Quality Requirements for gynecological ultrasound examinations of DEGUM level II – Recommendations of the Sections/Working Groups Gynecology and Obstetrics of DEGUM, ÖGUM and SGUM

Hoopmann, Markus; Tutschek, B.; Merz, Eberhard; Eichhorn, Karl-Heinz; Kagan, Karl Oliver; Faber, R.; Rempen, A.; Kaehler, Christiane; Manegold-Brauer, Gwendolin; Helmy, S.; Klaritsch, Philipp; Grab, Dieter

doi:10.1055/a-1663-6322

Cited by 9 publications

(14 citation statements)

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“…The terms and definitions have been standardized and described in a consensus paper of the Morphological Uterine Sonographic Assessment (MUSA) group [38]. These diagnostic criteria are also anchored in the current quality requirements for DEGUM level 2 for gynecological sonography [11]. The diagnostic accuracy of TVS is high.…”

Section: Adenomyosis Uteri Has Sonographically Well-defined Criteria ...mentioning

confidence: 99%

“…In addition, adhesions can also be visualized indirectly using organ mobility and sliding signs on transvaginal sonography (TVS) [6,7]. Accurate sonographic evaluation of the different forms of endometriosis has become one of the most important elements in the management of affected women, which is now included in the recommendations of the national and international societies [8][9][10][11][12]. However, the former lack of standardized definitions in the sonographic classification and divergent methods of classifying the affected anatomical location and extent of the disease led to evident and inconclusive variations in the reported diagnostic accuracy of TVS in the diagnosis of endometriosis.…”

Section: Introductionmentioning

confidence: 99%

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Expert opinion on the use of transvaginal sonography for presurgical staging and classification of endometriosis

Keckstein

Hoopmann

Merz³

et al. 2022

Arch Gynecol Obstet

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Gynecological ultrasonography plays a central role in the management of endometriosis. The rapid technical development as well as the currently increasing evidence for non-invasive diagnostic methods require an updated compilation of recommendations for the use of ultrasound in the management of endometriosis. The present work aims to highlight the accuracy of sonography for diagnosing and classifying endometriosis and will formulate the present list of key messages and recommendations. This paper aims to demonstrate the accuracy of TVS in the diagnosis and classification of endometriosis and to discuss the clinical applications and consequences of TVS findings for indication, surgical planning and assessment of associated risk factors. (1) Sophisticated ultrasound is the primary imaging modality recommended for suspected endometriosis. The examination procedure should be performed according to the IDEA Consensus. (2) Surgical intervention to confirm the diagnosis alone is not recommended. A preoperative imaging procedure with TVS and/or MRI is strongly recommended. (3) Ultrasound examination does not allow the definitive exclusion of endometriosis. (4) The examination is primarily transvaginal and should always be combined with a speculum and a bimanual examination. (5) Additional transabdominal ultrasonography may enhance the accuracy of the examination in case of extra pelvic disease, extensive findings or limited transvaginal access. (6) Sonographic assessment of both kidneys is mandatory when deep endometriosis (DE) and endometrioma are suspected. (7) Endometriomas are well defined by sonographic criteria. When evaluating the ovaries, the use of IOTA criteria is recommended. (8) The description of sonographic findings of deep endometriosis should be systematically recorded and performed using IDEA terminology. (9) Adenomyosis uteri has sonographically well-defined criteria (MUSA) that allow for detection with high sensitivity and specificity. MRI is not superior to differentiated skilled ultrasonography. (10) Classification of the extent of findings should be done according to the #Enzian classification. The current data situation proves the best possible prediction of the intraoperative situs of endometriosis (exclusive peritoneum) for the non-invasive application of the #Enzian classification. (11) Transvaginal sonographic examination by an experienced examiner is not inferior to MRI diagnostics regarding sensitivity and specificity in the prediction of the extent of deep endometriosis. (12) The major advantage of non-invasive imaging and classification of endometriosis is the differentiated planning or possible avoidance of surgical interventions. The recommendations represent the opinion of experts in the field of non-invasive and invasive diagnostics as well as therapy of endometriosis. They were developed with the participation of the following national and international societies: DEGUM, ÖGUM, SGUM, SEF, AGEM/DGGG, and EEL.

