Myoma Imaging by Gynecologic Surgeons Training in Intraoperative Ultrasound Technique

Rachel E. Bent, Machelle D. Wilson, Vanessa L. Jacoby, Shira Varon, Ram Parvataneni, Naghmeh Saberi, L Elaine Waetjen

Research output: Contribution to journalArticle

Abstract

Study Objective: To compare preoperative transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) with intraoperative ultrasound (IOUS) in surgeons first learning to use this technique. Design: A prospective study of IOUS accuracy for mapping the size and location of myomas compared with TVUS or MRI (Canadian Task Force classification II-2). Setting: Five University of California academic centers (Davis, Irvine, Los Angeles, San Diego, and San Francisco). Patients: Twenty-six premenopausal women seeking uterine-sparing surgical treatment of myomas. Eligible participants could have no more than 6 myomas ≥2 cm and <10 cm and a uterine size no larger than 16 weeks by pelvic examination. Interventions: Measurement of myomas by IOUS followed by radiofrequency ablation (RFA) of fibroids. Measurements and Main Results: Eligible participants had to have imaging with TVUS or MRI within the last year to assess myoma characteristics. During the RFA operation, surgeons who had undergone a 1-day training on RFA and IOUS measured all myomas visualized with IOUS. Surgeons measured more myomas than were reported on MRI (12 on MRI and 16 on IOUS) or TVUS (41 on TVUS and 62 on IOUS) in all positions (anterior, posterior, lateral, and fundal). In particular, they identified more myomas <2 cm (4 on MRI, 9 on IOUS, 1 on TVUS, and 19 on IOUS). They located 2.3 times as many myomas in the anterior position as TVUS. For the myomas ≥2 cm identified by IOUS and MRI or IOUS and TVUS, there was no statistically significant difference in the mean myoma number or the mean myoma diameter measurements. Conclusion: Surgeons first learning to use IOUS detect the same number of myomas ≥2 cm as identified by TVUS and MRI and find a greater number of myomas <2 cm on IOUS compared with radiologist-reported TVUS.

Original languageEnglish (US)
JournalJournal of Minimally Invasive Gynecology
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Fingerprint

Myoma
Magnetic Resonance Imaging
Surgeons
Learning
Gynecological Examination
San Francisco
Los Angeles
Leiomyoma
Advisory Committees

Keywords

  • Intra-abdominal ultrasound
  • Intraoperative ultrasound
  • Leiomyoma
  • Myoma
  • Transvaginal ultrasound

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Myoma Imaging by Gynecologic Surgeons Training in Intraoperative Ultrasound Technique. / Bent, Rachel E.; Wilson, Machelle D.; Jacoby, Vanessa L.; Varon, Shira; Parvataneni, Ram; Saberi, Naghmeh; Waetjen, L Elaine.

In: Journal of Minimally Invasive Gynecology, 01.01.2018.

Research output: Contribution to journalArticle

Bent, Rachel E. ; Wilson, Machelle D. ; Jacoby, Vanessa L. ; Varon, Shira ; Parvataneni, Ram ; Saberi, Naghmeh ; Waetjen, L Elaine. / Myoma Imaging by Gynecologic Surgeons Training in Intraoperative Ultrasound Technique. In: Journal of Minimally Invasive Gynecology. 2018.
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abstract = "Study Objective: To compare preoperative transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) with intraoperative ultrasound (IOUS) in surgeons first learning to use this technique. Design: A prospective study of IOUS accuracy for mapping the size and location of myomas compared with TVUS or MRI (Canadian Task Force classification II-2). Setting: Five University of California academic centers (Davis, Irvine, Los Angeles, San Diego, and San Francisco). Patients: Twenty-six premenopausal women seeking uterine-sparing surgical treatment of myomas. Eligible participants could have no more than 6 myomas ≥2 cm and <10 cm and a uterine size no larger than 16 weeks by pelvic examination. Interventions: Measurement of myomas by IOUS followed by radiofrequency ablation (RFA) of fibroids. Measurements and Main Results: Eligible participants had to have imaging with TVUS or MRI within the last year to assess myoma characteristics. During the RFA operation, surgeons who had undergone a 1-day training on RFA and IOUS measured all myomas visualized with IOUS. Surgeons measured more myomas than were reported on MRI (12 on MRI and 16 on IOUS) or TVUS (41 on TVUS and 62 on IOUS) in all positions (anterior, posterior, lateral, and fundal). In particular, they identified more myomas <2 cm (4 on MRI, 9 on IOUS, 1 on TVUS, and 19 on IOUS). They located 2.3 times as many myomas in the anterior position as TVUS. For the myomas ≥2 cm identified by IOUS and MRI or IOUS and TVUS, there was no statistically significant difference in the mean myoma number or the mean myoma diameter measurements. Conclusion: Surgeons first learning to use IOUS detect the same number of myomas ≥2 cm as identified by TVUS and MRI and find a greater number of myomas <2 cm on IOUS compared with radiologist-reported TVUS.",
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AU - Bent, Rachel E.

