OP11.01: Standardization of three dimensional ultrasonographic evaluation for the assessment of deep infiltrating endometriosis

To standardize the image display for the assessment deep pelvic endometriosis using three dimensional ultrasonography (3DTVS). Twenty volumes from women with surgically confirmed of deep infiltrating endometriosis (DIE) at level of rectovaginal septum (n = 9) and rectosigmoid involvement (n = 6) or both (n = 5) who underwent to 3DTVS (using a longitudinal plane of scanning) prior surgery were evaluated by consensus of two examiners to try to define the best plane, region of interest (ROI) orientation, and approaching for 3D rendering for each kind of lesion. We also evaluated the level of difficulty for the assessment. For cases of rectosigmoid lesion, 100% of cases could be analyzed. For rectovaginal localization, 30% of cases were difficult. For these lesions the best plane was plane B with ROI line on the left aspect of the 3D box and the green line curved into the centre of lesion. Typically these lesions appears as small irregular nodule. For rectosigmoid lesions, the best approach was obtained using plane A with ROI line in the upper aspect of the 3D box and the green line curved into the lesion. The same approach was found to be the best in cases with lesions present in both locations. On the 3D rendering rectosigmoid lesions typically appear as spiculated lesions (‘toy windmill’ appearance) with retracting line all around the nodule . For the first time we presented a consensus achieved approach for 3D rendering evaluation of DIE. We believe that this approach may be helpful for further prospective studies. This study has been supported by Fondazione Banco di Sardegna and performed under the auspices of Visiting Professor Program of University of Cagliari.