Tissue characterization using mean gray value analysis in deep infiltrating endometriosis

Area of Science:

• Medical imaging
• Gynecologic oncology
• Ultrasound tissue characterization

Background:

• Deeply infiltrating endometriosis (DIE) affects various pelvic locations.
• Accurate tissue characterization is crucial for diagnosing and managing DIE.
• Ultrasound-based quantitative metrics like mean gray value (MGV) show promise for DIE assessment.

Purpose of the Study:

• To compare the sonographic mean gray value (MGV) of retrocervical and rectosigmoid deeply infiltrating endometriosis.
• To evaluate the intra- and interobserver reproducibility of MGV measurements in DIE nodules.

Main Methods:

• Retrospective analysis of 57 DIE nodules from 50 women using stored ultrasound volumes.
• MGV quantification using virtual organ computer-aided analysis (VOCAL) software with semiautomated sphere-sampling.
• Comparison of MGV between retrocervical and rectosigmoid DIE, and with uterine myometrium. Inter- and intraobserver agreement assessed using intraclass correlation coefficients (ICC).

Main Results:

• Rectosigmoid DIE nodules exhibited significantly higher MGV than retrocervical nodules (23.863 vs. 17.705, P < 0.001).
• Myometrial MGV was significantly higher than that of DIE nodules in both locations (P < 0.001).
• Excellent intra- and interobserver reproducibility was observed (ICC > 0.95).

Conclusions:

• Significant differences in MGV exist between retrocervical and rectosigmoid DIE.
• MGV measurement demonstrates high reproducibility.
• Further studies are warranted to assess the clinical utility of MGV in diagnosing and assessing the distribution of deep endometriosis.