{"paper_id":"2078d5f4-a171-4199-b8ce-f383fbf6cba2","body_text":"Abstract\nEndovaginal sonographic imaging has been shown to reliably identify pelvic endometriosis, but most United States imaging practices do not adequately assess locations and features of endometriosis beyond ovarian endometrioma. In this article, we propose a protocol for sonographer-acquired images and maneuvers to be interpreted subsequently by sonologists (radiologists or gynecologists). The purpose is to improve the sensitivity of endovaginal sonography for the detection of endometriosis in imaging practices that involve the non-physician sonographer as part of their workflow.\nSimilar content being viewed by others\nReferences\nGiudice LC, Kao LC (2004) Endometriosis. Lancet 364 (9447):1789-1799. https://doi.org/10.1016/s0140-6736(04)17403-5\nCranney R, Condous G, Reid S (2017) An update on the diagnosis, surgical management, and fertility outcomes for women with endometrioma. Acta Obstet Gynecol Scand 96 (6):633-643. https://doi.org/10.1111/aogs.13114\nSimoens S, Hummelshoj L, D’Hooghe T (2007) Endometriosis: cost estimates and methodological perspective. Hum Reprod Update 13 (4):395-404. https://doi.org/10.1093/humupd/dmm010\nSoliman AM, Coyne KS, Gries KS, Castelli-Haley J, Snabes MC, Surrey ES (2017) The Effect of Endometriosis Symptoms on Absenteeism and Presenteeism in the Workplace and at Home. J Manag Care Spec Pharm 23(7):745-754. https://doi.org/10.18553/jmcp.2017.23.7.745\nSoliman AM, Taylor HS, Bonafede M, Nelson JK, Castelli-Haley J (2017) Incremental direct and indirect cost burden attributed to endometriosis surgeries in the United States. Fertil Steril 107 (5):1181-1190 e1182. https://doi.org/10.1016/j.fertnstert.2017.03.020\nBallard K, Lowton K, Wright J (2006) What’s the delay? A qualitative study of women’s experiences of reaching a diagnosis of endometriosis. Fertil Steril 86 (5):1296-1301. https://doi.org/10.1016/j.fertnstert.2006.04.054\nHadfield R, Mardon H, Barlow D, Kennedy S (1996) Delay in the diagnosis of endometriosis: a survey of women from the USA and the UK. Hum Reprod 11 (4):878-880\nNnoaham KE, Hummelshoj L, Webster P, d’Hooghe T, de Cicco Nardone F, de Cicco Nardone C, Jenkinson C, Kennedy SH, Zondervan KT (2011) Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril 96 (2):366-373 e368. https://doi.org/10.1016/j.fertnstert.2011.05.090\nAbrao MS, Goncalves MO, Dias JA, Jr., Podgaec S, Chamie LP, Blasbalg R (2007) Comparison between clinical examination, transvaginal sonography and magnetic resonance imaging for the diagnosis of deep endometriosis. Hum Reprod 22 (12):3092-3097. https://doi.org/10.1093/humrep/dem187\nGoncalves MO, Podgaec S, Dias JA, Jr., Gonzalez M, Abrao MS (2010) Transvaginal ultrasonography with bowel preparation is able to predict the number of lesions and rectosigmoid layers affected in cases of deep endometriosis, defining surgical strategy. Hum Reprod 25 (3):665-671. https://doi.org/10.1093/humrep/dep433\nGuerriero S, Ajossa S, Gerada M, Virgilio B, Angioni S, Melis GB (2008) Diagnostic value of transvaginal ‘tenderness-guided’ ultrasonography for the prediction of location of deep endometriosis. Hum Reprod 23 (11):2452-2457. https://doi.org/10.1093/humrep/den293\nHudelist G, English J, Thomas AE, Tinelli A, Singer CF, Keckstein J (2011) Diagnostic accuracy of transvaginal ultrasound for non-invasive diagnosis of bowel endometriosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol 37 (3):257-263. https://doi.org/10.1002/uog.8858\nHudelist G, Tuttlies F, Rauter G, Pucher S, Keckstein J (2009) Can transvaginal sonography predict infiltration depth in patients with deep infiltrating endometriosis of the rectum? Hum Reprod 24 (5):1012-1017. https://doi.org/10.1093/humrep/dep014\nNoventa M, Saccardi C, Litta P, Vitagliano A, D’Antona D, Abdulrahim B, Duncan A, Alexander-Sefre F, Aldrich CJ, Quaranta M, Gizzo S (2015) Ultrasound techniques in the diagnosis of deep pelvic endometriosis: algorithm based on a systematic review and meta-analysis. Fertil Steril 104 (2):366-383 e362. https://doi.org/10.1016/j.fertnstert.2015.05.002\nGuerriero S, Ajossa S, Minguez JA, Jurado M, Mais V, Melis GB, Alcazar JL (2015) Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in uterosacral ligaments, rectovaginal septum, vagina and bladder: systematic review and meta-analysis. Ultrasound Obstet Gynecol 46 (5):534-545. https://doi.org/10.1002/uog.15667\nGuerriero S, Ajossa S, Orozco R, Perniciano M, Jurado M, Melis GB, Alcazar JL (2016) Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in the rectosigmoid: systematic review and meta-analysis. Ultrasound Obstet