Ultrasound in Obstetrics & Gynecology最新文献

{"title":"Radiomics analysis of ultrasound images to discriminate between benign and malignant adnexal masses with solid morphology on ultrasound.","authors":"F Moro, M Vagni, H E Tran, F Bernardini, F Mascilini, F Ciccarone, C Nero, D Giannarelli, L Boldrini, A Fagotti, G Scambia, L Valentin, A C Testa","doi":"10.1002/uog.27680","DOIUrl":"10.1002/uog.27680","url":null,"abstract":"<p><strong>Objective: </strong>The primary aim was to identify radiomics ultrasound features that can distinguish between benign and malignant adnexal masses with solid ultrasound morphology, and between primary malignant (including borderline and primary invasive) and metastatic solid ovarian masses, and to develop ultrasound-based machine learning models that include radiomics features to discriminate between benign and malignant solid adnexal masses. The secondary aim was to compare the discrimination performance of our newly developed radiomics models with that of the Assessment of Different NEoplasias in the adneXa (ADNEX) model and that of subjective assessment by an experienced ultrasound examiner.</p><p><strong>Methods: </strong>This was a retrospective, observational single-center study conducted at Fondazione Policlinico Universitario A. Gemelli IRCC, in Rome, Italy. Included were patients with a histological diagnosis of an adnexal tumor with solid morphology according to International Ovarian Tumor Analysis (IOTA) terminology at preoperative ultrasound examination performed in 2014-2020, who were managed with surgery. The patient cohort was split randomly into training and validation sets at a ratio of 70:30 and with the same proportion of benign and malignant tumors in the two subsets, with malignant tumors including borderline, primary invasive and metastatic tumors. We extracted 68 radiomics features, belonging to two different families: intensity-based statistical features and textural features. Models to predict malignancy were built based on a random forest classifier, fine-tuned using 5-fold cross-validation over the training set, and tested on the held-out validation set. The variables used in model-building were patient age and radiomics features that were statistically significantly different between benign and malignant adnexal masses and assessed as not redundant based on the Pearson correlation coefficient. We evaluated the discriminative ability of the models and compared it to that of the ADNEX model and that of subjective assessment by an experienced ultrasound examiner using the area under the receiver-operating-characteristics curve (AUC) and classification performance by calculating sensitivity and specificity.</p><p><strong>Results: </strong>In total, 326 patients were included and 775 preoperative ultrasound images were analyzed. Of the 68 radiomics features extracted, 52 differed statistically significantly between benign and malignant tumors in the training set, and 18 uncorrelated features were selected for inclusion in model-building. The same 52 radiomics features differed significantly between benign, primary malignant and metastatic tumors. However, the values of the features manifested overlapped between primary malignant and metastatic tumors and did not differ significantly between them. In the validation set, 25/98 (25.5%) tumors were benign and 73/98 (74.5%) were malignant (6 borderline, 57 primary inv","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"353-363"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of deep or ovarian endometriosis on pelvic pain and quality of life: prospective cross-sectional ultrasound study.","authors":"P Chaggar, T Tellum, N Thanatsis, L V De Braud, T Setty, D Jurkovic","doi":"10.1002/uog.29150","DOIUrl":"10.1002/uog.29150","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether premenopausal women diagnosed with deep or ovarian endometriosis on transvaginal sonography (TVS) were more likely to suffer from dyspareunia and pelvic pain symptoms, and have a lower quality of life, compared to women without sonographically diagnosed deep or ovarian endometriosis.