MP05-02 VALIDATION OF A STANDING MAGNETIC RESONANCE IMAGING (MRI) PROTOCOL FOR ENHANCED DETECTION IN PELVIC ORGAN PROLAPSE (POP) STAGING
Notice bibliographique
Résumé
You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Pelvic Prolapse (MP05)1 Apr 2020MP05-02 VALIDATION OF A STANDING MAGNETIC RESONANCE IMAGING (MRI) PROTOCOL FOR ENHANCED DETECTION IN PELVIC ORGAN PROLAPSE (POP) STAGING Lynn Stothers*, Jenn Locke, Marwa Abdulaziz, Andrew Macnab, and Alex Kavanagh Lynn Stothers*Lynn Stothers* More articles by this author , Jenn LockeJenn Locke More articles by this author , Marwa AbdulazizMarwa Abdulaziz More articles by this author , Andrew MacnabAndrew Macnab More articles by this author , and Alex KavanaghAlex Kavanagh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000819.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In POP, posture and gravity impact organ position, pelvic floor muscle integrity and degree of prolapse. Current guidelines recommend staging (POPQ) of symptomatic women including valsalva to increase accuracy of staging diagnosis. But, further evaluation using imaging modalities including MRI is recommended when indication(s) are present. However, standard (supine) MRI does not allow the effect of posture and gravity on the pelvic structures to be visualized. Objective: to validate the use of a 2-minute standing MRI imaging protocol to enhance POP staging accuracy. METHODS: Cases (symptomatic POP) and controls completed clinical staging including POPQ, UGD-6, CRADI-8 by subspecialty urologists. Controls had no history of LUTS, no known history of pelvic surgery or prolapse. 3 position MRI images of the pelvis were obtained using a 0.5 T scanner, axial and sagittal T2-weighted pelvic scans when sitting, standing and supine: Transverse T1 pelvic images were obtained at 5-mm slice thickness, field of view 24x24 cm, matrix of 224x192. Sagittal T2 images were 5mm slice thickness with field of view of 30x30 cm & matrix 192x60. The standing protocol required 2 minutes for image acquisition, 5 min preparation. Reference lines including the pubococcygeal line (PCL) were used to compare within patient changes in organ position supine, seated & standing (no POP displacement inferior to PCL < 1 cm, mild 1-3 cm, moderate 3.1-6cm & severe > 6 cm). RESULTS: N = 62 (40 symptomatic POP/ 22 controls) participated age 40 - 78 years. There was a difference in the incidence of POP detection in symptomatic subjects comparing standing to supine images. When supine: 22%,1% and 1% demonstrating vaginal prolapse as mild, moderate and severe (M/M/S) and cystocele of 6%, 1% and 1% being M/M/S. When imaged standing PCL differences indicated 36%, 12%, 1% M/M/S vaginal prolapse and 36%, 42% and 12% M/M/S cystocele. Fig 1 demonstrates significant upstaging identified using standing imaging compared to supine. Seated images were not different from supine. 10% of controls had asymptomatic mild prolapse identified. CONCLUSIONS: The 2-minute standing MRI imaging protocol and methodology described allows upstaging of POP due to the detection of impact from posture and gravity. Source of Funding: Vancouver Coastal Research Institute © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e41-e41 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lynn Stothers* More articles by this author Jenn Locke More articles by this author Marwa Abdulaziz More articles by this author Andrew Macnab More articles by this author Alex Kavanagh More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,025 | 0,046 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,025 | 0,017 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».