Krista Elise Suarez-Weiss, Krupa Patel-Lippmann, Catherine Phillips, Kristine Burk, Angela Tong, Hina Arif, Refky Nicola, Priyanka Jha
{"title":"子宫内膜异位症:O-RADS及恶性转化风险评估。","authors":"Krista Elise Suarez-Weiss, Krupa Patel-Lippmann, Catherine Phillips, Kristine Burk, Angela Tong, Hina Arif, Refky Nicola, Priyanka Jha","doi":"10.1007/s00261-025-04885-0","DOIUrl":null,"url":null,"abstract":"<div><p>Endometriosis is a common disease, affecting approximately 10% of women of reproductive age. Several intersecting guidelines and consensus statements provide information on imaging diagnosis and surveillance strategies for endometriomas. SRU consensus panel recommendations provide information on initial detection of endometriosis on routine pelvic imaging. Revised American Society of Reproductive Medicine (rASRM) classification, the #ENZIAN classification, and the deep pelvic endometriosis index (dPEI) aim to assess the overall extent of disease and assist in presurgical planning. The Ovarian-Adnexal Reporting and Data System (O-RADS) aims to risk stratify lesions evaluated with US or MR based on their imaging morphology, from typical benign lesions to atypical presentations and malignant transformation. Emerging data shows increased risk of ovarian cancer in patients with endometriosis, especially following menopause and in those patients with long standing endometriosis. (Chen et al. in Front Oncol. 14:1329133, 2024;Streuli et al. in Climacteric. 20:138–143, 2017;Secosan et al. in Diagnostics (Basel). 10:134, 2020;Inceboz in Womens Health (Lond Engl). 11:711–715, 2015;Cassani et al. in Maturitas. 190, 2024;Gemmell et al. in Hum Reprod Update. 23:481–500, 2017;Giannella et al. in Cancers (Basel). 13:4026, 2021;) Current O-RADS guidelines mandate follow-up of endometriomas up to 2 years with further follow-up based on clinical factors. No consensus guidelines exist for imaging surveillance of patients with deep endometriosis from a malignancy standpoint. This review explores the imaging appearance of endometriomas, imaging features of malignant transformation, surveillance strategies and gaps in current literature, and attempts to better understand the risk of malignancy and to encourage further research for long-term imaging surveillance of endometriosis patients.</p></div>","PeriodicalId":7126,"journal":{"name":"Abdominal Radiology","volume":"50 10","pages":"4865 - 4877"},"PeriodicalIF":2.2000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Endometriosis: assessment on O-RADS and risk of malignant transformation\",\"authors\":\"Krista Elise Suarez-Weiss, Krupa Patel-Lippmann, Catherine Phillips, Kristine Burk, Angela Tong, Hina Arif, Refky Nicola, Priyanka Jha\",\"doi\":\"10.1007/s00261-025-04885-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Endometriosis is a common disease, affecting approximately 10% of women of reproductive age. Several intersecting guidelines and consensus statements provide information on imaging diagnosis and surveillance strategies for endometriomas. SRU consensus panel recommendations provide information on initial detection of endometriosis on routine pelvic imaging. Revised American Society of Reproductive Medicine (rASRM) classification, the #ENZIAN classification, and the deep pelvic endometriosis index (dPEI) aim to assess the overall extent of disease and assist in presurgical planning. The Ovarian-Adnexal Reporting and Data System (O-RADS) aims to risk stratify lesions evaluated with US or MR based on their imaging morphology, from typical benign lesions to atypical presentations and malignant transformation. Emerging data shows increased risk of ovarian cancer in patients with endometriosis, especially following menopause and in those patients with long standing endometriosis. (Chen et al. in Front Oncol. 14:1329133, 2024;Streuli et al. in Climacteric. 20:138–143, 2017;Secosan et al. in Diagnostics (Basel). 10:134, 2020;Inceboz in Womens Health (Lond Engl). 11:711–715, 2015;Cassani et al. in Maturitas. 190, 2024;Gemmell et al. in Hum Reprod Update. 23:481–500, 2017;Giannella et al. in Cancers (Basel). 