Skip to main content
Erschienen in: International Urogynecology Journal 5/2015

01.05.2015 | Original Article

Quantitative assessment of new MRI-based measurements to differentiate low and high stages of pelvic organ prolapse using support vector machines

verfasst von: S. Onal, S. Lai-Yuen, P. Bao, A. Weitzenfeld, D. Hogue, S. Hart

Erschienen in: International Urogynecology Journal | Ausgabe 5/2015

Einloggen, um Zugang zu erhalten

Abstract

Introduction and hypothesis

The objective of this study was to quantitatively assess the ability of new MRI-based measurements to differentiate low and high stages of pelvic organ prolapse. New measurements representing pelvic structural characteristics are proposed and analyzed using support vector machines (SVM).

Methods

This retrospective study used data from 207 women with different types and stages of prolapse. Their demographic information, clinical history, and dynamic MRI data were obtained from the database. New MRI measurements were extracted and analyzed based on these reference lines: pubococcygeal line (PCL), mid-pubic line (MPL), true conjugate line (TCL), obstetric conjugate line (OCL), and diagonal conjugate line (DCL). A classification model using SVM was designed to assess the impact of the features (variables) in classifying prolapse into low or high stage.

Results

The classification model using SVM can accurately identified anterior prolapse with very high accuracy (>0.90), and apical and posterior prolapse with good accuracy (0.80 – 0.90). Two newly proposed MRI-based features were found to be significant in the identification of anterior and posterior prolapse: the angle between TCL and MPL for anterior prolapse, and the angle between DCL and PCL for posterior prolapse. The overall accuracy of posterior prolapse identification increased from 47 % to 80 % when the newly proposed MRI-based features were taken into consideration.