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Section: Adenomyosis Uteri Has Sonographically Well-defined Criteria ...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Expert opinion on the use of transvaginal sonography for presurgical staging and classification of endometriosis

Keckstein

Hoopmann

Merz³

et al. 2022

Arch Gynecol Obstet

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“…The diagnosis of adnexal torsion is based on a combination of clinical picture and sonographic criteria (edema and enlargement of the ovary and/or fallopian tube and Doppler ultrasound imaging of the twisted vascular pedicle = whirlpool sign), which are discussed in greater detail in the quality requirements for gynecological examinations for DEGUM level II 32 . Since suspicion of adnexal torsion represents an emergency, the diagnosis should be able to be made in the basic ultrasound examination.…”

Section: Pathological Findingsmentioning

confidence: 99%

“…In the case of unclear findings in the lesser pelvis, suspicion of a malignancy, or prior to surgical interventions, detailed ultrasound examination is indicated 32 .…”

Section: Written Report and Documentationmentioning

confidence: 99%

“…Die Diagnostik der Adnextorsion basiert auf einer Kombination von klinischem Bild und sonografischen Kriterien (Ödem und Vergrößerung von Ovar und/oder Tube sowie dopplersonografische Darstellung des spiralförmig verdrehten Gefäßstiels = „Whirlpool-Zeichen“), welche in den Qualitätsanforderungen für gynäkologische Untersuchungen durch die DEGUM-Stufe II näher ausgeführt sind 32 . Da es sich beim Verdacht auf eine Adnextorsion um einen Notfall handelt, sollte die Diagnose allerdings auch schon in der Basisdiagnostik gestellt werden können.…”

Section: Pathologische Befundeunclassified

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Basic Gynecologic Ultrasound Examination (Level I): DEGUM, ÖGUM, and SGUM Recommendations

et al. 2022

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Ultrasound has become an essential diagnostic tool in gynecology, and every practicing gynecologist must be able to differentiate normal from pathologic findings, such as benign or malignant pelvic masses, adnexal torsion, pelvic inflammation disease, endometriosis, ectopic pregnancies, and congenital uterine malformations at least on a basic level. A standardized approach to the correct settings of the ultrasound system, the indications for gynecologic ultrasound investigations, and the sonographic appearance of normal anatomy and common pathologic findings in the standard planes are important prerequisites for safe and confident clinical management of gynecologic patients. Based on current publications and different national and international guidelines, updated DEGUM, ÖGUM, and SGUM recommendations for the performance of basic gynecologic ultrasound examinations were established.

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Development and implementation of a comprehensive postgraduate ultrasound curriculum for residents in obstetrics and gynecology: a feasibility study

Recker

Dugar

Böckenhoff

et al. 2022

Arch Gynecol Obstet

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Background In obstetric and gynecological practice, ultrasound is the essential diagnostic tool. Nevertheless, few clinics have standardized and structured training curricula for young obstetricians in the field of obstetric and gynecological ultrasound. Since ultrasound is best learned hands-on in small supervised groups, we developed and implemented a comprehensive ultrasound curriculum for all postgraduate residents of our department using a peer-teaching concept. Methods We used Kern‘s six-step model of curricular development comprising (1) problem identification and general needs assessment, (2) needs assessment of the targeted learners, (3) goals and objectives, (4) educational strategies, (5) implementation, and (6) evaluation and feedback. Results Assistant physicians in the 1st and 2nd year of training received a theoretical and practical ultrasound basic course (six modules) in addition to their obligatory clinic rotations. The six main topics were prioritized according to service relevance and included the main features according to DEGUM, EBCOG and ISUOG. The units focused on a three-level training based on the AMEE levels: theoretical knowledge, well-founded theoretical knowledge and basic practical skills under guidance and self-employment of practical skills. Conclusion Structured and standardized sonographic training allows young gynecology and obstetrics residents to conceptually grasp and practically implement topic-related themes. Furthermore, the course concept demonstrates the high inter-rater agreement among DEGUM-certified examiners. More research is needed to analyze the learning outcomes for residents and the improvement of the patient's outcome by establishing such an ultrasound curriculum.

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Quality Requirements for gynecological ultrasound examinations of DEGUM level II – Recommendations of the Sections/Working Groups Gynecology and Obstetrics of DEGUM, ÖGUM and SGUM

Cited by 9 publications

References 56 publications

Expert opinion on the use of transvaginal sonography for presurgical staging and classification of endometriosis

Expert opinion on the use of transvaginal sonography for presurgical staging and classification of endometriosis

Basic Gynecologic Ultrasound Examination (Level I): DEGUM, ÖGUM, and SGUM Recommendations

Development and implementation of a comprehensive postgraduate ultrasound curriculum for residents in obstetrics and gynecology: a feasibility study

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