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In Search of an Imaging Classification of Adenomyosis: A Role for Elastography?
Adenomyosis is a complex and poorly understood gynecological disease. It used to be diagnosed exclusively by histology after hysterectomy; today its diagnosis is carried out increasingly by imaging techniques, including transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI). However, th...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821156/ https://www.ncbi.nlm.nih.gov/pubmed/36615089 http://dx.doi.org/10.3390/jcm12010287 |
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author | Guo, Sun-Wei Benagiano, Giuseppe Bazot, Marc |
author_facet | Guo, Sun-Wei Benagiano, Giuseppe Bazot, Marc |
author_sort | Guo, Sun-Wei |
collection | PubMed |
description | Adenomyosis is a complex and poorly understood gynecological disease. It used to be diagnosed exclusively by histology after hysterectomy; today its diagnosis is carried out increasingly by imaging techniques, including transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI). However, the lack of a consensus on a classification system hampers relating imaging findings with disease severity or with the histopathological features of the disease, making it difficult to properly inform patients and clinicians regarding prognosis and appropriate management, as well as to compare different studies. Capitalizing on our grasp of key features of lesional natural history, here we propose adding elastographic findings into a new imaging classification of adenomyosis, incorporating affected area, pattern, the stiffest value of adenomyotic lesions as well as the neighboring tissues, and other pathologies. We argue that the tissue stiffness as measured by elastography, which has a wider dynamic detection range, quantitates a fundamental biologic property that directs cell function and fate in tissues, and correlates with the extent of lesional fibrosis, a proxy for lesional “age” known to correlate with vascularity and hormonal receptor activity. With this new addition, we believe that the resulting classification system could better inform patients and clinicians regarding prognosis and the most appropriate treatment modality, thus filling a void. |
format | Online Article Text |
id | pubmed-9821156 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98211562023-01-07 In Search of an Imaging Classification of Adenomyosis: A Role for Elastography? Guo, Sun-Wei Benagiano, Giuseppe Bazot, Marc J Clin Med Review Adenomyosis is a complex and poorly understood gynecological disease. It used to be diagnosed exclusively by histology after hysterectomy; today its diagnosis is carried out increasingly by imaging techniques, including transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI). However, the lack of a consensus on a classification system hampers relating imaging findings with disease severity or with the histopathological features of the disease, making it difficult to properly inform patients and clinicians regarding prognosis and appropriate management, as well as to compare different studies. Capitalizing on our grasp of key features of lesional natural history, here we propose adding elastographic findings into a new imaging classification of adenomyosis, incorporating affected area, pattern, the stiffest value of adenomyotic lesions as well as the neighboring tissues, and other pathologies. We argue that the tissue stiffness as measured by elastography, which has a wider dynamic detection range, quantitates a fundamental biologic property that directs cell function and fate in tissues, and correlates with the extent of lesional fibrosis, a proxy for lesional “age” known to correlate with vascularity and hormonal receptor activity. With this new addition, we believe that the resulting classification system could better inform patients and clinicians regarding prognosis and the most appropriate treatment modality, thus filling a void. MDPI 2022-12-30 /pmc/articles/PMC9821156/ /pubmed/36615089 http://dx.doi.org/10.3390/jcm12010287 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Guo, Sun-Wei Benagiano, Giuseppe Bazot, Marc In Search of an Imaging Classification of Adenomyosis: A Role for Elastography? |
title | In Search of an Imaging Classification of Adenomyosis: A Role for Elastography? |
title_full | In Search of an Imaging Classification of Adenomyosis: A Role for Elastography? |
title_fullStr | In Search of an Imaging Classification of Adenomyosis: A Role for Elastography? |
title_full_unstemmed | In Search of an Imaging Classification of Adenomyosis: A Role for Elastography? |
title_short | In Search of an Imaging Classification of Adenomyosis: A Role for Elastography? |
title_sort | in search of an imaging classification of adenomyosis: a role for elastography? |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821156/ https://www.ncbi.nlm.nih.gov/pubmed/36615089 http://dx.doi.org/10.3390/jcm12010287 |
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