</p><p><strong>Methods: </strong>This was a prospective, cross-sectional study carried out between February 2019 and October 2020 at the general gynecology clinic at University College London Hospital, London, UK. All premenopausal women aged 18-50 years, who were examined consecutively by a single experienced examiner and underwent a detailed TVS scan, were eligible for inclusion. Pregnant women and those who had received a previous diagnosis of endometriosis or who had experienced a hysterectomy or unilateral/bilateral oophorectomy were excluded. Sonographic findings consistent with deep or ovarian endometriosis were noted. All women completed the British Society of Gynaecological Endoscopy pelvic pain questionnaire. The primary outcome was to determine whether women with sonographic evidence of endometriosis were more likely to experience moderate-to-severe levels of dyspareunia (score of ≥ 4 on an 11-point numerical rating scale (NRS)). Secondary outcomes included assessing moderate-to-severe levels of other pelvic pain symptoms (NRS score of ≥ 4), bowel symptoms (score of ≥ 2 on a 5-point Likert scale) and quality of life, which was measured using the EuroQol-5D-3L (EQ-5D) questionnaire. The number of women with pain scores ≥ 4 and bowel scores ≥ 2, as well as the mean EQ-5D scores, were compared between the group with and that without sonographic evidence of endometriosis using logistic regression analysis, and multivariable analysis was used to adjust for demographic and clinical variables.</p><p><strong>Results: </strong>A total of 514 women were included in the final study population, of whom 146 (28.4%) were diagnosed with deep or ovarian endometriosis on TVS. On multivariable analysis, the presence of moderate-to-severe dyspareunia was not found to be associated with endometriosis. Moderate-to-severe dyspareunia was significantly associated with lower age (odds ratio (OR), 0.70 (95% CI, 0.56-0.89); P = 0.003) and a history of migraine (OR, 3.52 (95% CI, 1.42-8.77); P = 0.007), and it occurred significantly less frequently in women with non-endometriotic ovarian cysts (OR, 0.47 (95% CI, 0.28-0.78); P = 0.003). There was also a trend towards a positive association between anxiety/depression and moderate-to-severe dyspareunia (OR, 1.94 (95% CI, 0.93-4.03); P = 0.08). Following multivariable analysis, the only symptoms that were significantly more common in women with endometriosis compared to those without were menstrual dyschezia (OR, 2.44 (95% CI, 1.59-3.78); P < 0.001) and difficulty emptying the bladder (OR, 2.56 (95% CI, 1.52-4.31); P < 0.001). Although not reaching statistical significance on multivariable","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"372-383"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra- and interobserver agreement of proposed objective transvaginal ultrasound image-quality scoring system for use in artificial intelligence algorithm development.","authors":"A Deslandes, J C Avery, H-T Chen, M Leonardi, S Knox, G Lo, R O'Hara, G Condous, M L Hull","doi":"10.1002/uog.29178","DOIUrl":"10.1002/uog.29178","url":null,"abstract":"<p><strong>Objectives: </strong>The development of valuable artificial intelligence (AI) tools to assist with ultrasound diagnosis depends on algorithms developed using high-quality data. This study aimed to test the intra- and interobserver agreement of a proposed image-quality scoring system to quantify the quality of gynecological transvaginal ultrasound (TVS) images, which could be used in clinical practice and AI tool development.</p><p><strong>Methods: </strong>A proposed scoring system to quantify TVS image quality was created following a review of the literature. This system involved a score of 1-4 (2 = poor, 3 = suboptimal and 4 = optimal image quality) assigned by a rater for individual ultrasound images. If the image was deemed inaccurate, it was assigned a score of 1, corresponding to 'reject'. Six professionals, including two radiologists, two sonographers and two sonologists, reviewed 150 images (50 images of the uterus and 100 images of the ovaries) obtained from 50 women, assigning each image a score of 1-4. The review of all images was repeated a second time by each rater after a period of at least 1 week. Mean scores were calculated for each rater. Overall interobserver agreement was assessed using intraclass correlation coefficient (ICC), and interobserver agreement between paired professionals and intraobserver agreement for all professionals were assessed using weighted Cohen's kappa and ICC.