{"paper_id":"d3b124f7-ad00-4841-b2d8-fb3926bcab90","body_text":"Abstract\nPurpose\nThe goal of this study was to determine the accuracy of three-dimensional (3D) MRI reconstructions obtained with segmentation technique in the preoperative assessment of deep infiltrating endometriosis (DIE) and in particular to evaluate rectosigmoid and bladder wall involvement.\nMaterials and methods\nInstitutional review board approval for this study was obtained, and each patient gave written informed consent. Fifty-seven consecutive patients with diagnosis of DIE who had undergone pelvic MRI at 1.5 T before surgery between 2007 and 2011, were retrospectively evaluated and 3D post-processed in order to obtain a detailed mapping of DIE. A blinded reader interpreted images. MRI results were compared with surgical findings and were scored by using a four-point scale (0_3 score).\nResults\n36/57 patients with symptomatic DIE underwent surgery: 18/36 had endometriotic nodules infiltrating the rectouterine pouch, 12/36 the vesicouterine pouch, and 6/36 the rectovaginal pouch. The sensitivity of MRI and 3D MRI vs. surgery was, respectively, 64% vs. 83%; diagnostic accuracy of 3D MRI respect to MRI alone was 86% vs. 67% for localization; 86% vs. 67% for dimension; 79% vs. 58% for rectosigmoid infiltration; 92% vs. 75% for bladder infiltration.\nConclusions\nIn this preliminary study, 3D MRI reconstructions obtained with semi-automatic method of segmentation provided encouraging results for staging DIE preoperatively. In fact, the addition of 3D MRI reconstructions improved diagnostic accuracy and staging of DIE providing the exact volume of the lesions and enabling a precise mapping of these before surgery.\nSimilar content being viewed by others\nReferences\nKinkel K, Frei KA, Balleyguier C, Chapron C (2006) Diagnosis of endometriosis with imaging: a review. Eur Radiol 16:285–298. doi:10.1007/s00330-005-2882-y\nCornillie FJ, Oosterlynck D, Lauweryns JM, Koninckx PR (1990) Deeply infiltrating pelvic endometriosis: histology and clinical significance. Fertil Steril 53(6):978–983\nKoninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ (1991) Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril 55(4):759–765\nAnaf V, Simon P, El Nakadi I, et al. (2000) Relationship between endometriotic foci and nerves in rectovaginal endometriotic nodules. Hum Reprod 15(8):1744–1750\nAnaf V, Simon P, El Nakadi I, et al. (2001) Impact of surgical resection of rectovaginal pouch of Douglas endometriotic nodules on pelvic pain and some elements of patient’s sex life. J Am Assoc Gynecol Laparosc 8(1):55–60\nChapron C, Fauconnier A, Vieira M, et al. (2003) Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification. Hum Reprod 18(1):157–161\nChapron C, Chopin N, Borghese B, et al. (2006) Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution. Hum Reprod 21(7):1839–1845\nNisolle M, Donnez J (1997) Peritoneal endometriosis, ovarian endometriosis and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril 68(4):585–596\nRe′genet N, Me′tairie S, Cousin GM, Lehur PA (2001) Colorectal endometriosis: diagnosis and management [in French]. Ann Chir 126(8):734–742\nChopin N, Vieira M, Borghese B, et al. (2005) Operative management of deeply infiltrating endometriosis: results on pelvic pain symptoms according to surgical classification. J Minim Invasive Gynecol 12(2):106–112\nBazot M, Darai E, Hourani R, et al. (2004) Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 232(2):379–389\nKinkel K, Frei KA, Balleyguier C, Chapron C (2006) Diagnosis of endometriosis with imaging: a review. Eur Radiol 16(2):285–2987\nReinhold C, McCarthy S, Bret PM, et al. (1996) Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology 199(1):151–158\nTogashi K, Nishimura K, Kimura I, et al. (1991) Endometrial cysts: diagnosis with MR imaging. Radiology 180(1):73–78\nWoodward PJ, Sohaey R, Mezzetti TP Jr (2001) Endometriosis: radiologic-pathologic correlation. RadioGraphics 