title: Can magnetic resonance imaging at 3.0-Tesla reliably detect patients with endometriosis? Initial results.
abstract: OBJECTIVE
  The aim of this study was to determine whether an optimized 3.0-Tesla magnetic resonance imaging (MRI) protocol is sensitive and specific enough to detect patients with endometriosis.
  
  
  METHODS
  This was a prospective cohort study with consecutive patients. Forty consecutive patients with clinical suspicion of endometriosis underwent 3.0-Tesla MRI, including a T2-weighted high-resolution fast spin echo sequence (spatial resolution=0.75 ×1.2 ×1.5 mm³) and a 3D T1-weighted high-resolution gradient echo sequence (spatial resolution=0.75 ×1.2 × 2.0 mm³). Two radiologists reviewed the dataset with consensus reading. During laparoscopy, which was used as reference standard, all lesions were characterized according to the revised criteria of the American Fertility Society. Patient-level and region-level sensitivities and specificities and lesion-level sensitivities were calculated.
  
  
  RESULTS
  Patient-level sensitivity was 42% for stage I (5/12) and 100% for stages II, III and IV (25/25). Patient-level specificity for all stages was 100% (3/3). The region-level sensitivity and specificity was 63% and 97%, respectively. The sensitivity per lesion was 61% (90% for deep lesions, 48% for superficial lesions and 100% for endometriomata). The detection rate of obliteration of the cul-the-sac was 100% (10/10) with no false positive findings. The interreader agreement was substantial to perfect (kappa=1 per patient, 0.65 per lesion and 0.71 for obliteration of the cul-the-sac).
  
  
  CONCLUSIONS
  An optimized 3.0-Tesla MRI protocol is accurate in detecting stage II to stage IV endometriosis.
authors.affiliation: Department of Radiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Maarten G
authors.initials: MG
authors.lastname: Thomeer
authors.forename: Anneke B
authors.initials: AB
authors.lastname: Steensma
authors.forename: Evert J
authors.initials: EJ
authors.lastname: van Santbrink
authors.forename: Francois E
authors.initials: FE
authors.lastname: Willemssen
authors.forename: Piotr A
authors.initials: PA
authors.lastname: Wielopolski
authors.forename: Myriam G
authors.initials: MG
authors.lastname: Hunink
authors.forename: Sandra
authors.initials: S
authors.lastname: Spronk
authors.forename: Joop S
authors.initials: JS
authors.lastname: Laven
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004715:Endometriosis / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging / Q000295:instrumentation; D009426:Netherlands; D010049:Ovarian Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D010532:Peritoneal Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D051598:Whole Body Imaging; D055815:Young Adult
keywords: 3.0-Tesla; endometriosis; magnetic resonance imaging