Conclusions

The proposed MRI-based measurements are effective in differentiating low and high stages of pelvic organ prolapse, particularly for posterior prolapse.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Dallenbach P, Kaelin-Gambirasio I, Jacob S, Dubuisson JB, Boulvain M (2008) Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J 19(12):1623–1629CrossRef Dallenbach P, Kaelin-Gambirasio I, Jacob S, Dubuisson JB, Boulvain M (2008) Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J 19(12):1623–1629CrossRef
2.
Zurück zum Zitat Mouritsen L, Larsen JP (2003) Symptoms, bother and POPQ in women referred with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 14:122–127CrossRefPubMed Mouritsen L, Larsen JP (2003) Symptoms, bother and POPQ in women referred with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 14:122–127CrossRefPubMed
3.
Zurück zum Zitat Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JOL, Klarskov P, Shull BL, Smith ARB (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17CrossRefPubMed Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JOL, Klarskov P, Shull BL, Smith ARB (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175(1):10–17CrossRefPubMed
4.
Zurück zum Zitat Comiter CV, Vasavada SP, Barbaric ZL, Gousse AE, Raz S (1999) Grading pelvic prolapse and pelvic floor relaxation using dynamic magnetic resonance imaging. Urology 3:454–457CrossRef Comiter CV, Vasavada SP, Barbaric ZL, Gousse AE, Raz S (1999) Grading pelvic prolapse and pelvic floor relaxation using dynamic magnetic resonance imaging. Urology 3:454–457CrossRef
5.
Zurück zum Zitat Singh K, Cortes E, Reid WM (2003) Evaluation of the fascial technique for surgical repair of isolated posterior vaginal wall prolapse. Obstet Gynecol 101:320–324CrossRefPubMed Singh K, Cortes E, Reid WM (2003) Evaluation of the fascial technique for surgical repair of isolated posterior vaginal wall prolapse. Obstet Gynecol 101:320–324CrossRefPubMed
6.
Zurück zum Zitat Gousse AE, Barbaric ZL, Safir MH (1998) Dynamic “HASTE” MRI sequence in the evaluation of all female pelvic pathology. Urology 159:328–334 Gousse AE, Barbaric ZL, Safir MH (1998) Dynamic “HASTE” MRI sequence in the evaluation of all female pelvic pathology. Urology 159:328–334
8.
Zurück zum Zitat Betschart C, Chen L, Ashton-Miller JA, DeLancey JOL (2013) On pelvic reference lines and the MR evaluation of genital prolapse: a proposal for standardization using the pelvic inclination correction system. Int Urogynecol J 24(9):1421–1428CrossRefPubMedCentralPubMed Betschart C, Chen L, Ashton-Miller JA, DeLancey JOL (2013) On pelvic reference lines and the MR evaluation of genital prolapse: a proposal for standardization using the pelvic inclination correction system. Int Urogynecol J 24(9):1421–1428CrossRefPubMedCentralPubMed
9.
Zurück zum Zitat Goh V, Halligan S, Kaplan G, Healy JC, Bartram CI (2000) Dynamic MR imaging of the pelvic floor in asymptomatic subjects. AJR Am J Roentgenol 174:661–666CrossRefPubMed Goh V, Halligan S, Kaplan G, Healy JC, Bartram CI (2000) Dynamic MR imaging of the pelvic floor in asymptomatic subjects. AJR Am J Roentgenol 174:661–666CrossRefPubMed
10.
Zurück zum Zitat Healy JC, Kaufman HS, Reznek RH (1997) Dynamic MR imaging compared with evacuation proctography when evaluating anorectal configuration and pelvic floor movement. AJR Am J Roentgenol 169:775–779CrossRefPubMed Healy JC, Kaufman HS, Reznek RH (1997) Dynamic MR imaging compared with evacuation proctography when evaluating anorectal configuration and pelvic floor movement. AJR Am J Roentgenol 169:775–779CrossRefPubMed
11.
Zurück zum Zitat Lienemann A, Anthuber C, Baron A, Kohn P, Reiser M (1997) Dynamic MR colpocystorectography assessing pelvic floor descent. Eur Radiol 7:1309–1317CrossRefPubMed Lienemann A, Anthuber C, Baron A, Kohn P, Reiser M (1997) Dynamic MR colpocystorectography assessing pelvic floor descent. Eur Radiol 7:1309–1317CrossRefPubMed
12.
Zurück zum Zitat Cortes E, Reid WMN, Singh K, Berger L (2004) Clinical examination and dynamic magnetic resonance imaging in vaginal vault prolapse. Obstet Gynecol 103:41–46CrossRefPubMed Cortes E, Reid WMN, Singh K, Berger L (2004) Clinical examination and dynamic magnetic resonance imaging in vaginal vault prolapse. Obstet Gynecol 103:41–46CrossRefPubMed
13.
Zurück zum Zitat Lienemann A, Sprenger D, Janssen U, Grosch E, Pellengahr C, Anthuber C (2004) Assessment of pelvic organ descent by use of functional cine-MRI: which reference line should be used? Neurourol Urodyn 23:33–37CrossRefPubMed Lienemann A, Sprenger D, Janssen U, Grosch E, Pellengahr C, Anthuber C (2004) Assessment of pelvic organ descent by use of functional cine-MRI: which reference line should be used? Neurourol Urodyn 23:33–37CrossRefPubMed
14.
Zurück zum Zitat Robinson CJ, Swift S, Johnson DD, Almeida JS (2008) Prediction of pelvic organ prolapse using an artificial neural network. Am J Obstet Gynecol 199:193.e1–193.e6 Robinson CJ, Swift S, Johnson DD, Almeida JS (2008) Prediction of pelvic organ prolapse using an artificial neural network. Am J Obstet Gynecol 199:193.e1–193.e6
15.
Zurück zum Zitat Broekhuis SR, Futterer JJ, Barentsz JO, Vierhout ME (2009) A systematic review of clinical studies on dynamic magnetic resonance imaging of pelvic organ prolapse: the use of reference lines and anatomical landmarks. Int Urogynecol J Pelvic Floor Dysfunct 20:721–729CrossRefPubMed Broekhuis SR, Futterer JJ, Barentsz JO, Vierhout ME (2009) A systematic review of clinical studies on dynamic magnetic resonance imaging of pelvic organ prolapse: the use of reference lines and anatomical landmarks. Int Urogynecol J Pelvic Floor Dysfunct 20:721–729CrossRefPubMed
