Accuracy of findings in the diagnosis of uterine adenomyosis on ultrasound

Sam, Medica; Raubenheimer, Monique; Manolea, Florin; Aguilar, Hector N.; Mathew, Rishi Philip; Patel, Vimal; Low, Gavin

doi:10.1007/s00261-019-02231-9

Cited by 26 publications

(17 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Adenomyosis is a common benign chronic gynaecological disorder; however, it also displays some malignant tumour features, including invasion, migration and abnormal proliferation [21]. The endometrium directly invaded the myometrium, and misplaced pluripotent Müllerian remnants were proposed to cause the pathogenesis of AM [6]. Moreover, in ammatory factors, such as LOX5 and COX2, are related to dysmenorrhoea and menstruation [40], and it has also been reported that angiogenesis participates in the pathophysiology of abnormal uterine bleeding and subfertility in AM [3].…”

Section: Discussionmentioning

confidence: 99%

“…It is believed that a mean proportion of 20-35% of women worldwide suffer from AM [4]. Furthermore, there is evidence showing that the incidence rate has presented an increasing trend because of the optimization of diagnostic imaging techniques such as transvaginal ultrasound scan (TVUS) and magnetic resonance imaging (MRI), and the increased proportion of young women diagnosed is remarkable [5,6]. Nevertheless, the clinical diagnosis of AM is still a challenging problem because its symptoms are nonspeci c. In addition, its imaging characteristics are similar to those of other gynaecological diseases (such as leiomyoma, endometrial polyps and endometriosis) [7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Single-cell Transcriptomic Analysis of Eutopic Endometrium and Ectopic Lesions of Adenomyosis

Sun

Liu

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Adenomyosis (AM) is a common benign chronic gynaecological disorder; however, the precise pathogenesis of adenomyosis is still poorly understood. Single-cell RNA sequencing (scRNA-seq) can uncover rare subpopulations, explore genetic and functional heterogeneity, and reveal the uniqueness of each cell. It provides us a new approach to reveal biological issues from a more detailed and microscopic perspective. Here, we utilize this revolutionary technology to identify the changes of gene expression patterns between ectopic lesions and the eutopic endometrium at the single-cell level and explore a potential novel pathogenesis of AM.Methods: A control endometrium (sample with leiomyoma excluding endometrial disorders, n=1), eutopic endometrium and ectopic lesion (from a patient with adenomyosis, n=1) samples were analysed by scRNA-seq, and additional leiomyoma (n=3) and adenomyosis (n=3) samples were used to confirm colocalization and vasculogenic mimicry (VM) formation. Protein colocalization was visualized by immunofluorescence, and CD34-periodic acid-Schiff (PAS) double staining was used to assess the formation of VM.Results: The scRNA-seq results suggest that cancer-, cell motility- and inflammation- (CMI) associated terms, cell proliferation and angiogenesis play important roles in the progression of AM. Moreover, the colocalization of EPCAM and PECAM1 increased significantly in the ectopic endometrium group (P < 0.05), cell subpopulation with high copy number variation (CNV) levels possessing tumour-like features existed in the ectopic lesion sample, and VNN1- and EPCAM-positive cell subcluster displayed active cell motility in endometrial epithelial cells. Furthermore, the epithelial cells transformed to endothelial cells with the obvious accumulation of vasculogenic mimicry formations (positively stained with PAS but not CD34, P < 0.05) in ectopic lesions.Conclusions: In the present study, our results support the theory of adenomyosis derived from the invasion and migration of the endometrium. Moreover, cell subcluster with high CNV level and tumour-associated characteristics is identified. Furthermore, epithelial-endothelial transition (EET) and the formation of VM in tumours, the latter of which facilitates the blood supply and plays an important role in maintaining cell growth, were also confirmed to occur in AM. These results indicated that the inhibition of EET and VM formation may be a potential strategy for AM management.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Single-cell Transcriptomic Analysis of Eutopic Endometrium and Ectopic Lesions of Adenomyosis

