MP05-02 VALIDATION OF A STANDING MAGNETIC RESONANCE IMAGING (MRI) PROTOCOL FOR ENHANCED DETECTION IN PELVIC ORGAN PROLAPSE (POP) STAGING
Bibliographic record
Abstract
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 ...
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.025 | 0.046 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.025 | 0.017 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".