ACR Appropriateness Criteria® Pelvic Floor Dysfunction in Females

Khatri, Gaurav; Bhosale, Priyadarshani R.; Robbins, Jessica B.; Akin, Esma A.; Ascher, Susan M.; Brook, Olga R.; Dassel, Mark; Glanc, Phyllis; Henrichsen, Tara L.; Learman, Lee A.; Sadowski, Elizabeth A.; Saphier, Carl J.; Wasnik, Ashish P.; Maturen, Katherine E.

doi:10.1016/j.jacr.2022.02.016

Cited by 9 publications

(8 citation statements)

References 123 publications

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“…According to the practice guidelines of IUGA and ACR [2][3][4], pelvic floor ultrasound examination requires the collection of two-dimensional images and threedimensional/four-dimensional volume data of patients in the resting state, pelvic floor muscle contraction, and maximum Valsalva state. Then, the volume data are reconstructed, and the mobility of pelvic organs (bladder, uterus, and rectum), the integrity of the levator ani muscle (LAM) and anal sphincter (AS), and the area of the levator hiatus (LH) are measured at the maximum Valsalva state.…”

Section: The Three Main Planes and One Angle Of Pelvic Floor Ultrasou...mentioning

confidence: 99%

“…The mid-sagittal plane of the pelvic floor is mainly used to diagnose organ prolapse and its severity, pressure urinary incontinence and its severity, pelvic floor lesions, which are important parts of female pelvic floor assessment [2][3][4]. In 2021, Zhang [25] .…”

Section: Automatic Identification and Diagnosis Of The Midsagittal Pl...mentioning

confidence: 99%

“…Its applications are becoming increasingly widespread, including postpartum pelvic floor screening, female pelvic floor dysfunction (FPFD), and childbirth monitoring and prediction. PFU has the advantages of simple operation, no radiation, high resolution, and real-time dynamic observation, making it the preferred method for pelvic floor disease examination recommended by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Urogynecological Association (IUGA), and the American College of Radiology (ACR) [1][2][3][4]. However, PFU has drawbacks in clinical practice, such as a high operator dependency, long measurement time, and tedious measurement process.…”

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confidence: 99%

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Advanced Application of Artificial Intelligence for Pelvic Floor Ultrasound in Diagnosis and Treatment

Qu¹,

Zhang²

2023

Advanced Ultrasound in Diagnosis and Therapy

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Artificial intelligence-based pelvic floor ultrasound helps the diagnosis, preoperative assessment, and postoperative monitoring of female pelvic floor dysfunction (FPFD). The application of artificial intelligence in pelvic floor ultrasound mainly includes automatic segmentation and measurement, the diagnosis of muscle injury, childbirth prediction and postoperational evaluation. It can not only overcome the problem of operator experience dependence but also improve work efficiency and simplify the workflow, which has popularized the application of pelvic floor ultrasound. However, most of the current research is still limited to the automatic segmentation of three-dimensional axial plane levator hiatus (LH). The automatic reconstruction, real-time tracking of 3D/4D images and the imaging navigation of pelvic floor surgery remain major challenges for researchers.

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Section: The Three Main Planes and One Angle Of Pelvic Floor Ultrasou...mentioning

confidence: 99%

Section: Automatic Identification and Diagnosis Of The Midsagittal Pl...mentioning

confidence: 99%

mentioning

confidence: 99%

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Advanced Application of Artificial Intelligence for Pelvic Floor Ultrasound in Diagnosis and Treatment

Qu¹,

Zhang²

2023

Advanced Ultrasound in Diagnosis and Therapy

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“…Pelvic floor disorders (PFDs) such as pelvic organ prolapse (POP), urinary dysfunction (UD), and defecatory dysfunction (DD) impact daily activities and quality of life, affecting approximately 23.7% of women worldwide, with a high rate (11%) ( 1 - 3 ) of these women undergoing surgical procedures. The high reoperation rate (9.7–29%) ( 4 - 8 ) and low patient satisfaction rate (58.3%) ( 1 , 3 , 4 , 8 - 10 ) after surgery are particularly distressing. Therefore, the accurate assessment of PFDs is of the utmost importance for diagnosis and treatment ( 1 , 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…The high reoperation rate (9.7–29%) ( 4 - 8 ) and low patient satisfaction rate (58.3%) ( 1 , 3 , 4 , 8 - 10 ) after surgery are particularly distressing. Therefore, the accurate assessment of PFDs is of the utmost importance for diagnosis and treatment ( 1 , 3 , 4 ). In China, due to the large population and the weakness of community health care, treatment for PFDs has typically centered on postpartum screening and prevention, including early exercise and timely rehabilitation ( 3 , 4 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

