Location, color, size, depth, and volume may predict endometriosis in lesions resected at surgery

Stratton, Pamela; Winkel, Craig A.; Sinaii, Ninet; Merino, María J.; Zimmer, C.; Nieman, Lynnette K.

doi:10.1016/s0015-0282(02)03337-x

Cited by 62 publications

(45 citation statements)

References 19 publications

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“…At surgery, information was collected on all visible lesions as previously described (11). Lesions suspected of being endometriosis were excised with contact neodymium:yttrium-aluminum-garnet laser (Surgical Laser Technologies, The Oaks, PA); no lesions were ablated and all were sent for histology.…”

Section: Data Collectionmentioning

confidence: 99%

“…Unfortunately, visual assessment of lesions has poor intra-physician agreement and high rates of misdiagnosis (5) and correlates poorly with actual histologic findings (4,(6)(7)(8)(9)(10)(11)(12)(13)(14). Presurgical screening tests to increase the probability of a woman having endometriosis at surgery are one way to improve the likelihood of accurate diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…Presurgical screening tests to increase the probability of a woman having endometriosis at surgery are one way to improve the likelihood of accurate diagnosis. However, questionnaires, MRI, ultrasound and adjunctive lab tests all lack the sensitivity and specificity to significantly increase the pretest probability of disease (1,8,11,15,16), except for women with severe endometriosis (Stage III or IV) (6,(17)(18)(19). Based on these facts, some method to assess which lesions are most likely to represent true disease is needed, particularly if visual appearance is used.…”

Section: Introductionmentioning

confidence: 99%

“…At surgery, endometriosis lesions present with a variety of colors, sizes, and locations (8,10,11,15,20). The heterogeneity of lesion characteristics suggests that visual inspection may not be sufficient to identify endometriosis (9), especially when subtle lesions are present.…”

Section: Introductionmentioning

confidence: 99%

“…By correlating patient and individual lesion characteristics with pathologic findings in a multivariate regression model, we sought to assess which lesions are most likely to be biopsyconfirmed as endometriosis. Knowing this fact might improve on the poor histologic correlation with surgical assessment (4,(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

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A logistic model for the prediction of endometriosis

Stegmann

Funk

Sinaii

et al. 2009

Fertility and Sterility

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Objective-To develop a model using individual and lesion characteristics to help surgeons choose lesions with a high probability of containing histologically-confirmed endometriosis.Design-Secondary analysis of prospectively collected information. Setting: Government research hospital.Patients-Healthy women aged 18-45 with chronic pelvic pain and possible endometriosis, enrolled in a clinical trial.Intervention-All participants underwent laparoscopy, and information was collected on all visible lesions. Lesion data were randomly allocated to a training and test dataset. Main Outcome Measures(s)-Predictive logistic regression with the outcome of interest being histologic diagnosis of endometriosis.Results-After validation, the model was applied to the complete dataset with a sensitivity of 88.4% and specificity of 24.6%. The positive predictive value was 69.2% and the negative predictive value was 53.3%, equating to correct classification of a lesion of 66.5%. Mixed color, larger width and location in the ovarian fossa, colon, or appendix were most strongly associated with the presence of endometriosis.Conclusions-This model identified characteristics which indicated a high and low probability of biopsy-proven endometriosis. It is useful as a guide in choosing appropriate lesions for biopsy, but is not sufficiently robust to use alone.

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Section: Data Collectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A logistic model for the prediction of endometriosis

Stegmann

Funk

Sinaii

et al. 2009

Fertility and Sterility

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Surgical Therapies: Peritoneal Endometriosis Surgery

Diamond

Shavell

2011

Endometriosis

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Strengths and limitations of diagnostic tools for endometriosis and relevance in diagnostic test accuracy research

Pascoal

Wessels

Aas-Eng

et al. 2022

Ultrasound in Obstet & Gyne

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Endometriosis is a chronic systemic disease that can cause pain, infertility and reduced quality of life. Diagnosing endometriosis remains challenging, which yields diagnostic delays for patients. Research on diagnostic test accuracy in endometriosis can be difficult due to verification bias, as not all patients with endometriosis undergo definitive diagnostic testing. The purpose of this State-of-the-Art Review is to provide a comprehensive update on the strengths and limitations of the diagnostic modalities used in endometriosis and discuss the relevance of diagnostic test accuracy research pertaining to each. We performed a comprehensive literature review of the following methods: clinical assessment including history and physical examination, biomarkers, diagnostic imaging, surgical diagnosis and histopathology. Our review suggests that, although non-invasive diagnostic methods, such as clinical assessment, ultrasound and magnetic resonance imaging, do not yet qualify formally as replacement tests for surgery in diagnosing all subtypes of endometriosis, they are likely to be appropriate for advanced stages of endometriosis. We also demonstrate in our review that all methods have strengths and limitations, leading to our conclusion that there should not be a single gold-standard diagnostic method for endometriosis, but rather, multiple accepted diagnostic methods appropriate for different circumstances.

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Location, color, size, depth, and volume may predict endometriosis in lesions resected at surgery

Cited by 62 publications

References 19 publications

A logistic model for the prediction of endometriosis

A logistic model for the prediction of endometriosis

Surgical Therapies: Peritoneal Endometriosis Surgery

Strengths and limitations of diagnostic tools for endometriosis and relevance in diagnostic test accuracy research

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