AU - Wilson, Machelle D.

AU - Jacoby, Vanessa L.

AU - Varon, Shira

AU - Parvataneni, Ram

AU - Saberi, Naghmeh

AU - Waetjen, L Elaine

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N2 - Study Objective: To compare preoperative transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) with intraoperative ultrasound (IOUS) in surgeons first learning to use this technique. Design: A prospective study of IOUS accuracy for mapping the size and location of myomas compared with TVUS or MRI (Canadian Task Force classification II-2). Setting: Five University of California academic centers (Davis, Irvine, Los Angeles, San Diego, and San Francisco). Patients: Twenty-six premenopausal women seeking uterine-sparing surgical treatment of myomas. Eligible participants could have no more than 6 myomas ≥2 cm and <10 cm and a uterine size no larger than 16 weeks by pelvic examination. Interventions: Measurement of myomas by IOUS followed by radiofrequency ablation (RFA) of fibroids. Measurements and Main Results: Eligible participants had to have imaging with TVUS or MRI within the last year to assess myoma characteristics. During the RFA operation, surgeons who had undergone a 1-day training on RFA and IOUS measured all myomas visualized with IOUS. Surgeons measured more myomas than were reported on MRI (12 on MRI and 16 on IOUS) or TVUS (41 on TVUS and 62 on IOUS) in all positions (anterior, posterior, lateral, and fundal). In particular, they identified more myomas <2 cm (4 on MRI, 9 on IOUS, 1 on TVUS, and 19 on IOUS). They located 2.3 times as many myomas in the anterior position as TVUS. For the myomas ≥2 cm identified by IOUS and MRI or IOUS and TVUS, there was no statistically significant difference in the mean myoma number or the mean myoma diameter measurements. Conclusion: Surgeons first learning to use IOUS detect the same number of myomas ≥2 cm as identified by TVUS and MRI and find a greater number of myomas <2 cm on IOUS compared with radiologist-reported TVUS.

AB - Study Objective: To compare preoperative transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) with intraoperative ultrasound (IOUS) in surgeons first learning to use this technique. Design: A prospective study of IOUS accuracy for mapping the size and location of myomas compared with TVUS or MRI (Canadian Task Force classification II-2). Setting: Five University of California academic centers (Davis, Irvine, Los Angeles, San Diego, and San Francisco). Patients: Twenty-six premenopausal women seeking uterine-sparing surgical treatment of myomas. Eligible participants could have no more than 6 myomas ≥2 cm and <10 cm and a uterine size no larger than 16 weeks by pelvic examination. Interventions: Measurement of myomas by IOUS followed by radiofrequency ablation (RFA) of fibroids. Measurements and Main Results: Eligible participants had to have imaging with TVUS or MRI within the last year to assess myoma characteristics. During the RFA operation, surgeons who had undergone a 1-day training on RFA and IOUS measured all myomas visualized with IOUS. Surgeons measured more myomas than were reported on MRI (12 on MRI and 16 on IOUS) or TVUS (41 on TVUS and 62 on IOUS) in all positions (anterior, posterior, lateral, and fundal). In particular, they identified more myomas <2 cm (4 on MRI, 9 on IOUS, 1 on TVUS, and 19 on IOUS). They located 2.3 times as many myomas in the anterior position as TVUS. For the myomas ≥2 cm identified by IOUS and MRI or IOUS and TVUS, there was no statistically significant difference in the mean myoma number or the mean myoma diameter measurements. Conclusion: Surgeons first learning to use IOUS detect the same number of myomas ≥2 cm as identified by TVUS and MRI and find a greater number of myomas <2 cm on IOUS compared with radiologist-reported TVUS.

KW - Intra-abdominal ultrasound

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KW - Leiomyoma

KW - Myoma

KW - Transvaginal ultrasound

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