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Vandermeulen L, Cornelis A, Kjaergaard Rasmussen C, et al. Guiding histological assessment of uterine lesions using 3D in vitro ultrasonography and stereotaxis. Facts Views Vis Obgyn. 2017;9(2):77-84
Vandermeulen, L., Cornelis, A., Kjaergaard Rasmussen, C., Timmerman, D., & Van den Bosch, T. (2017). Guiding histological assessment of uterine lesions using 3D in vitro ultrasonography and stereotaxis. Facts, views & vision in ObGyn, 9(2), 77-84.
Vandermeulen, Lieselore, et al. "Guiding histological assessment of uterine lesions using 3D in vitro ultrasonography and stereotaxis." Facts, views & vision in ObGyn vol. 9,2 (2017): 77-84.
Vandermeulen L, Cornelis A, Kjaergaard Rasmussen C, Timmerman D, Van den Bosch T. Guiding histological assessment of uterine lesions using 3D in vitro ultrasonography and stereotaxis. Facts Views Vis Obgyn. 2017 Jun;9(2):77-84. PMID: 29209483; PMCID: PMC5707776.
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Facts Views Vis Obgyn. 2017 Jun;9(2):77-84.

Guiding histological assessment of uterine lesions using 3D in vitro ultrasonography and stereotaxis.

Facts, views & vision in ObGyn

Lieselore Vandermeulen, Ann Cornelis, Christina Kjaergaard Rasmussen, Dirk Timmerman, Thierry Van den Bosch

Affiliations

  1. Department of Obstetrics and Gynaecology, University Hospitals KU Leuven, 3000 Leuven, Belgium.
  2. Department of Obstetrics and Gynaecology, Regional Hospital RZTienen, 3300 Tienen, Belgium.
  3. Department of Pathology, Regional, Hospital RZTienen, 3300 Tienen, Belgium.
  4. Department of Obstetrics and Gynaecology, Aarhus University Hospital, 8000 Aarhus, Denmark.

PMID: 29209483 PMCID: PMC5707776

Abstract

OBJECTIVE: To compare ultrasonographic features of uterine lesions with the findings at macroscopy and microscopy.

METHODS: Case series of ten consecutive women undergoing a hysterectomy for uterine pathology. A preoperative transvaginal ultrasound examination was performed. After hysterectomy, the uterus was re-evaluated by 3D in vitro ultrasonography and in vitro gel instillation sonography (iGIS). The lesion of interest was pinpointed by inserting an intramuscular injection needle using a free-hand 2D-ultrasound guided technique to focus the macroscopic and the microscopic examination by the pathologist.

RESULTS: Adenomyosis, benign fibroids and infiltrating endometrial cancer were diagnosed in six, five and one patient, respectively. We found that iGIS improved image quality of in vitro ultrasound. There was a good correlation between the reported ultrasound features and the final histological diagnosis. Some lesions had been misinterpreted during preoperative ultrasonography or at macroscopical examination: e.g. dense myometrial vessels reported as small myometrial cysts at grey scale ultrasound examination; absence of macroscopical lesions in a case of diffuse adenomyosis.

CONCLUSIONS: In vitro 3D ultrasonography and iGIS allow for accurate mapping of uterine lesions so that ultrasound features can be matched with final histology. Our series demonstrates some pitfalls in the interpretation of sonographic and macroscopic features of uterine lesions. Stereotaxis of focal uterine lesions could focus histological assessment and reduces examination time for the pathologist.

Keywords: 3D ultrasonography; adenomyosis; iGIS; in vitro; in vitro gel instillation sonography; myoma; stereotaxis

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