title: Sensitivity of myoma imaging using laparoscopic ultrasound compared with magnetic resonance imaging and transvaginal ultrasound.
abstract: OBJECTIVE
  To determine the efficacy of laparoscopic ultrasound (LUS) as compared with contrast-enhanced magnetic resonance imaging (CE-MRI) and transvaginal ultrasound (TVUS) in detection of uterine myomas.
  
  
  METHODS
  Retrospective study of imaging methods used in a trial of LUS-guided radiofrequency volumetric thermal ablation in women with symptomatic myomas (Canadian Task Force classification II-2).
  
  
  METHODS
  Eleven medical university or private outpatient surgery clinics in the United States (nine sites) and Latin America (two sites).
  
  
  METHODS
  One hundred thirty-five women with symptomatic myomas and objectively confirmed moderate to severe heavy menstrual bleeding.
  
  
  METHODS
  LUS-guided radiofrequency volumetric thermal ablation of myomas.
  
  
  RESULTS
  Preoperative TVUS scans and CE-MRIs were read at each site, and all CE-MRIs were read by a central reader. LUS-guided scans were obtained intraoperatively by each surgeon by mapping the uterus just before radiofrequency volumetric thermal ablation. The imaging methods and their yields in terms of number of myomas found per subject were as follows: TVUS, 403 myomas (mean [SD] 3 [1.8]; range, 1-8); site CE-MRI, 562 myomas (4.2 [3.8]; range, 1-18); central reader, 619 myomas (4.6 [3.7]; range, 0-20); and LUS, 818 myomas (6.1 [4.9]; range, 1-29) (p < .001). LUS was superior to TVUS, CE-MRI, and the central reader for detection of small (≤1 cm(3)) myomas. Most imaged myomas were intramural: 197 (50.9%) by TVUS, 298 (55.5%) by site CE-MRI, 290 (48.7%) by the central reader, and 386 (48.5%) by LUS.
  
  
  CONCLUSIONS
  Compared with CE-MRI and TVUS, LUS demonstrates the most myomas, regardless of size or type.
authors.affiliation: Department of Obstetrics and Gynecology, St. John's Mercy Hospital, St. Louis, Missouri. Electronic address: levine-d@sbcglobal.net.
authors.forename: David J
authors.initials: DJ
authors.lastname: Levine
authors.forename: Jay M
authors.initials: JM
authors.lastname: Berman
authors.forename: Micah
authors.initials: M
authors.lastname: Harris
authors.forename: Scott G
authors.initials: SG
authors.lastname: Chudnoff
authors.forename: Fredrick S
authors.initials: FS
authors.lastname: Whaley
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Palmer
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology
keywords: Intraabdominal ultrasound; Laparoscopic ultrasound; Magnetic resonance imaging; Myoma; Radiofrequency volumetric thermal ablation; Transvaginal ultrasound