Sun

Liu

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The routine use of MRI where the resource is not readily available can lead to diagnostic and treatment delays. 37 However, an accurate cost-effectiveness analyses would also require the appraisal of costs and morbidity incurred by unnecessary treatment from the higher falsepositive rates when US is used for diagnosis. These treatments could entail long-term hormonal therapy and, in often, hysterectomy and their attendant complications.…”

Section: Comparative Diagnostic Performance Of Tvus and Mrimentioning

confidence: 99%

Imaging Diagnosis of Adenomyosis

2020

View full text Add to dashboard Cite

Uterine adenomyosis can be diagnosed on ultrasonography (US) and magnetic resonance imaging (MRI) with a high degree of accuracy. Adenomyosis is a myometrial process that can appear as diffuse or focal on imaging. Diffuse adenomyosis typically causes uterine enlargement, while focal adenomyosis can mimic other myometrial lesions, such as leiomyomas. Imaging features frequently seen on US include a heterogenous thickened myometrium and myometrial cysts. On MRI, widening of the junctional zone, whether focal or diffuse, and the presence of myometrial cysts, either simple or hemorrhagic, support the diagnosis of adenomyosis. Despite these characteristic imaging appearances, there are several gynecologic pathologies which can mimic adenomyosis and it is important to be vigilant of these when interpreting cross-sectional imaging exams. The decision to evaluate patients with US or MRI is contingent on multiple factors, including availability of the necessary technology and expertise for the latter. However, MRI appears to offer greater specificity and positive predictive value for the diagnosis of adenomyosis.

show abstract

“…17 Textural features of adenomyosis in ultrasonographic images, such as subendometrial linear striation, alterations in the junctional zone such as thickening or hyperplasia, and heterogeneous myometrium, 11,18,19 can therefore be detected and quantitated using CAIA software and grayscale histograms, to provide an accurate diagnosis of adenomyosis. 11,20…”

Section: Introductionmentioning

confidence: 99%

“…Magnetic resonance imaging is currently considered the best imaging modality for diagnosing adenomyosis, but its high cost and limited availability often make it less useful than transvaginal ultrasound, which provides a cost-effective, accurate, and accessible alternative. 20 Quantitative analysis of ultrasonographic images by computer-aided diagnosis can thus be a potentially useful tool for the diagnosis of adenomyosis. 14…”

Section: Introductionmentioning

confidence: 99%

Evaluation of adenomyosis after gonadotrophin-releasing hormone agonist therapy using ultrasound post-processing imaging: a pilot study

et al. 2020

View full text Add to dashboard Cite

Objective We explored a method for the quantitative sonographic analysis of myometrial texture using computer-aided image analysis software to assess outcomes following treatment with gonadotrophin-releasing hormone (GnRH) agonist for adenomyosis in women with infertility. Method Data for patients with ultrasound images of the myometrium obtained at Taipei Medical University Hospital from 1 September 2018 to 5 April 5 2019 were analyzed. Only 10 patients with 20 ultrasound images matched the eligibility criteria. The images were divided into pre-treatment (n = 10) and post-treatment images (n = 10) and quantitative grayscale histograms were obtained from the ultrasound images using publicly available ImageJ computer-aided image analysis software. We analyzed the differences between the pre- and post-treatment images using the Mann–Whitney test and compared the results with outcomes assessed by serum CA-125 levels. Results Image analysis of the grayscale histograms revealed significant differences between before and after treatment. The classification of the myometrium pre-treatment and post-treatment was similar using CA-125 and histogram grayscale analysis. Conclusion Computer-aided image analysis of grayscale histograms of the myometrium obtained from ultrasound images is an alternative method for assessing myometrial conditions after GnRH agonist treatment in patients with adenomyosis.

show abstract

Accuracy of findings in the diagnosis of uterine adenomyosis on ultrasound

Cited by 26 publications

References 18 publications

Single-cell Transcriptomic Analysis of Eutopic Endometrium and Ectopic Lesions of Adenomyosis

Single-cell Transcriptomic Analysis of Eutopic Endometrium and Ectopic Lesions of Adenomyosis

Imaging Diagnosis of Adenomyosis

Evaluation of adenomyosis after gonadotrophin-releasing hormone agonist therapy using ultrasound post-processing imaging: a pilot study

Contact Info

Product

Resources

About