Anogenital distance on MRI does not correlate to surgical diagnosis of endometriosis in patients without prior abdominal surgery

Harth, Sebastian, Metze, Lena, Leufkens, Daniel, Roller, Fritz C., Brose, Alexander, Zeppernick, Felix, Meinhold-Heerlein, Ivo, Krombach, Gabriele A., Justus Liebig University Giessen
2024 · doi:10.22029/jlupub-19746 · W6963825989
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Anogenital distance measured on MRI did not correlate with surgical endometriosis diagnosis and is not a valuable biomarker for patients with suspected endometriosis.

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This study evaluated whether anogenital distance (AGD) measured on MRI can predict surgical diagnosis of endometriosis, focusing on 127 patients who underwent MRI for suspected endometriosis without prior abdominal surgery. Two readers measured AGD using two MRI-based definitions (clitoris-to-anus and posterior fourchette-to-anus), and the authors assessed feasibility, interobserver reliability, and differences between patients with and without surgical diagnoses including deep infiltrating endometriosis, peritoneal endometriosis, and ovarian endometriosis. Reliability was good to excellent for one measurement (intraclass correlation 0.92) but poor to good for the other (0.68), and there were no statistically significant AGD differences by endometriosis surgical status across the evaluated subtypes. The area under the curve values were near chance, and the authors conclude that MRI-based AGD is not a valuable biomarker for clinically suspected endometriosis; This paper is centrally about endometriosis — it tests whether MRI anogenital distance predicts surgical endometriosis diagnosis in patients without prior abdominal surgery.

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Abstract

Anogenital distance (AGD) is regarded as a potential biomarker for endometriosis, and a measurement on MRI images has been found to be promising. This study aimed to evaluate the measurement of AGD on MRI to predict the surgical diagnosis of endometriosis. We included 127 patients who received an MRI for endometriosis between October 2018 and February 2023. AGD was measured on MRI by two readers (MRI-AGD-AC: clitoris to anus; MRI-AGD-AF: posterior fourchette to anus). The feasibility and interobserver reliability of AGD measurements were evaluated. Differences in AGD between patient groups were analyzed. The intraclass correlation coefficient estimates indicated a good to excellent reliability of MRI-AGD-AC (0.92; 95% CI: 0.83–0.95) and a poor to good reliability of MRI-AGD-AF (0.68; 95% CI: 0.27–0.83). No statistically significant differences in the mean MRI-AGD-AC and MRI-AGD-AF in patients with and without surgical diagnosis of DIE (p = 0.413; p = 0.110), peritoneal endometriosis with and without DIE (p = 0.641; p = 0.323), and ovarian endometriosis (p = 0.155; p = 0.150) were found. The AUC ranged from 0.475 (95% CI: 0.365–0.584) to 0.586 (95% CI: 0.454–0.718). Thus, AGD does not constitute a valuable biomarker for patients with clinically suspected endometriosis.
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Anogenital distance on MRI does not correlate to surgical diagnosis of endometriosis in patients without prior abdominal surgery Loading... Date Advisors/Reviewers Further Contributors Contributing Institutions Publisher Journal Title Journal ISSN Volume Title Publisher License Quotable link DOI: https://doi.org/10.22029/jlupub-19746Abstract Anogenital distance (AGD) is regarded as a potential biomarker for endometriosis, and a measurement on MRI images has been found to be promising. This study aimed to evaluate the measurement of AGD on MRI to predict the surgical diagnosis of endometriosis. We included 127 patients who received an MRI for endometriosis between October 2018 and February 2023. AGD was measured on MRI by two readers (MRI-AGD-AC: clitoris to anus; MRI-AGD-AF: posterior fourchette to anus). The feasibility and interobserver reliability of AGD measurements were evaluated. Differences in AGD between patient groups were analyzed. The intraclass correlation coefficient estimates indicated a good to excellent reliability of MRI-AGD-AC (0.92; 95% CI: 0.83–0.95) and a poor to good reliability of MRI-AGD-AF (0.68; 95% CI: 0.27–0.83). No statistically significant differences in the mean MRI-AGD-AC and MRI-AGD-AF in patients with and without surgical diagnosis of DIE (p = 0.413; p = 0.110), peritoneal endometriosis with and without DIE (p = 0.641; p = 0.323), and ovarian endometriosis (p = 0.155; p = 0.150) were found. The AUC ranged from 0.475 (95% CI: 0.365–0.584) to 0.586 (95% CI: 0.454–0.718). Thus, AGD does not constitute a valuable biomarker for patients with clinically suspected endometriosis.Link to publications or other datasets Description Notes Original publication in Scientific reports 14 (2024), 1 - 11, 30507

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