16.
Zurück zum Zitat Fauconnier A, Zareski E, Abichedid J, Bader G, Falissard B, Fritel X (2007) Dynamic magnetic resonance imaging for grading pelvic organ prolapse according to the International Continence Society classification: which line should be used? Neurourol Urodyn 27:191–197CrossRef Fauconnier A, Zareski E, Abichedid J, Bader G, Falissard B, Fritel X (2007) Dynamic magnetic resonance imaging for grading pelvic organ prolapse according to the International Continence Society classification: which line should be used? Neurourol Urodyn 27:191–197CrossRef
17.
Zurück zum Zitat Pannu KH, Scatrige CJ, Eng J (2011) MRI diagnosis of pelvic organ prolapse compared with clinical examination. Acad Radiol 18(10):1245–1251CrossRefPubMed Pannu KH, Scatrige CJ, Eng J (2011) MRI diagnosis of pelvic organ prolapse compared with clinical examination. Acad Radiol 18(10):1245–1251CrossRefPubMed
18.
Zurück zum Zitat Onal S, Lai-Yuen S, Bao P, Weitzenfeld A, Hart S (2014) MRI based segmentation of pubic bone for evaluation of pelvic organ prolapse. IEEE J Biomed Health Inform 18(4):1370–1378CrossRefPubMed Onal S, Lai-Yuen S, Bao P, Weitzenfeld A, Hart S (2014) MRI based segmentation of pubic bone for evaluation of pelvic organ prolapse. IEEE J Biomed Health Inform 18(4):1370–1378CrossRefPubMed
19.
Zurück zum Zitat Onal S, Lai-Yuen S, Bao P, Weitzenfeld A, Greene K, Kedar R, Stuart H (2014) Assessment of a semi-automated pelvic floor measurement model for the evaluation of pelvic organ prolapse on MRI. Int Urogynecol J 25(6):767–773CrossRefPubMed Onal S, Lai-Yuen S, Bao P, Weitzenfeld A, Greene K, Kedar R, Stuart H (2014) Assessment of a semi-automated pelvic floor measurement model for the evaluation of pelvic organ prolapse on MRI. Int Urogynecol J 25(6):767–773CrossRefPubMed
20.
Zurück zum Zitat Swift SE, Woodman P, O’Boyle A (2005) Pelvic organ support study (POSST): the distribution, clinical definition and epidemiology of pelvic organ support defects. Am J Obstet Gynecol 192(3):795–806CrossRefPubMed Swift SE, Woodman P, O’Boyle A (2005) Pelvic organ support study (POSST): the distribution, clinical definition and epidemiology of pelvic organ support defects. Am J Obstet Gynecol 192(3):795–806CrossRefPubMed
21.
Zurück zum Zitat Onal S, Lai-Yuen S, Bao P, Weitzenfeld A, Hart S (2013) Image based measurements for evaluation of pelvic organ prolapse. J Biomed Sci Eng 6(1):45–55CrossRef Onal S, Lai-Yuen S, Bao P, Weitzenfeld A, Hart S (2013) Image based measurements for evaluation of pelvic organ prolapse. J Biomed Sci Eng 6(1):45–55CrossRef
22.
Zurück zum Zitat Ubeyli ED (2007) Implementing automated diagnostic systems for breast cancer detection. Exp Syst Appl 33(4):1054–1062CrossRef Ubeyli ED (2007) Implementing automated diagnostic systems for breast cancer detection. Exp Syst Appl 33(4):1054–1062CrossRef
23.
Zurück zum Zitat Gousse AE, Barbaric ZL, Safir MH, Madjar S, Marumoto AK, Raz S (2000) Dynamic half Fourier acquisition, single shot turbo spin-echo magnetic resonance imaging for evaluating the female pelvis. J Urol 164:1606–1613CrossRefPubMed Gousse AE, Barbaric ZL, Safir MH, Madjar S, Marumoto AK, Raz S (2000) Dynamic half Fourier acquisition, single shot turbo spin-echo magnetic resonance imaging for evaluating the female pelvis. J Urol 164:1606–1613CrossRefPubMed
24.
Zurück zum Zitat Kelvin FM, Hale DS, Maglinte DD, Patten BJ, Benson JT (1999) Female pelvic organ prolapse: diagnostic contribution of dynamic cystoproctography and comparison with physical examination. AJR Am J Roentgenol 173:31–37CrossRefPubMed Kelvin FM, Hale DS, Maglinte DD, Patten BJ, Benson JT (1999) Female pelvic organ prolapse: diagnostic contribution of dynamic cystoproctography and comparison with physical examination. AJR Am J Roentgenol 173:31–37CrossRefPubMed
25.
Zurück zum Zitat Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506CrossRefPubMed Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506CrossRefPubMed
Metadaten
Titel
Quantitative assessment of new MRI-based measurements to differentiate low and high stages of pelvic organ prolapse using support vector machines
verfasst von
S. Onal
S. Lai-Yuen
P. Bao
A. Weitzenfeld
D. Hogue
S. Hart
Publikationsdatum
01.05.2015
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 5/2015
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-014-2582-8

Weitere Artikel der Ausgabe 5/2015

International Urogynecology Journal 5/2015 Zur Ausgabe

Hirsutismus bei PCOS: Laser- und Lichttherapien helfen

26.04.2024 Hirsutismus Nachrichten

Laser- und Lichtbehandlungen können bei Frauen mit polyzystischem Ovarialsyndrom (PCOS) den übermäßigen Haarwuchs verringern und das Wohlbefinden verbessern – bei alleiniger Anwendung oder in Kombination mit Medikamenten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

22.04.2024 DGIM 2024 Kongressbericht

Durch die Häufung nach der COVID-19-Pandemie sind Infektionen mit dem Respiratorischen Synzytial-Virus (RSV) in den Fokus gerückt. Fachgesellschaften empfehlen eine Impfung inzwischen nicht nur für Säuglinge und Kleinkinder.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.