Diagnostic accuracy of clinically reported adenomyosis on pelvic ultrasound and MRI compared to surgical pathology

Zanolli NC, Nicole Zanolli, Nicole C Zanolli, B. Cline, Brendan C Cline, Cline BC, Nicholas T. Befera, Befera NT, Jonathan G Martin, J. Martín
Clinical imaging · 2021 · vol. 82 , pp. 117–120 · doi:10.1016/j.clinimag.2021.11.012 · PMID:34808582 · W3216147833
Diagnostic accuracy OA: closed CC0 ⤵ 5 in-corpus citations
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This study compared the diagnostic accuracy of pelvic ultrasound and MRI for adenomyosis against surgical pathology findings.

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Abstract

BACKGROUND: Adenomyosis is a common gynecologic pathology that relies on diagnostic imaging to guide treatment. Accuracy of both pelvic ultrasound and magnetic resonance imaging (MRI) when specifically evaluating for the presence of adenomyosis is high. However, the accuracy of reported rates in clinical practice is less well understood. PURPOSE: To demonstrate the accuracy in reporting of adenomyosis on pelvic ultrasound and MRI compared to histopathology in common clinical practice. BASIC PROCEDURES: An institutional database was searched for women with a pelvic ultrasound and a pelvic MRI with a subsequent hysterectomy. Findings were extracted from radiology and pathology reports, and the documented presence or absence of adenomyosis was recorded for each modality. Blinded radiologists viewed each imaging pair to directly evaluate for adenomyosis. MAIN FINDINGS: Compared to prior published data, imaging had lower accuracy in clinical practice when adenomyosis was not specifically evaluated for. For the finding of adenomyosis, pelvic ultrasound had a sensitivity of 10.9%, a specificity of 98.3%, positive predictive value (PPV) of 77.8%, negative predictive value (NPV) of 66.7%, an accuracy of 67.2%, and a diagnostic odds ratio (DOR) of 7. Pelvic MRI had a sensitivity of 29.7%, specificity of 85.3%, PPV of 52.8%, NPV of 68.8%, an accuracy of 65.6%, and DOR of 2.5. Overall accuracy of MRI improved when adenomyosis was directly evaluated for (82.4% vs 65.6%). PRINCIPLE CONCLUSIONS: Without direct communication to evaluate for adenomyosis, pelvic ultrasound and MRI may underestimate or misreport adenomyosis. Providers should be aware of these discrepancies when relying on radiology reports to guide treatment and potential interventions when diagnosing and managing adenomyosis.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Endometriosis Endometriosis Endometriosis Endometriosis Pathology, Surgical Pathology, Surgical Female Female Humans Humans Magnetic Resonance Imaging Magnetic Resonance Imaging Sensitivity and Specificity Sensitivity and Specificity Ultrasonography Ultrasonography

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (23)

Cited by (7)

Source provenance

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License: CC0 · commercial use OK