Deep pelvic infiltrating endometriosis: MRI consensus lexicon and compartment-based approach from the ENDOVALIRM group

Purpose: The purpose of this consensus article was to develop guidelines by a focused panel of experts to elaborate a lexicon of image interpretation, and a standardized region-based reporting of deep infiltrating endometriosis (DIE) with magnetic resonance imaging (MRI).Materials and methods: Evidence-based data and expert opinion were combined using the RAND-UCLA Appropriateness Method to attain consensus guidelines. Experts scoring of pelvic compartment delineation and reporting template were collected; responses were analyzed and classified as RECOMMENDED versus NOT RECOMMENDED (when >= 80% consensus among experts) or uncertain (when < 80% consensus among experts).Results: Consensus regarding pelvic compartment delineation and DIE reporting was attained using the RAND-UCLA Appropriateness Method. The pelvis was divided in nine compartments and extrapelvic lesions were assigned to an additional (tenth) compartment. A consensus was also reached for each structure attrib-uted to a compartment and each reporting template item among the experts. No consensus was reached for a normal aspect of uterosacral ligament, but a consensus was reached for an unequivocal involvement lead-ing to a positive diagnosis and an equivocal involvement leading to uncertain diagnosis. Tailored MRI lexicon and standardized region-based report were proposed.Conclusion: These consensus recommendations should be used as a guide for DIE reporting and staging with MRI. Standardized MRI compartment-based structured reporting is recommended to enable consistent accu-racy and help select the best therapeutic approach.(c) 2022 The Author(s). Published by Elsevier Masson SAS on behalf of Societe francaise de radiologie. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Automated summary

The purpose of this consensus article was to develop guidelines for the interpretation and reporting of deep infiltrating endometriosis (DIE) with magnetic resonance imaging (MRI). Consensus was reached on pelvic compartment delineation and reporting template using the RAND-UCLA Appropriateness Method. A tailored MRI lexicon and standardized region-based report were proposed.