{"paper_id":"422885c7-d3e4-438e-97c5-23fe044519f3","body_text":"Abstract\nIntroduction\nThe main objective of this study was to evaluate the performances of MRI and rectal endoscopy sonography (RES) in predicting the depth of bowel wall infiltration by deep infiltrating endometriosis (DIE).\nMaterial and method\nWe conducted a single center retrospective study from April 2014 to March 2020 including all patients who had undergone digestive tract resection (discoid or segmental) for DIE removal and who had benefited from full preoperative imaging workup based on both pelvic MRI and RES.\nResults\nFifty two patients were enrolled in the study. Median age was 35.8 years (26.1–44.5 years). Indications for surgery mainly comprised chronic pelvic pain (94.2%) and infertility (36.5%). Overall, pathological examination showed digestive involvement in 92.3% of patients, while transmural infiltration was found in 38.4% of cases. In contrast, both MRI and RES suspected transmural involvement in 42 patients (80.8%). Corresponding sensitivity and specificity were 0.95 [95% CI (0.751–0.999)] and 0.28 [95% CI (0.137–0.467)], respectively. Our results revealed agreement between MRI and RES in 85% of cases with a kappa at 0.5 [95% CI (0.207–0.803), moderate agreement]. Subgroup analysis in patients with transmural MRI lesions showed a sensitivity of 0.95 [95% CI (0.740–0.999)] and a specificity of 0.13 [95% CI (0.028–0.336)].\nConclusion\nOur study suggests that performing a second-line examination is not useful if there is no transmural impairment in MRI or RES. Nevertheless, the combination of these two preoperative examinations seems to be essential for the evaluation of the depth of digestive involvement of endometriosis to guide surgical management as effectively as possible. 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FV: protocol and project development.\nCorresponding author\nEthics declarations\nConflicts of interest\nThe authors declare that they have no conflict of interest.\nEthical approval\nIn conformity with the reference methodology MR-004, this work is registered in the retrospective studies register of the Toulouse University Hospital under the CNIL Number 2206723v0.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nBuffeteau, A., Weyl, A., Vavasseur, A. et al. MRI and rectal endoscopy sonography performance to diagnose the digestive depth infiltration of pelvic endometriosis. Arch Gynecol Obstet 307, 51–58 (2023). https://doi.org/10.1007/s00404-022-06532-1\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-022-06532-1","source_license":"CC0","license_restricted":false}