Marianne Wild1,2, Shikha Pandhi3, John Rendle3, Ian Swift4, Emmanuel Ofuasia1. 1. Department of Obstetrics and Gynaecology, Croydon University Hospital Endometriosis Centre 530 London Road , Croydon CR7 7YE, United Kingdom. 2. Department of Obstetrics and Gynaecology, Homerton University Hospital Endometriosis Centre Homerton Row , London E9 6DY, United Kingdom. 3. Department of Radiology, Croydon University Hospital Endometriosis Centre 530 London Road, Croydon CR7 7YE, United Kingdom. 4. Department of Colorectal Surgery, Croydon University Hospital Endometriosis Centre 530 London Road , Croydon CR7 7YE, United Kingdom.
Abstract
OBJECTIVES: Our objective was to establish the primary mode of imaging and MR protocols utilised in the preoperative staging of deeply infiltrating endometriosis in centres accredited by the British Society of Gynaecological Endoscopy (BSGE). METHODS: The lead consultant radiologist in each centre was invited to complete an online survey detailing their protocols. RESULTS: Out of 49 centres, 32 (65%) responded to the survey. Two centres performed transvaginal ultrasound as the primary method for preoperative staging of deeply infiltrating endometriosis and the remainder performed MRI. 21/25 centres did not recommend a period of fasting prior to MRI and 22/25 administered hyoscine butylbromide. None of the centres routinely offered bowel preparation or recommended a specific pre-procedure diet. 21/25 centres did not time imaging according to the woman's menstrual cycle, and instructions regarding bladder filling were varied. Rectal and vaginal opacification methods were infrequently utilised. All centres preferentially performed MRI in the supine position - six used an abdominal strap and four could facilitate prone imaging. Just under half of centres used pelvic-phased array coils and three centres used gadolinium contrast agents routinely. All centres performed T1W with fat-suppression and T2W without fat-suppression sequences. There was significant variation relating to other MR sequences depending on the unit. CONCLUSIONS: There was significant inconsistency between centres in terms of MR protocols, patient preparation and the sequences performed. Many practices were out of line with current published evidence. ADVANCES IN KNOWLEDGE: Our survey demonstrates a need for evidence-based standardisation of imaging in BSGE accredited endometriosis centres.
OBJECTIVES: Our objective was to establish the primary mode of imaging and MR protocols utilised in the preoperative staging of deeply infiltrating endometriosis in centres accredited by the British Society of Gynaecological Endoscopy (BSGE). METHODS: The lead consultant radiologist in each centre was invited to complete an online survey detailing their protocols. RESULTS: Out of 49 centres, 32 (65%) responded to the survey. Two centres performed transvaginal ultrasound as the primary method for preoperative staging of deeply infiltrating endometriosis and the remainder performed MRI. 21/25 centres did not recommend a period of fasting prior to MRI and 22/25 administered hyoscine butylbromide. None of the centres routinely offered bowel preparation or recommended a specific pre-procedure diet. 21/25 centres did not time imaging according to the woman's menstrual cycle, and instructions regarding bladder filling were varied. Rectal and vaginal opacification methods were infrequently utilised. All centres preferentially performed MRI in the supine position - six used an abdominal strap and four could facilitate prone imaging. Just under half of centres used pelvic-phased array coils and three centres used gadolinium contrast agents routinely. All centres performed T1W with fat-suppression and T2W without fat-suppression sequences. There was significant variation relating to other MR sequences depending on the unit. CONCLUSIONS: There was significant inconsistency between centres in terms of MR protocols, patient preparation and the sequences performed. Many practices were out of line with current published evidence. ADVANCES IN KNOWLEDGE: Our survey demonstrates a need for evidence-based standardisation of imaging in BSGE accredited endometriosis centres.
Authors: M Bazot; N Bharwani; C Huchon; K Kinkel; T M Cunha; A Guerra; L Manganaro; L Buñesch; A Kido; K Togashi; I Thomassin-Naggara; A G Rockall Journal: Eur Radiol Date: 2016-12-05 Impact factor: 5.315