VP62.25: Endometriomas on routine pelvic ultrasound predict need for magnetic resonance imaging for deep infiltrating endometriosis

In this IRB approved, HIPAA compliant study, radiology database was queried for MRI exams dedicated for endometriosis evaluation over a 3-year period (2016–2019). Images were reviewed for endometriomas and DIE on MRI. For the patients with endometriomas, records were reviewed for concurrent routine US. These US exams were not tailored to DIE protocols. US images were reviewed for the presence of endometriomas and, if present, the total number, laterality and largest dimension of each. Descriptive statistics and receiver operating curve (ROC) analysis were performed. Pathology and surgical notes were used as reference standard. 253 patients underwent MRI for DIE over three years. 82/253 patients had endometriomas on MRI. 47/82 (57.3%) of patients had a concurrent US. 33/47 (70.2%) had endometriomas seen on US (size range 0.9–7.0cm). 12 had bilateral endometriomas and 13 had multiple (more than 1) endometriomas. 27/33 (82%) of these patients had DIE on MRI. When endometriomas more than 3cm were taken into consideration, 19/21 (90%) of patients had DIE on MRI. AUC was 0.7106. Using ROC anaylsis, a threshold of 3.8cm, provided a sensitivity of 71% and specificity of 78% for detection of DIE on MRI. When using a threshold diameter of 3cm and larger on US, 92% patients had DIE on MRI and surgery. Endometriomas >3cm in diameter encountered on routine pelvic US can be a used to obtain MRI for DIE evaluation, particularly in the setting of chronic pelvic pain and suspected endometriosis. Supporting information can be found in the online version of this abstract Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.