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T2*-Weighted Imaging Performance in the Detection of Deep Endometriosis among Readers with Different Experience:
Paolo Niccolò Franco1,2, Simona Annibali1,2, Sara Viganò1,2
1Department of Radiology, Papa Giovanni XXIII Hospital, Piazza OMS 1, 24127 Bergamo, Italy.
Abstract:
Magnetic resonance imaging (MRI) is an effective technique for the diagnosis and preoperative staging of deep infiltrative endometriosis (DIE). The usefulness of MRI sequences susceptible to chronic blood degradation products, such as T2*-weighted imaging, remains uncertain. The present study aims to evaluate the diagnostic performance of these sequences in addition to the conventional protocol for DIE assessment. Forty-four MRI examinations performed for clinical and/or ultrasound DIE suspicion were evaluated by three readers with variable experience in female imaging. The inter-observer agreement between the reader who analysed only the conventional protocol and the one who also considered T2*-weighted sequences was excellent. The less experienced reader diagnosed a significantly higher number of endometriosis foci on the T2*-weighted sequences compared with the most experienced observer. T2*-weighted sequences do not seem to provide significant added value in the evaluation of DIE, especially in less experienced readers. Furthermore, artifacts caused by undesirable sources of magnetic inhomogeneity may lead to overdiagnosis.
Insights
T2*-weighted imaging in magnetic resonance imaging (MRI) does not significantly improve the diagnosis of deep infiltrative endometriosis (DIE). Less experienced readers may overdiagnose DIE using these sequences, potentially due to artifacts.
Area of Science:
- Radiology
- Medical Imaging
- Women's Health
Background:
- Magnetic resonance imaging (MRI) is crucial for diagnosing deep infiltrative endometriosis (DIE).
- The role of T2*-weighted imaging, sensitive to blood products, in DIE assessment is unclear.
Purpose of the Study:
- To evaluate the diagnostic performance of T2*-weighted sequences compared to conventional MRI protocols for DIE.
- To assess the added value of T2*-weighted imaging for radiologists with varying experience levels.
Main Methods:
- Retrospective analysis of 44 MRI examinations for suspected DIE.
- Evaluation by three readers with different experience levels, with and without T2*-weighted sequences.
- Assessment of inter-observer agreement and diagnostic accuracy.
Main Results:
- Excellent inter-observer agreement was achieved when T2*-weighted sequences were included.
- Less experienced readers identified more DIE foci with T2*-weighted sequences.
- T2*-weighted sequences did not show significant added diagnostic value and may lead to overdiagnosis due to artifacts.
Conclusions:
- T2*-weighted sequences do not appear to offer substantial benefits for DIE diagnosis in MRI.
- Caution is advised, particularly for less experienced readers, to avoid overdiagnosis from potential artifacts.
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