21(1):193–216\nKinkel K, Chapron C, Balleyguier C, et al. (1999) Magnetic resonance imaging characteristics of deep endometriosis. Hum Reprod 14(4):1080–1086\nFaccioli N, Foti G, Manfredi R, et al. (2011) Evaluation of colonic involvement in endometriosis: double-contrast barium enema vs. magnetic resonance imaging. Abdom Imaging. doi:10.1007/s00261-009-9544-5\nGrasso RF, Di Giacomo V, Sedati P, Sizzi O, et al. (2010) Diagnosis of deep infiltrating endometriosis: accuracy of magnetic resonance imaging and transvaginal 3D ultrasonography. Abdom Imaging 35(6):716–725\nNovelias S, Chassang M, Bouaziz J, et al. (2010) Anterior pelvic endometriosis: MRI features. Abdom Imaging 35(6):742–749\nGaeta M, Minutoli F, Mileto A, et al. (2010) Nuck canal endometriosis: MR imaging findings and clinical features. Abdom Imaging 35(6):737–741\nMarcal L, Nothaft MA, Coelho F, Choi H (2010) Deep pelvic endometrisois: MR imaging. Abdom Imaging 35(6):708–715\nBusard MPH, van der Houven LEE, Bleeker MCG, et al. (2011) Deep infiltrating endometriosis of the bowel: MR imaging as a method to predict muscular invasion. Abdom Imaging. doi:10-1007/s00261-011-9790-1\nDel Frate C, Girometti R, Pittino M, et al. (2006) Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. RadioGraphics 26(6):1705–1718\nVercellini P, Meschia M, De Giorgi O, et al. (1996) Bladder detrusor endometriosis: clinical and pathogenic implications. J Urol 155(1):84–86\nBalleyguier C, Chapron C, Dubuisson JB, et al. (2002) Comparison of magnetic resonance Imaging and transvaginal ultrasonography in diagnosing bladder endometriosis. J Am Assoc Gynecol Laparosc 9(1):15–23\nPham DL, Xu C, Prince JL (2000) Current methods in medical image segmentation. Annu Rev Biomed Eng 2:315–337\nGrimson WEL, Ettinger GJ, Kapur T, et al. (1997) Utilizing segmented MRI data in image-guided surgery. Int J Pattern Recognit Artif Intell 11:1367–1397\nHaralick RM, Shapiro LG (1985) Image segmentation techniques. Comput Vis Graph Image Proc 29:100–132\nGonzalez RC, Woods RE (1992) Digital image processing. Reading: Addison-Wesley, p 716\nPal NR, Pal SK (1993) A review on image segmentation techniques. Pattern Recognit 26:1277–1294\nLangan DA, Modestino JW, Zhang J (1998) Cluster validation for unsupervised stochastic model-based image segmentation. IEEE Trans Image Process 7:180–195\nKhaneja N, Miller MI, Grenander U (1998) Dynamic programming generation of curves on brain surfaces. IEEE Trans Pattern Anal Mach Intell 20:1260–1265\nPham DL, Prince JL (1999) An adaptive fuzzy c-means algorithm for image segmentation in the presence of intensity inhomogeneities. Pattern Recognit Lett 20:57–68\nPham DL, Xu C, Prince JL (2000) Current methods in medical image segmentation. Annu Rev Biomed Eng 2:315–337\nWithey DJ, Koles ZJ, Department of Electrical and Computer Engineering, Department of Biomedical Engineering. University of Alberta, Edmonton, Alberta, Canada, Medical image segmentation: methods and software.\nClarke LP, Velthuizen RP, Camacho MA, et al. (1995) MRI segmentation: methods and applications. Magn Reson Imaging 13(3):343–368\nBezdek JC, Hall LO, Clarke LP (1993) Review of MR image segmentation techniques using pattern recognition. Med Phys 20(4):1033–1048\nOlabarriaga SD, Smeulders AWM (2001) Interaction in the segmentation of medical images: a survey. Med Image Anal 5:127–142\nAndrea Pietrabissa, Vincenzo Ferrari, Facoltà Di Ingegneria , Ing. Marina Carbone, CDLS in Ingegneria Biomedica. Segmentazione di Immagini MDCT per la Pianificazione di Interventi di Chirurgia Pancreatica tramite Visualizzazione 3D.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nGiusti, S., Forasassi, F., Bastiani, L. et al. Anatomical localization of deep infiltrating endometriosis: 3D MRI reconstructions. Abdom Imaging 37, 1110–1121 (2012). https://doi.org/10.1007/s00261-012-9848-8\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00261-012-9848-8","source_license":"CC0","license_restricted":false}