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Reasons why it is time to change imaging guidelines on endometriosis

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Abstract

In light of the rising number of patients referred for magnetic resonance imaging (MRI) due to suspected endometriosis and the high expectations of these patients, there is a need for new imaging guidelines to optimally protocol and indicate MRI and transvaginal ultrasonography (TVUS) examinations. This is crucial for accurately addressing the inquiries of gynecologists, encompassing complete mapping and preoperative staging, and facilitating effective communication with patients. In this context, the development of a standardized lexicon, as well as dedicated imaging classifications, is recommended to aid in the comprehensive management of patients.

Clinical relevance statement

The radiologist should use a standardized lexicon and provide a score along with details about the specific compartments affected by endometriosis disease. This helps in offering clearer guidance to the surgeon.

Key Points

• An optimal staging is based on the combination of clinical examination, transvaginal US, and MRI.

• MRI is able to detect location that is hidden at the beginning of a laparoscopic surgery and thus the need for dedicated MR classifications to correctly stage the disease.

• Deep pelvic endometriosis index (dPEI) classification is externally validated and highly correlated with operating time, hospital stay, and postoperative complications.

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Abbreviations

DPE:

Deep pelvic endometriosis

dPEI:

Deep Pelvic Endometriosis Index

ESUR:

European Society of UroRadiology

MRI:

Magnetic resonance imaging

PE:

Physical examination

SAR:

Society of Abdominal Radiology

SIFEM:

Société d’Imagerie de la Femme

TVUS:

Transvaginal ultrasonography

USL:

Uterosacral ligament

References

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology Imaging and Interventional Radiology (IRIS), Service IRIS, Tenon Hospital, APHP, Sorbonne University, 4 rue de la Chine, 75020, Paris, France

    Isabelle Thomassin-Naggara & Leo Razakamanantsoa

  2. Saint-Antoine Research Cancer Center, Sorbonne University, INSERM UMR S 938, 75012, Paris, France

    Isabelle Thomassin-Naggara, Cyril Touboul & Leo Razakamanantsoa

  3. Hospices Civils de Lyon, Lyon, France

    Pascal Rousset

  4. APHP, Sorbonne University, Department of Gynaecological Surgery, Obstetrics and Reproductive Medicine, Tenon Hospital, Paris, France

    Cyril Touboul

  5. Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I Hospital, University Spienza, Rome, Italia

    Lucia Manganaro

Authors
  1. Isabelle Thomassin-Naggara
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  2. Pascal Rousset
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  3. Cyril Touboul
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  4. Leo Razakamanantsoa
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  5. Lucia Manganaro
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Corresponding author

Correspondence to Isabelle Thomassin-Naggara.

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Guarantor

The scientific guarantor of this publication is Isabelle Thomassin-Naggara.

Conflict of interest

I. Thomassin-Naggara declares remunerated lectures by General Electric, Siemens, Canon, Guerbet, Fuji, incepto, iCAD, GSK, and punctual board participation with Guerbet, Bayer, Bracco, Bard.

No conflict of interest directly related to the article.

The remaining authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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Thomassin-Naggara, I., Rousset, P., Touboul, C. et al. Reasons why it is time to change imaging guidelines on endometriosis. Eur Radiol 34, 6175–6181 (2024). https://doi.org/10.1007/s00330-024-10595-w

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  • DOI: https://doi.org/10.1007/s00330-024-10595-w

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