Quality assessment of transperineal ultrasound in Chinese tertiary medical centers: a multicenter study

Zhang,

Wu,

Lin

et al. 2023

Quant Imaging Med Surg

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Background Transperineal ultrasound (TPUS) is a vital examination method for diagnosing pelvic floor diseases. However, the quality of TPUS largely relies on the operator's experience, and there is a lack of studies on the evaluation of TPUS quality. Therefore, the objective of this study was to assess the quality of TPUS examinations in Chinese tertiary medical centers. Methods This multicenter study conducted in 44 Chinese tertiary medical centers recruited postpartum women between September 2020 and September 2021. All participants underwent a standardized inquiry and TPUS examination. The participating centers were required to submit 5 parts of ultrasound data to the National Ultrasound Quality Control Center: 2-dimensional images at rest, 2-dimensional images at strain; 4-dimensional images of the levator ani hiatus; 4-dimensional images of the levator ani muscle; and 4-dimensional images of the anal sphincter. Quality assessment was performed by 2 experts with more than 5 years of experience in TPUS, and the reasons for nonqualification were stated. Results In this study, 31 hospitals that were distributed across 20 provinces in China were included, submitting 2,251 cases in total. The overall qualified rate ranged from 12.00% to 86.92%. In each part, the qualified rate of 2-dimensional images at rest, 2-dimensional images at straining, levator ani hiatus, levator ani muscle, and anal sphincter was 94.27% (2,122/2,251), 78.54% (1,768/2,251), 85.52% (1,925/2,251), 93.03% (2,094/2,251), and 88.09% (1,983/2,251), respectively. Most of the nonqualified images belonged to 2-dimensional images at strain, and the errors in image acquisition (221/483, 45.76%) and measurement (262/483, 54.24%) were the main reasons for nonqualification. For levator ani hiatus images, error in image acquisition (275/326, 84.36%) was the main reason for nonqualification. Reconstruction error was the most common reason for nonqualification for levator ani muscle (133/157, 84.71%) and anal sphincter images (133/268, 49.63%). Conclusions This multicenter study assessed the quality of TPUS in tertiary medical centers in China and identified the common reasons for nonqualification in each part. These findings can aid in forming the basis for quality control management and training for TPUS.

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Pelvic organ movements in asymptomatic nulliparous and symptomatic premenopausal women with pelvic organ prolapse in dynamic MRI: a feasibility study comparing midsagittal single-slice with multi-slice sequences

et al. 2023

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Purpose To compare multi-slice (MS) MRI sequences of the pelvis acquired at rest and straining to dynamic midsagittal single-slice (SS) sequences for the assessment of pelvic organ prolapse (POP). Methods This IRB-approved prospective single-center feasibility study included 23 premenopausal symptomatic patients with POP and 22 asymptomatic nulliparous volunteers. MRI of the pelvis at rest and straining was performed with midsagittal SS and MS sequences. Straining effort, visibility of organs and POP grade were scored on both. Organ points (bladder, cervix, anorectum) were measured. Differences between SS and MS sequences were compared with Wilcoxon test. Results Straining effort was good in 84.4% on SS and in 64.4% on MS sequences (p = 0.003). Organ points were always visible on MS sequences, whereas the cervix was not fully visible in 31.1–33.3% on SS sequences. At rest, there were no statistically significant differences of organ point measurements between SS and MS sequences in symptomatic patients. At straining, positions of bladder, cervix, and anorectum were + 1.1 cm (± 1.8 cm), − 0.7 cm (± 2.9 cm), and + 0.7 cm (± 1.3 cm) on SS and + 0.4 mm (± 1.7 cm), − 1.4 cm (± 2.6 cm), and + 0.4 cm (± 1.3 cm) on MS sequences (p < 0.05). Only 2 cases of higher-grade POP were missed on MS sequences (both with poor straining effort). Conclusion MS sequences increase the visibility of organ points compared to SS sequences. Dynamic MS sequences can depict POP if images are acquired with sufficient straining effort. Further work is needed to optimize the depiction of the maximum straining effort with MS sequences. Graphical abstract

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ACR Appropriateness Criteria® Pelvic Floor Dysfunction in Females

Cited by 9 publications

References 123 publications

Advanced Application of Artificial Intelligence for Pelvic Floor Ultrasound in Diagnosis and Treatment

Advanced Application of Artificial Intelligence for Pelvic Floor Ultrasound in Diagnosis and Treatment

Quality assessment of transperineal ultrasound in Chinese tertiary medical centers: a multicenter study

Pelvic organ movements in asymptomatic nulliparous and symptomatic premenopausal women with pelvic organ prolapse in dynamic MRI: a feasibility study comparing midsagittal single-slice with multi-slice sequences

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