Early Learning Curve in the Assessment of Deep Pelvic Endometriosis for Ultrasound and Magnetic Resonance Imaging

Indrielle-Kelly, Tereza; Fischerová, D.; Hanus, P.; Frühauf, F.; Fanta, M.; Dundr, Pavel; Lavu, Deepthi; Cibula, David; Burgetová, Andrea

doi:10.1155/2020/8757281

Cited by 17 publications

(9 citation statements)

References 12 publications

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“…Kelly et al ( 2020 ) showed that, when comparing ultrasound and MRI learning curves for diagnosis of DE, ultrasound trainees had positive learning curves in more anatomical locations (bladder, adenomyosis, overall bowel DE, frozen pelvis) than the radiology/MRI trainees (bladder, adenomyosis). This may indicate that when assessing bowel DE, the learning curve for ultrasound is faster compared to the learning curve for MRI.…”

Section: Discussionmentioning

confidence: 99%

Indirect and atypical imaging signals of endometriosis: A wide range of manifestations

Smith¹,

Cabrera²,

Trippia³

et al. 2021

Facts Views Vis ObGyn

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Background: Whilst some imaging signs of endometriosis are common and widely accepted as ‘typical’, a range of ‘subtle’ signs could be present in imaging studies, presenting an opportunity to the radiologist and the surgeon to aid the diagnosis and facilitate preoperative surgical planning. Objective: To summarise and analyse the current information related to indirect and atypical signs of endometriosis by ultrasound (US) and magnetic resonance imaging (MRI). Methods: Through the use of PubMed and Google scholar, we conducted a comprehensive review of available articles related to the diagnosis of indirect signs in transvaginal US and MRI. All abstracts were assessed and the studies were finally selected by two authors. Results: Transvaginal US is a real time dynamic exploration, that can reach a sensitivity of 79-94% and specificity of 94%. It allows evaluation of normal sliding between structures in different compartments, searching for adhesions or fibrosis. MRI is an excellent tool that can reach a sensitivity of 94% and specificity of 77% and allows visualisation of the uterus, bowel loop deviation and peritoneal inclusion cysts. It also allows the categorisation and classification of ovarian cysts, rectovaginal and vesicovaginal septum obliteration, and small bowel endometriotic implants. Conclusion: The use of an adequate mapping protocol with systematic evaluation and the reporting of direct and indirect signs of endometriosis is crucial for detailed and safe surgical planning.

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Section: Discussionmentioning

confidence: 99%

Indirect and atypical imaging signals of endometriosis: A wide range of manifestations

Smith¹,

Cabrera²,

Trippia³

et al. 2021

Facts Views Vis ObGyn

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“…In order to explore a possible learning curve, the older adults were divided over three sets of participants based on the chronological order of the first ultrasound measurement occasion [ 48 ]. The SEM for each morphology measure was calculated for each set of participants.…”

Section: Methodsmentioning

confidence: 99%

Intra‐assessor reliability and measurement error of ultrasound measures for foot muscle morphology in older adults using a tablet‐based ultrasound machine

