Recommendations of experts on transvaginal ultrasonography

Transvaginal ultrasonography is the most valuable non-invasive clinical step in endometriosis

Key Points

Highlights :

• As a widely accepted first-line step in clinical investigations of pelvic pain and infertility, transvaginal sonography is also utilized in the management of endometriosis.

Importance :

• Preoperative transvaginal sonography provides appropriate patient counseling and surgical planning, besides delineating the need for additional surgical expertise.

What's done here :

• This manuscript summarizes the recommendations of sixteen experts from The Society of Radiologists in Ultrasound following their panel on imaging and management of endometriosis.
• Following a structured review of electronic databases, panel members completed a survey to gather expert opinions to augment this analysis.

Main key feature :

• Transvaginal ultrasound of the posterior compartment and observation of the relative anatomy of the uterus and ovaries, along with the uterine sliding sign maneuver improves the detection of endometriosis and are highly recommended.

Limitations of recommendations :

• Validation studies are necessary to prove the accuracy of augmented pelvic ultrasound in widespread clinical applications.

Lay Summary

Following June 2022, the Society of Radiologists in Ultrasound composed of a panel of 16 experts in imaging and management of endometriosis, the recommendations have been published in a recent issue of Radiology.

Transvaginal sonography is accepted as a first-line clinical step for pelvic pain and infertility besides being a second-line modality for preoperative visualization of endometriomas and deep endometriosis management. There is immense published literature describing the techniques on endometriosis, the Society of Radiologists in Ultrasound had a multidisciplinary panel of experts for recommendations for improving this non-invasive diagnostic modality. The panelists were experts in the imaging and the management of endometriosis, namely radiologists, sonographers, gynecologists, reproductive endocrinologists, and gynecologic surgeons.

An electronic database search was made to obtain the following information regarding the use of pelvic US in detecting endometriosis: sensitivities and specificities for detection in various locations, technique descriptions, and examples of direct observations in PubMed for literature published from January 1994 to December 2022. The panel has recommended reporting and follow-up of endometriosis based on the literature review and expert consensus in the instance of limited or no data, which pertains predominantly to indirect observations and endometriosis-associated observations.

The panel of experts emphasizes that transvaginal ultrasound of the posterior compartment along with observation of the relative structure of the uterus and ovaries, and the uterine sliding sign maneuver to improve the detection of endometriosis are valuable for endometriosis detection. However, it is well-accepted that validation studies are necessary to prove the accuracy of augmented pelvic ultrasound in widespread clinical applications.

Research Source: https://pubmed.ncbi.nlm.nih.gov/38591980/