</p><p><strong>Results: </strong>Poor levels of interobserver agreement were obtained between the six raters for all 150 images (ICC, 0.480 (95% CI, 0.363-0.586)), as well as for assessment of the uterine images only (ICC, 0.359 (95% CI, 0.204-0.523)). Moderate agreement was achieved for the ovarian images (ICC, 0.531 (95% CI, 0.417-0.636)). Agreement between the paired sonographers and sonologists was poor for all images (ICC, 0.336 (95% CI, -0.078 to 0.619) and 0.425 (95% CI, 0.014-0.665), respectively), as well as when images were grouped into uterine images (ICC, 0.253 (95% CI, -0.097 to 0.577) and 0.299 (95% CI, -0.094 to 0.606), respectively) and ovarian images (ICC, 0.400 (95% CI, -0.043 to 0.669) and 0.469 (95% CI, 0.088-0.689), respectively). Agreement between the paired radiologists was moderate for all images (ICC, 0.600 (95% CI, 0.487-0.693)) and for their assessment of uterine images (ICC, 0.538 (95% CI, 0.311-0.707)) and ovarian images (ICC, 0.621 (95% CI, 0.483-0.728)). Weak-to-moderate intraobserver agreement was seen for each of the raters with weighted Cohen's kappa ranging from 0.533 to 0.718 for all images and from 0.467 to 0.751 for ovarian images. Similarly, for all raters, the ICC indicated moderate-to-good intraobserver agreement for all images overall (ICC ranged from 0.636 to 0.825) and for ovarian images (ICC ranged from 0.596 to 0.862). Slightly better intraobserver agreement was seen for uterine images, with weighted Cohen's kappa ranging from 0.568 to 0.808 indicating weak-to-strong agreement, and ICC ranging","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"364-371"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiogenic factors alone or in combination with ultrasound Doppler criteria for risk classification among late-onset small fetuses with or without pre-eclampsia.","authors":"L Youssef, F Crispi, S Paolucci, J Miranda, S Lobmaier, F Crovetto, F Figueras, E Gratacos","doi":"10.1002/uog.29181","DOIUrl":"10.1002/uog.29181","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prognostic value of maternal angiogenic factors in late-onset small fetuses, alone or in combination with the ultrasound and Doppler parameters currently used for the classification of low-risk small-for-gestational-age (SGA) fetuses or high-risk fetal growth restriction (FGR), overall and according to the presence or absence of pre-eclampsia.</p><p><strong>Methods: </strong>This was a prospective cohort study of women with a singleton pregnancy with a diagnosis of late-onset fetal smallness (defined as birth weight < 10<sup>th</sup> centile) and a gestational age of ≥ 34 weeks at delivery. Ultrasound assessment of estimated fetal weight (EFW) and Doppler assessment of uterine artery pulsatility index (UtA-PI) and cerebroplacental ratio (CPR) were performed every 1-2 weeks. Biochemical analysis of the angiogenic factors placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) in maternal peripheral venous blood samples was performed using enzyme-linked immunosorbent assay within 1-2 weeks after diagnosis of SGA or FGR. The primary outcome was adverse perinatal outcome, defined as a composite of emergency Cesarean section for non-reassuring fetal status, metabolic acidosis (umbilical artery pH < 7.0), neonatal unit admission and/or perinatal death. The predictive value of EFW < 3<sup>rd</sup> centile, Doppler parameters (UtA-PI > 95<sup>th</sup> centile and CPR < 5<sup>th</sup> centile) and sFlt-1/PlGF ratio > 95<sup>th</sup> centile, alone or in combination, was assessed using logistic regression analysis in the overall population and stratified by presence or absence of pre-eclampsia developing at any time before delivery.</p><p><strong>Results: </strong>Among the 602 included cases, 91 (15.1%) developed pre-eclampsia and 511 (84.9%) did not. In the overall study population, all parameters were associated independently with adverse perinatal outcome: EFW < 3<sup>rd</sup> centile (adjusted odds ratio (aOR), 2.58 (95% CI, 1.67-4.00)), UtA-PI > 95<sup>th</sup> centile (aOR, 1.92 (95% CI, 1.25-2.94)), CPR < 5<sup>th</sup> centile (aOR, 2.35 (95% CI, 1.46-3.78)) and sFlt-1/PlGF ratio > 95<sup>th</sup> centile (aOR, 1.71 (95% CI, 1.09-2.69)). Only sFlt-1/PlGF ratio > 95<sup>th</sup> centile was associated independently with adverse perinatal outcome in cases with pre-eclampsia, whereas in those without pre-eclampsia, only EFW < 3<sup>rd</sup> centile and CPR < 5<sup>th</sup> centile were associated independently with adverse perinatal outcome. In the overall population, the detection rate (DR) and false-positive rate for adverse perinatal outcome were, respectively: 39.8% (95% CI, 31.7-47.9%) and 16.9% (95% CI, 10.7-23.1%) for sFlt-1/PlGF ratio > 95<sup>th</sup> centile alone; 86.8% (95% CI, 83.4-90.2%) and 61.9% (95% CI, 57.1-66.7%) for a combined model of EFW < 3<sup>rd</sup> centile, UtA-PI > 95<sup>th</sup> centile and CPR < 5<sup>th</sup> centile; 81.3% (95% CI, 77.3-85.3%) a","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"317-324"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"M L Larsen, S Kumar","doi":"10.1002/uog.29157","DOIUrl":"10.1002/uog.29157","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"394"},"PeriodicalIF":6.