Gynecol 47 (3):281-289. https://doi.org/10.1002/uog.15662\nGuerriero S, Condous G, Van den Bosch T, Valentin L, Leone FP, Van Schoubroeck D, Exacoustos C, Installe AJ, Martins WP, Abrao MS, Hudelist G, Bazot M, Alcazar JL, Goncalves MO, Pascual MA, Ajossa S, Savelli L, Dunham R, Reid S, Menakaya U, Bourne T, Ferrero S, Leon M, Bignardi T, Holland T, Jurkovic D, Benacerraf B, Osuga Y, Somigliana E, Timmerman D (2016) Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol. https://doi.org/10.1002/uog.15955\nYoung SW, Saphier NB, Dahiya N, Menias CO, Bridge AA, Czaplicki CD, Patel MD (2016) Sonographic evaluation of deep endometriosis: protocol for a US radiology practice. Abdom Radiol (NY) 41 (12):2364-2379. https://doi.org/10.1007/s00261-016-0886-5\nFraser MA, Agarwal S, Chen I, Singh SS (2015) Routine vs. expert-guided transvaginal ultrasound in the diagnosis of endometriosis: a retrospective review. Abdom Imaging 40 (3):587-594. https://doi.org/10.1007/s00261-014-0243-5\nCornillie FJ, Oosterlynck D, Lauweryns JM, Koninckx PR (1990) Deeply infiltrating pelvic endometriosis: histology and clinical significance. Fertil Steril 53 (6):978-983\nReid S, Leonardi M, Lu C, Condous G (2019) The association between ultrasound-based ‘soft markers’ and endometriosis type/location: A prospective observational study. Eur J Obstet Gynecol Reprod Biol 234:171-178. https://doi.org/10.1016/j.ejogrb.2019.01.018\nAbrao MS (2012) Surgical Management of deep infiltrating endometriosis. International Journal of Gynecology and Obstetrics 119 (Supplement 3):S161\nGuerriero S, Pascual MA, Ajossa S, Rodriguez I, Zajicek M, Rolla M, Rams NL, Yulzari V, Bardin R, Buonomo F, Comparetto O, Perniciano M, Saba L, Mais V, Alcazar JL (2018) Learning curve for the ultrasonographic diagnosis of deep endometriosis using a structured off-line training program. Ultrasound Obstet Gynecol. https://doi.org/10.1002/uog.20176\nTammaa A, Fritzer N, Strunk G, Krell A, Salzer H, Hudelist G (2014) Learning curve for the detection of pouch of Douglas obliteration and deep infiltrating endometriosis of the rectum. Hum Reprod 29 (6):1199-1204. https://doi.org/10.1093/humrep/deu078\nYoung SW, Dahiya N, Patel MD, Abrao MS, Magrina JF, Temkit M, Kho RM (2017) Initial Accuracy of and Learning Curve for Transvaginal Ultrasound with Bowel Preparation for Deep Endometriosis in a US Tertiary Care Center. J Minim Invasive Gynecol 24 (7):1170-1176. https://doi.org/10.1016/j.jmig.2017.07.002\nHudelist G, Fritzer N, Staettner S, Tammaa A, Tinelli A, Sparic R, Keckstein J (2013) Uterine sliding sign: a simple sonographic predictor for presence of deep infiltrating endometriosis of the rectum. Ultrasound Obstet Gynecol 41 (6):692-695. https://doi.org/10.1002/uog.12431\nReid S, Lu C, Casikar I, Reid G, Abbott J, Cario G, Chou D, Kowalski D, Cooper M, Condous G (2013) Prediction of pouch of Douglas obliteration in women with suspected endometriosis using a new real-time dynamic transvaginal ultrasound technique: the sliding sign. Ultrasound Obstet Gynecol 41 (6):685-691. https://doi.org/10.1002/uog.12305\nTimor-Tritsch IE (2015) Sliding organs sign in gynecological ultrasound. Ultrasound Obstet Gynecol 46 (1):125-126. https://doi.org/10.1002/uog.14901\nGhezzi F, Raio L, Cromi A, Duwe DG, Beretta P, Buttarelli M, Mueller MD (2005) “Kissing ovaries”: a sonographic sign of moderate to severe endometriosis. Fertil Steril 83 (1):143-147. https://doi.org/10.1016/j.fertnstert.2004.05.094\nChapron C, Fauconnier A, Vieira M, Barakat H, Dousset B, Pansini V, Vacher-Lavenu MC, Dubuisson JB (2003) Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification. Hum Reprod 18 (1):157-161\nRowland R, Langman JM (1989) Endometriosis of the large bowel: a report of 11 cases. Pathology 21 (4):259-265\nMattos LA, Goncalves MO, Andres MP, Young SW, Feldman M, Abrao MS, Kho RM (2019) Structured US and MRI imaging report for patients with suspected endometriosis: Guide for Imagers and Clinicians. J Minim Invasive Gynecol. https://doi.org/10.1016/j.jmig.2019.02.017\nAuthor information\nAuthors and Affiliations\nCorresponding author\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nElectronic supplementary material\nBelow is the link to the electronic supplementary material.\nRights and permissions\nAbout this article\nCite this article\nYoung, S.W., Groszmann, Y., Dahiya, N. et al. Sonographer-acquired ultrasound protocol for deep endometriosis. Abdom Radiol 45, 1659–1669 (2020). https://doi.org/10.1007/s00261-019-02341-4\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00261-019-02341-4","source_license":"public-domain-us","license_restricted":false}