Dataset Information

Transvaginal Ultrasound for Endometrial Carcinoma Screening - Current Evidence-based Data.

ABSTRACT: The value of transvaginal ultrasound in gynaecological examinations is beyond dispute. But it is of particular forensic importance that the validity of this type of imaging with regard to the reliable detection of early-stage malignancy is properly understood. Vaginal ultrasound screening in asymptomatic patients for the early detection of endometrial carcinoma is not useful from a medical point of view, nor is it cost-efficient. However, even though the validity of transvaginal ultrasound for screening has currently not been proven, the method should still be an integral part of gynaecological examinations.

SUBMITTER: Steiner E

PROVIDER: S-EPMC4168340 | biostudies-other | 2012 Dec

REPOSITORIES: biostudies-other

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Transvaginal Ultrasound for Endometrial Carcinoma Screening - Current Evidence-based Data.

Steiner E E Juhasz-Bösz I I Emons G G Kölbl H H Kimmig R R Mallmann P P

Geburtshilfe und Frauenheilkunde 20121201 12

The value of transvaginal ultrasound in gynaecological examinations is beyond dispute. But it is of particular forensic importance that the validity of this type of imaging with regard to the reliable detection of early-stage malignancy is properly understood. Vaginal ultrasound screening in asymptomatic patients for the early detection of endometrial carcinoma is not useful from a medical point of view, nor is it cost-efficient. However, even though the validity of transvaginal ultrasound for s ...[more]

PMID: 25278620

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Project description:Objectives: Endometrial peristalsis (EP) in non-pregnant uterine can be assessed by visual assessment of transvaginal ultrasound (TVUS). However, visual assessment is subjective, and the outcome depends on the sonographers and video analysts. This study aimed to create a newly developed automatic analysis algorithm for measuring the EP compared to visual assessment. Methods: A retrospective analysis was performed using the datasets from in vitro fertilization and embryo transfer (IVF-ET), who underwent the evaluation of EP by TVUS within 5 days prior to transplantation. 158 cine TVUS images were used to develop the automated analysis algorithm, and 37 cine TVUS images were evaluated by both visual and automated analysis algorithms. The algorithm was developed by applying the optical flow technology and enabled objective analysis of the number, direction, and intensity of EP. Results: The number of peristaltic waves counted by visual assessment was 4.2 ± 2.3 (mean ± standard deviation) and 4.1 ± 2.1 for doctors one and two, respectively. The number of waves counted with the algorithm was 3.6 ± 2.1 at first evaluation and 3.7 ± 2.0 at repeated evaluation. A significant difference was found between the algorithm count and visual assessment (p = 0.001, 0.002, 0.003, 0.008). The ICC values for algorithm versus manuals ranged from 0.84 to 0.96 and 0.87 to 0.96. The numbers of the cervix-to-fundus (CF), fundus-to-cervix (FC), and both cervix-to-fundal and fundus-to-cervix (CF + FC) directions of EP counted by the algorithm were 50, 52, and 32, respectively. The numbers counted by visual assessment were 43, 45, and 46, respectively. The number of EP was the same in 87% of the two algorithm counts. The number was lower between the algorithm and visual analysis (79% with complete agreement). The EP intensity assessed by the algorithm was 2.6 ± 1.1, and the peristalsis velocity was 0.147 (0.07) mm/s. Conclusion: The fully automated analysis algorithm can be used to quantify uterine peristalsis comparable to visual assessment.

Project description:BackgroundEndometrial thickness is an essential factor affecting female fertility. Clinically, ultrasound imaging is the first choice for the examination of uterine and endometrial-related diseases. However, the boundary of some endometrial is challenging to distinguish due to the effects of image resolution and noise. In addition, the irregular shape of the endometrium makes it more difficult for doctors to measure its thickness. Through the automatic segmentation and extraction of the endometrium, the maximum thickness of the endometrium can be measured automatically and accurately. This provides a quantitative index for doctors to use diagnostically.MethodsIn this study, 85 cases of three-dimensional transvaginal ultrasound (3D TVUS) images were collected retrospectively, including 75 cases of endometrial adhesion and 10 cases of non-adhesion. Firstly, the ultrasound images were filtered by block-matching and 3D filtering and speckle reducing anisotropic diffusion (SRAD). These two kinds of filtered images were combined with the original image to construct a three-channel image. Then, the augmented images were sent to 3D U-Net to realize endometrium segmentation. The performance of the segmentation models was evaluated using the Dice similarity coefficient (DSC), Jaccard, sensitivity, and 95th percentile Hausdorff distance (HD95). Finally, the medial axis transform was used to extract the endometrial centerline, based on which the endometrial thickness could be automatically measured.ResultsThe endometrium segmentation method proposed in this paper achieved 90.83% in Dice, 83.35% in Jaccard, 90.85% in sensitivity, and 12.75 mm in HD95 in the testing set. Taking the doctor's manual measurement as the gold standard, 94.20% of the automatic endometrial thickness measurements based on the segmentation results were within the allowable error range of clinical diagnosis.ConclusionsThis paper presents an automatic endometrium segmentation and thickness measurement method for 3D TVUS images. The experimental results show that this method has high segmentation accuracy to recognize endometrial adhesion images. Furthermore, the thickness measurement based on the segmentation results has high reliability and repeatability, and the accuracy can meet clinical diagnosis needs.

Project description:High-grade serous ovarian cancer (HGSOC) represents the majority of ovarian cancers and accounts for the largest proportion of deaths from the disease. A timely detection of low volume HGSOC should be the goal of any screening studies. However, numerous transvaginal ultrasound (TVU) detection-based population studies aimed at detecting low-volume disease have not yielded reduced mortality rates. A quantitative invalidation of TVU as an effective HGSOC screening strategy is a necessary next step. Herein, we propose a mathematical model for a quantitative explanation on the reported failure of TVU-based screening to improve HGSOC low-volume detectability and overall survival.We develop a novel in silico mathematical assessment of the efficacy of a unimodal TVU monitoring regimen as a strategy aimed at detecting low-volume HGSOC in cancer-positive cases, defined as cases for which the inception of the first malignant cell has already occurred. Our findings show that the median window of opportunity interval length for TVU monitoring and HGSOC detection is approximately 1.76 years. This does not translate into reduced mortality levels or improved detection accuracy in an in silico cohort across multiple TVU monitoring frequencies or detection sensitivities. We demonstrate that even a semiannual, unimodal TVU monitoring protocol is expected to miss detectable HGSOC. Lastly, we find that circa 50% of the simulated HGSOC growth curves never reach the baseline detectability threshold, and that on average, 5-7 infrequent, rate-limiting stochastic changes in the growth parameters are associated with reaching HGSOC detectability and mortality thresholds respectively. Focusing on a malignancy poorly studied in the mathematical oncology community, our model captures the dynamic, temporal evolution of HGSOC progression. Our mathematical model is consistent with recent case reports and prospective TVU screening population studies, and provides support to the empirical recommendation against frequent HGSOC screening.

Dataset Information

Transvaginal Ultrasound for Endometrial Carcinoma Screening - Current Evidence-based Data.

Publications

Transvaginal Ultrasound for Endometrial Carcinoma Screening - Current Evidence-based Data.

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