13:4026, 2021;) Current O-RADS guidelines mandate follow-up of endometriomas up to 2 years with further follow-up based on clinical factors. No consensus guidelines exist for imaging surveillance of patients with deep endometriosis from a malignancy standpoint. This review explores the imaging appearance of endometriomas, imaging features of malignant transformation, surveillance strategies and gaps in current literature, and attempts to better understand the risk of malignancy and to encourage further research for long-term imaging surveillance of endometriosis patients.</p></div>\",\"PeriodicalId\":7126,\"journal\":{\"name\":\"Abdominal Radiology\",\"volume\":\"50 10\",\"pages\":\"4865 - 4877\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-03-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Abdominal Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s00261-025-04885-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Abdominal Radiology","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s00261-025-04885-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
子宫内膜异位症是一种常见病,影响约10%的育龄妇女。一些交叉的指导方针和共识声明提供了子宫内膜异位瘤影像诊断和监测策略的信息。SRU共识小组的建议提供了子宫内膜异位症在常规盆腔成像中的初步检测信息。修订后的美国生殖医学学会(rASRM)分类、#ENZIAN分类和深盆腔子宫内膜异位症指数(dPEI)旨在评估疾病的总体程度并协助术前计划。卵巢附件报告和数据系统(O-RADS)旨在根据超声或磁共振成像形态学对病变进行风险分层,从典型的良性病变到非典型表现和恶性转化。新出现的数据显示,患有子宫内膜异位症的患者患卵巢癌的风险增加,尤其是绝经后和长期患有子宫内膜异位症的患者。(Chen et al. in Front Oncol. 14: 1329133,2024;Streuli et al. in Climacteric. 20:138- 143,2017;Secosan et al. in Diagnostics(巴塞尔).)10:134, 2020;妇女健康研究所(伦敦)。Cassani et al. in Maturitas. 190,2024;Gemmell et al. in Hum repd Update. 23:481- 500,2017;Giannella et al. in cancer (Basel)。13:4026, 2021,)目前的O-RADS指南要求对子宫内膜异位瘤进行长达2年的随访,并根据临床因素进行进一步随访。从恶性肿瘤的角度来看,对于深部子宫内膜异位症患者的影像学监测尚无一致的指导方针。本文综述了子宫内膜异位症的影像学表现、恶性转化的影像学特征、监测策略和现有文献的空白,旨在更好地了解子宫内膜异位症的恶性风险,并鼓励进一步研究子宫内膜异位症患者的长期影像学监测。
Endometriosis: assessment on O-RADS and risk of malignant transformation
Endometriosis is a common disease, affecting approximately 10% of women of reproductive age. Several intersecting guidelines and consensus statements provide information on imaging diagnosis and surveillance strategies for endometriomas. SRU consensus panel recommendations provide information on initial detection of endometriosis on routine pelvic imaging. Revised American Society of Reproductive Medicine (rASRM) classification, the #ENZIAN classification, and the deep pelvic endometriosis index (dPEI) aim to assess the overall extent of disease and assist in presurgical planning. The Ovarian-Adnexal Reporting and Data System (O-RADS) aims to risk stratify lesions evaluated with US or MR based on their imaging morphology, from typical benign lesions to atypical presentations and malignant transformation. Emerging data shows increased risk of ovarian cancer in patients with endometriosis, especially following menopause and in those patients with long standing endometriosis. (Chen et al. in Front Oncol. 14:1329133, 2024;Streuli et al. in Climacteric. 20:138–143, 2017;Secosan et al. in Diagnostics (Basel). 10:134, 2020;Inceboz in Womens Health (Lond Engl). 11:711–715, 2015;Cassani et al. in Maturitas. 190, 2024;Gemmell et al. in Hum Reprod Update. 23:481–500, 2017;Giannella et al. in Cancers (Basel). 13:4026, 2021;) Current O-RADS guidelines mandate follow-up of endometriomas up to 2 years with further follow-up based on clinical factors. No consensus guidelines exist for imaging surveillance of patients with deep endometriosis from a malignancy standpoint. This review explores the imaging appearance of endometriomas, imaging features of malignant transformation, surveillance strategies and gaps in current literature, and attempts to better understand the risk of malignancy and to encourage further research for long-term imaging surveillance of endometriosis patients.
期刊介绍:
Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section.
Reasons to Publish Your Article in Abdominal Radiology:
· Official journal of the Society of Abdominal Radiology (SAR)
· Published in Cooperation with:
European Society of Gastrointestinal and Abdominal Radiology (ESGAR)
European Society of Urogenital Radiology (ESUR)
Asian Society of Abdominal Radiology (ASAR)
· Efficient handling and Expeditious review
· Author feedback is provided in a mentoring style
· Global readership
· Readers can earn CME credits