papillary ovarian cancer at initial diagnosis: a retrospective analysis of 191 women treated at Bayreuth Hospital, 2006\u20132015","volume":"299","author":"J Krugmann","year":"2019","journal-title":"Arch Gynecol Obstet"},{"issue":"1","key":"pone.0349602.ref025","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1006\/gyno.2002.6800","article-title":"Ascites as a predictor of ovarian malignancy","volume":"87","author":"J Shen-Gunther","year":"2002","journal-title":"Gynecol Oncol"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0349602","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T17:49:18Z","timestamp":1778780958000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0349602"}},"subtitle":[],"editor":[{"given":"Manasa","family":"Varra","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,14]]},"references-count":25,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,14]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0349602","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,14]]}}}