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Estimated Levator Ani Subtended Volume: A Predictive Biomarker for Surgical Outcomes Following Native Tissue Apical
Allison M Wyman1, Jason L Salemi2, Susana Lai-Yuen3
1From the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology.
Female Pelvic Medicine & Reconstructive Surgery
|March 2, 2022
Summary
Elevated estimated levator ani subtended volume (eLASV) on preoperative MRI predicts surgical failure in pelvic reconstructive surgery. This biomarker indicates a higher risk of failure, regardless of patient factors.
Area of Science:
- Pelvic reconstructive surgery
- Biomarker discovery
- Medical imaging analysis
Background:
- Surgical outcomes in pelvic reconstructive procedures can be variable.
- Predictive biomarkers for surgical success are needed.
- Estimated levator ani subtended volume (eLASV) is a potential imaging biomarker.
Purpose of the Study:
- To investigate the clinical utility of eLASV as a preoperative biomarker.
- To predict surgical outcomes in patients undergoing pelvic reconstructive surgery.
Main Methods:
- Prospective case-control pilot study.
- eLASV calculated using a validated algorithm from preoperative pelvic MRI.
- Surgical failure defined by a composite score at 1-year follow-up.
- Statistical analysis included log-binomial regression and ROC analysis.
Main Results:
- A high eLASV was significantly associated with surgical failure (P=0.0173).
- Patients with high eLASV were 8.7 times more likely to experience surgical failure.
- The area under the ROC curve (c-statistic) was 0.829, indicating good predictive performance.
Conclusions:
- Elevated preoperative eLASV is associated with increased risk of surgical failure.
- eLASV shows potential as a reliable preoperative biomarker for predicting surgical outcomes.
- This finding holds true irrespective of patient age, BMI, stage, or parity.
