ArticleJournal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine2025
Grading Sonographic Severity of Adenomyosis: A Pilot Study Assessing Feasibility and Interobserver Reliability.
Article in Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Article
- Adenomyosis and Uterine Fibroids: Two Distinct Yet Overlapping Clinical Entities.Diagnostics (Basel, Switzerland) · 2026Review
- A hypothesis on the aetiology of adenomyosis: is there an association between cumulative number of menstruations and severity of adenomyosis on ultrasound?European journal of obstetrics & gynecology and reproductive biology: X · 2026Article
- A Novel Semi-Quantified Method for Grading Sonographic Severity of Adenomyosis and its Relation With Clinical Symptoms: An Observational Study.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2026Observational
- Acromegalic Uteropathy: Specific Uterine Ultrasound Findings in Female Patients.Diagnostics (Basel, Switzerland) · 2026Article
- Association Between 3D Transvaginal Ultrasound-Based XI VOCAL Counting Severity and Tissue MMP-9 Levels in Patients with Adenomyosis.International journal of women's health · 2026Article
- Revealing the unseen: 3D synchrotron X-Ray imaging of uterine vasculature in adenomyosis.Angiogenesis · 2025Article
- Article
- Synergistic Efficacy and Safety Evaluation of Focused Ultrasound Ablation Surgery Combined with Thermal Balloon Endometrial Ablation in Treating Adenomyosis: A Prospective Controlled Study.Gynecology and minimally invasive therapyArticle
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Abstract
objectivesThe reported prevalence of adenomyosis ranges widely due to different study populations, diagnostic tests and criteria. Categorizing the severity of disease may prove important. This study aims to develop a semi-quantifiable sonographic method to grade the severity of adenomyosis and assess the feasibility and interobserver reliability of this method.
methodsCross-sectional pilot study performed at a gynecology outpatient clinic, included 35 premenopausal women with adenomyosis, not taking hormonal medication. Diagnosis required ≥1 direct sonographic feature of adenomyosis. Two-dimensional (2D) grayscale video clips and 3-dimensional (3D) volumes of the uterus of the first 5 patients were evaluated using 6 offline methods to assess feasibility. Feasible methods were analyzed for interobserver (n = 3) reliability (Fleiss kappa or intraclass correlation) and compared with current ultrasound methods (Cohen's weighted kappa and Spearman's rank correlation). Current methods include real-time estimation (mild/moderate/severe) and counting the individual sonographic features.
results"eXtended Imaging virtual organ computer-aided analysis (XI VOCAL) counting" (counting affected slices of 20 parallel slices in the 3D volume), "Multiplanar and 3D rendering (MPR) estimation" (grading volume by eyeballing in multiplanar render mode), and "2D-clip estimation" (grading volume in 2D-clips) emerged as feasible methods. "XI VOCAL counting" and "2D-clip estimation" demonstrated good interobserver reliability, whereas "MPR estimation" had poor reliability. Comparison with real-time estimation showed moderate reliability with all methods. "XI VOCAL counting" and "MPR estimation" correlated positively with the number of sonographic features.
conclusion"XI VOCAL counting" demonstrated to be feasible with good interobserver reliability to assess the severity of adenomyosis in an objective, systematic, and semi-quantifiable fashion and should be validated with large-scale studies for future use. Future studies should also explore the association between sonographic severity and symptoms of adenomyosis.
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