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Reproducibility of assessment of severity of pelvic endometriosis using transvaginal ultrasound.
Ultrasound Obstet Gynecol 2013; 41(2):210-5UO

Abstract

OBJECTIVE

To examine the reproducibility of assessment of severity of pelvic endometriosis by transvaginal sonography (TVS).

METHODS

This was a prospective observational study conducted from August 2006 to July 2009 in two academic departments of obstetrics and gynecology. Women with clinically suspected or proven pelvic endometriosis were invited to join the study. All patients included underwent TVS performed by two observers and a laparoscopic assessment of pelvic endometriosis. The ultrasound observers were blinded to each other's results. The reproducibility of TVS was examined by evaluation of interobserver agreement for the American Society of Reproductive Medicine (ASRM) score by Bland-Altman analysis and the stage and the diagnosis of deeply infiltrating endometriosis (DIE) by calculation of kappa coefficients. Agreement between the findings on TVS for each observer and those on laparoscopy was also evaluated.

RESULTS

Thirty-four patients were recruited to the study, and TVS was performed by two ultrasound observers. Of these patients, one did not undergo laparoscopy and was therefore excluded from the final analysis. No endometriosis was found in 12 (36.4%) patients. One patient (3%) had minimal disease, one (3%) had mild disease, five (15.2%) had moderate disease and 14 (42.4%) had severe disease. Interobserver agreement was very good for disease classification on TVS (Cohen's kappa, 0.931). Agreement between TVS and laparoscopy findings was also very good (Cohen's kappa, 0.955 and 0.966 for the two examiners). For ASRM score on TVS, the interobserver 95% limits of agreement were -16.6 to 12.7, with a mean difference of -1.9 (95% CI, -4.35 to 0.71).

CONCLUSION

TVS is a reproducible method for assessment of the severity of pelvic endometriosis and shows good agreement with findings on laparoscopy.

Authors+Show Affiliations

Early Pregnancy and Gynaecology Assessment Unit, Department of Obstetrics and Gynaecology, King's College Hospital, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Studies
Journal Article
Multicenter Study

Language

eng

PubMed ID

22745055

Citation

Holland, T K., et al. "Reproducibility of Assessment of Severity of Pelvic Endometriosis Using Transvaginal Ultrasound." Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, vol. 41, no. 2, 2013, pp. 210-5.
Holland TK, Hoo WL, Mavrelos D, et al. Reproducibility of assessment of severity of pelvic endometriosis using transvaginal ultrasound. Ultrasound Obstet Gynecol. 2013;41(2):210-5.
Holland, T. K., Hoo, W. L., Mavrelos, D., Saridogan, E., Cutner, A., & Jurkovic, D. (2013). Reproducibility of assessment of severity of pelvic endometriosis using transvaginal ultrasound. Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 41(2), pp. 210-5. doi:10.1002/uog.11216.
Holland TK, et al. Reproducibility of Assessment of Severity of Pelvic Endometriosis Using Transvaginal Ultrasound. Ultrasound Obstet Gynecol. 2013;41(2):210-5. PubMed PMID: 22745055.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reproducibility of assessment of severity of pelvic endometriosis using transvaginal ultrasound. AU - Holland,T K, AU - Hoo,W L, AU - Mavrelos,D, AU - Saridogan,E, AU - Cutner,A, AU - Jurkovic,D, PY - 2012/06/18/accepted PY - 2012/6/30/entrez PY - 2012/6/30/pubmed PY - 2013/7/13/medline SP - 210 EP - 5 JF - Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology JO - Ultrasound Obstet Gynecol VL - 41 IS - 2 N2 - OBJECTIVE: To examine the reproducibility of assessment of severity of pelvic endometriosis by transvaginal sonography (TVS). METHODS: This was a prospective observational study conducted from August 2006 to July 2009 in two academic departments of obstetrics and gynecology. Women with clinically suspected or proven pelvic endometriosis were invited to join the study. All patients included underwent TVS performed by two observers and a laparoscopic assessment of pelvic endometriosis. The ultrasound observers were blinded to each other's results. The reproducibility of TVS was examined by evaluation of interobserver agreement for the American Society of Reproductive Medicine (ASRM) score by Bland-Altman analysis and the stage and the diagnosis of deeply infiltrating endometriosis (DIE) by calculation of kappa coefficients. Agreement between the findings on TVS for each observer and those on laparoscopy was also evaluated. RESULTS: Thirty-four patients were recruited to the study, and TVS was performed by two ultrasound observers. Of these patients, one did not undergo laparoscopy and was therefore excluded from the final analysis. No endometriosis was found in 12 (36.4%) patients. One patient (3%) had minimal disease, one (3%) had mild disease, five (15.2%) had moderate disease and 14 (42.4%) had severe disease. Interobserver agreement was very good for disease classification on TVS (Cohen's kappa, 0.931). Agreement between TVS and laparoscopy findings was also very good (Cohen's kappa, 0.955 and 0.966 for the two examiners). For ASRM score on TVS, the interobserver 95% limits of agreement were -16.6 to 12.7, with a mean difference of -1.9 (95% CI, -4.35 to 0.71). CONCLUSION: TVS is a reproducible method for assessment of the severity of pelvic endometriosis and shows good agreement with findings on laparoscopy. SN - 1469-0705 UR - https://www.unboundmedicine.com/medline/citation/22745055/Reproducibility_of_assessment_of_severity_of_pelvic_endometriosis_using_transvaginal_ultrasound_ L2 - https://doi.org/10.1002/uog.11216 DB - PRIME DP - Unbound Medicine ER -