MRI for the diagnosis and staging of deeply infiltrating endometriosis: a national survey of BSGE accredited endometriosis centres and review of the literature

Marianne Wild, Shikha Pandhi, Pandhi S, John Rendle, Rendle J, Swift I, Ian Swift, Ofuasia E, Emmanuel Ofuasia
The British journal of radiology · 2020 · vol. 93(1114) , pp. 20200690 · doi:10.1259/bjr.20200690 · PMID:32706984 · PMC7548358 · W3044481592
Review OA: bronze CC0 ⤵ 6 in-corpus citations
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A survey of BSGE accredited endometriosis centers revealed significant inconsistencies in MRI protocols, patient preparation, and imaging sequences used for deeply infiltrating endometriosis.

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Abstract

OBJECTIVES: Our objective was to establish the primary mode of imaging and MR protocols utilised in the preoperative staging of deeply infiltrating endometriosis in centres accredited by the British Society of Gynaecological Endoscopy (BSGE). METHODS: The lead consultant radiologist in each centre was invited to complete an online survey detailing their protocols. RESULTS: Out of 49 centres, 32 (65%) responded to the survey. Two centres performed transvaginal ultrasound as the primary method for preoperative staging of deeply infiltrating endometriosis and the remainder performed MRI. 21/25 centres did not recommend a period of fasting prior to MRI and 22/25 administered hyoscine butylbromide. None of the centres routinely offered bowel preparation or recommended a specific pre-procedure diet. 21/25 centres did not time imaging according to the woman's menstrual cycle, and instructions regarding bladder filling were varied. Rectal and vaginal opacification methods were infrequently utilised. All centres preferentially performed MRI in the supine position - six used an abdominal strap and four could facilitate prone imaging. Just under half of centres used pelvic-phased array coils and three centres used gadolinium contrast agents routinely. All centres performed T1W with fat-suppression and T2W without fat-suppression sequences. There was significant variation relating to other MR sequences depending on the unit. CONCLUSIONS: There was significant inconsistency between centres in terms of MR protocols, patient preparation and the sequences performed. Many practices were out of line with current published evidence. ADVANCES IN KNOWLEDGE: Our survey demonstrates a need for evidence-based standardisation of imaging in BSGE accredited endometriosis centres.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Magnetic Resonance Imaging Clinical Protocols Clinical Protocols Contrast Media Contrast Media Endometriosis Endometriosis Endometriosis Female Female Humans Humans Magnetic Resonance Imaging Magnetic Resonance Imaging

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 ]

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