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometrioma decidualization in pregnancy: not just about papillations.","authors":"M Doglioli, L De Meis, E Mantovani, G Cristani, R Seracchioli, S Del Forno","doi":"10.1002/uog.29203","DOIUrl":"https://doi.org/10.1002/uog.29203","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incremental yield of exome sequencing over standard prenatal testing in structurally normal fetuses: systematic review and meta-analysis.","authors":"A Sotiriadis, E Demertzidou, A Ververi, E Tsakmaki, C Chatzakis, F Mone","doi":"10.1002/uog.29195","DOIUrl":"https://doi.org/10.1002/uog.29195","url":null,"abstract":"<p><strong>Objective: </strong>To critically review the literature and synthesize evidence on the incremental yield of prenatal exome sequencing (PES) in fetuses with an apparently normal phenotype with a normal G-banded karyotype or chromosomal microarray (CMA).</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted using a predetermined protocol and registered with PROSPERO (ID: CRD42024593349). We included observational cohort studies reporting on the incremental yield of PES in fetuses with an apparently normal phenotype and a previously normal G-banded karyotype/CMA. The risk of bias of the included studies was assessed using the Newcastle-Ottawa Scale. The pooled proportion of events was calculated using generalized linear mixed models, using the metaprop function in R version 2.15.1.</p><p><strong>Results: </strong>Four studies (1916 fetuses) were included in this systematic review and meta-analysis, of which 32 cases had a pathogenic or likely pathogenic variant. The pooled incremental yield of PES in fetuses with an apparently normal phenotype was 1.6% (95% CI, 1.0-2.6%); the majority of variants were de novo within genes associated with autosomal dominant inherited conditions (pooled incremental yield, 0.9% (95% CI, 0.5-1.7%)). Based on the expected severity of the associated disease, the pooled incremental yield was 0.5% (95% CI, 0.1-1.5%) for severe disease and 0.5% (95% CI, 0.2-1.5%) for moderate disease. There were insufficient data to conduct the predefined secondary analyses according to normality of phenotype at birth, variants of uncertain significance and expected age of disease onset.</p><p><strong>Conclusion: </strong>Pooling data from four studies, we found that 1.6% of phenotypically normal fetuses with a normal G-banded karyotype or CMA may have a pathogenic or likely pathogenic variant identified on PES, most of which occur de novo. The likelihood of a variant being associated with severe disease in such fetuses is 0.5%. However, more research is needed regarding the development of a universal classification of disease severity and the utilization of this evidence in clinical practice. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal diagnosis of duplicated gallbladder: two-dimensional and three-dimensional ultrasound imaging and reconstruction.","authors":"G H A S Pacheco, P T Castro, G Tonni, H Werner, E Araujo Júnior","doi":"10.1002/uog.29173","DOIUrl":"https://doi.org/10.1002/uog.29173","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive prenatal ultrasound for surgical risk assessment: differentiating placenta accreta spectrum from uterine scar dehiscence for improved clinical decision-making.","authors":"R A Aryananda, T K Adu-Bredu","doi":"10.1002/uog.29138","DOIUrl":"10.1002/uog.29138","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"241-242"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior complex: clue for suspicion of partial agenesis of corpus callosum at fetal brain screening.","authors":"F Viñals, F Correa","doi":"10.1002/uog.29136","DOIUrl":"10.1002/uog.29136","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"239-241"},"PeriodicalIF":6.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}