Willemse

Wouters

Pisters

et al. 2022

Journal of Foot and Ankle Research

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Background To gain insight into the role of plantar intrinsic foot muscles in fall-related gait parameters in older adults, it is fundamental to assess foot muscles separately. Ultrasonography is considered a promising instrument to quantify the strength capacity of individual muscles by assessing their morphology. The main goal of this study was to investigate the intra-assessor reliability and measurement error for ultrasound measures for the morphology of selected foot muscles and the plantar fascia in older adults using a tablet-based device. The secondary aim was to compare the measurement error between older and younger adults and between two different ultrasound machines. Methods Ultrasound images of selected foot muscles and the plantar fascia were collected in younger and older adults by a single operator, intensively trained in scanning the foot muscles, on two occasions, 1–8 days apart, using a tablet-based and a mainframe system. The intra-assessor reliability and standard error of measurement for the cross-sectional area and/or thickness were assessed by analysis of variance. The error variance was statistically compared across age groups and machines. Results Eighteen physically active older adults (mean age 73.8 (SD: 4.9) years) and ten younger adults (mean age 21.9 (SD: 1.8) years) participated in the study. In older adults, the standard error of measurement ranged from 2.8 to 11.9%. The ICC ranged from 0.57 to 0.97, but was excellent in most cases. The error variance for six morphology measures was statistically smaller in younger adults, but was small in older adults as well. When different error variances were observed across machines, overall, the tablet-based device showed superior repeatability. Conclusions This intra-assessor reliability study showed that a tablet-based ultrasound machine can be reliably used to assess the morphology of selected foot muscles in older adults, with the exception of plantar fascia thickness. Although the measurement errors were sometimes smaller in younger adults, they seem adequate in older adults to detect group mean hypertrophy as a response to training. A tablet-based ultrasound device seems to be a reliable alternative to a mainframe system. This advocates its use when foot muscle morphology in older adults is of interest.

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“…Videoclips were downloaded in Mp4 format from the hospital electronic database system and then de-identi ed prior to get reanalyzed by three intermediate ultrasound skilled trainees. These trainees were 4th year residents in O&G with intermediate ultrasound skills (consisting of more than 500 gynecologic ultrasound cases) doing their postgraduate studies in endometriosis management [27]. The trainees blinded to clinical data were asked separately to make their own diagnosis reviewing uterine images of testing set.…”

Section: Diagnostic Performance Of Traineesmentioning

confidence: 99%

“…The development of standardized and shared diagnostic criteria for the ultrasound diagnosis of adenomyosis has made it possible to achieve adequate levels of accuracy (around 83%), but only in the hands of experienced sonographers or after an intensive and supervised training of O&G trainees [9,27].…”

Section: Main and Interpretationmentioning

confidence: 99%

Application of deep learning model in the sonographic diagnosis of uterine adenomyosis

Raimondo

Raffone

Aru

et al. 2022

Preprint

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Purpose: To evaluate the diagnostic performance of Deep Learning (DL) machine for the detection of adenomyosis on uterine ultrasonographic images and compare it to intermediate ultrasound skilled trainees. Methods: Prospective observational study conducted between 1st and 30th April 2022. Transvaginal ultrasound (TVUS) diagnosis of adenomyosis was investigated by an experienced sonographer on 100 fertile-age patients. Videoclips of the uterine corpus were recorded and sequential ultrasound images were extracted. Intermediate ultrasound skilled trainees and DL machine were asked to make a diagnosis reviewing uterine images. We evaluated and compared the accuracy, sensitivity, positive predictive value, F1- score, specificity and negative predictive value of the DL model and the trainees for adenomyosis diagnosis. Results: Accuracy of DL and intermediate ultrasound skilled trainees for the diagnosis of adenomyosis were 0.51 (95% CI, 0.48-0.54) and 0.70 (95% CI, 0.60-0.79), respectively. Sensitivity, specificity and F1-score of DL were 0.43 (95% CI, 0.38-0.48), 0.82 (95% CI, 0.79-0.85) and 0.46 (0.42-0.50), whereas intermediate ultrasound skilled trainees had sensitivity of 0.72 (95% CI, 0.52-0.86), specificity of 0.69 (95% CI, 0.58-0.79) and F1-score of 0.55 (95% CI, 0.43-0.66). Conclusion: In this preliminary study DL model showed a lower accuracy but a higher specificity in diagnosing adenomyosis on ultrasonographic images compared to intermediate skilled trainees.

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Early Learning Curve in the Assessment of Deep Pelvic Endometriosis for Ultrasound and Magnetic Resonance Imaging

Cited by 17 publications

References 12 publications

Indirect and atypical imaging signals of endometriosis: A wide range of manifestations

Indirect and atypical imaging signals of endometriosis: A wide range of manifestations

Intra‐assessor reliability and measurement error of ultrasound measures for foot muscle morphology in older adults using a tablet‐based ultrasound machine

Application of deep learning model in the sonographic diagnosis of uterine adenomyosis

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