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Trial Title:
Role of US in Uterine Fibroids in Comparison With MRI Using FIGO Classification
NCT ID:
NCT05695690
Condition:
Uterine Fibroid
Conditions: Official terms:
Leiomyoma
Myofibroma
Study type:
Observational
Overall status:
Not yet recruiting
Study design:
Time perspective:
Prospective
Intervention:
Intervention type:
Device
Intervention name:
Ultrasonography
Description:
Comparing between value of ultrasound vs MRI in uterine fibroids
Other name:
MRI
Summary:
Evaluation of diagnostic accuracy of ultrasound in uterine fibroid characterization
compared with MRI using FIGO classification
Detailed description:
Uterine fibroids, also known as uterine leiomyomata or myomas, are the most common
gynecologic tumors occurring in 20-30% of women of reproductive age and in up to 80% of
all women.
Leiomyomas have a wide spectrum of clinical presentations, but are mostly asymptomatic.
Submucosal leiomyomas are more commonly associated with symptoms such as AUB,
dysmenorrhea, infertility, and recurrent pregnancy loss. Subserosal leiomyomas can cause
gastrointestinal or genitourinary symptoms related to size such as constipation, urinary
retention, urinary frequency and urgency, or bladder and bowel incontinence.
Fibroids are monoclonal smooth muscle tumors arising from the myometrium. While benign,
their growth is dependent on estrogen and progesterone levels, and thus fibroids may
enlarge with pregnancy and use of oral contraceptives and regress during menopause.
Ultrasonography (USG) is the first-line imaging modality for any suspected structural
anomaly of the female pelvis as well as the most appropriate imaging modality for
abnormal uterine bleeding. USG has high sensitivity and specificity in diagnosing
leiomyomas, but can vary with the experience of the operator performing the USG, ranging
from 65 to 99%.
Pelvic USG usually consists of a combined approach to include both transabdominal (TAS)
and transvaginal (TVUS) imaging. TVUS is generally considered to be more sensitive and
specific with greater contrast and spatial resolution when compared to TAS. TVUS is more
useful in obese patients, patients with a large amount of bowel gas, and in patients with
incomplete bladder filling, all of which lower the sensitivity of TAS. TAS, on the other
hand, is helpful in females with a larger uterus that extends superiorly from the pelvis
and cannot be completely visualized in the field of TVUS. TAS provides an anatomic
overview to better estimate overall uterine size and visualize the fundus in such cases.
For incomplete visualization or indeterminate US findings, MRI is recommended. MR imaging
is considered to be superior to USG offering anatomic detail with increased sensitivity
and specificity in mapping the location and size of leiomyomas prior to treatment.
Previous studies have shown that MRI has the greatest advantage in diagnosing leiomyomas
especially in cases of multiple leiomyomas (> 4) or a large volume uterus (> 375 mL).
Through the use of diffusion weighted imaging MR may also help identify lesions with
higher cellularity such as leiomyosarcomas.
Despite these limitations, TVUS remains as efficient as MR in detecting the presence of
leiomyomas and due to the lower cost, greater availability, and fewer contraindications,
USG remains the first-line imaging modality for diagnosing the presence of leiomyomas.
Furthermore, Baird et al. found that the presence of leiomyomas on a baseline ultrasound
is strongly predictive of future uterine procedures approaching nearly 50% for those
patients with a leiomyoma 4 cm or greater at baseline.
Leiomyomas have traditionally been classified as submucosal, intramural, and subserosal.
With the advancements in the treatment modalities, there was a need for a more detailed
and universally accepted classification system to direct optimal treatment options. For
this reason, the FIGO classification system was developed in 2011 for causes of AUB.
The International Federation of Gynecology and Obstetrics (FIGO) classification system
for abnormal uterine bleeding is intended to help both clinicians and researchers better
categorize the causes of bleeding and plan treatments for the patient, be it
hysteroscopy, laparoscopy/laparotomy, or UAE. Precise classification is also necessary in
the post-treatment setting in order to assess treatment response, change in overall tumor
burden and presence of recurrent lesions. The FIGO classification system subdivides
fibroids into submucosal, other (intramural and subserosal), and hybrid types.
Criteria for eligibility:
Study pop:
All females known or clinically suspected to have uterine fibroids
Sampling method:
Non-Probability Sample
Criteria:
Inclusion Criteria:
- All females known or clinically suspected to have uterine fibroids & fit for the MRI
examination.
Exclusion Criteria:
- Patients with metallic prosthesis which are not MRI compatible.
- Patients refused the examination.
- Patients who suffer from claustrophobia.
- Pregnant women especially in the first trim
Gender:
Female
Gender based:
Yes
Gender description:
Female
Minimum age:
N/A
Maximum age:
N/A
Start date:
May 2023
Completion date:
May 2024
Lead sponsor:
Agency:
Assiut University
Agency class:
Other
Source:
Assiut University
Record processing date:
ClinicalTrials.gov processed this data on November 12, 2024
Source: ClinicalTrials.gov page:
https://clinicaltrials.gov/ct2/show/NCT05695690