Diagnostic Accuracy of Ultrasound and MRI in the Mapping of Deep Pelvic Endometriosis Using the International Deep Endometriosis Analysis (IDEA) Consensus

Table 3

Cross tabulation of study results.

Compartment

Areas investigated for DE

Index tests

TP (%)

FP (%)

TN (%)

FN (%)

Sensitivity (95% CI)

Specificity (95% CI)

PPV (95% CI)

NPV (95% CI)

LR+ (95% CI)

LR− (95% CI)

Accuracy (95% CI)

p-value

Anterior compartment

Bladder

TVS

8 (16.3%)

0 (0.0%)

40 (81.6%)

1 (2%)

0.89 (0.52–1.00)

1.00 (0.91–1.00)

1.00 (1.00–1.00)

0.98 (0.86–1.00)

Infinity

0.11 (0.02–0.71)

0.98 (0.89–1.00)

0.25

MRI

9 (18.3%)

2 (4.1%)

38 (77.6%)

0 (0.0%)

1.00 (0.66–1.00)

0.95 (0.83–0.99)

0.82 (0.54–0.95)

1.00 (1.00–1.00)

20 (5.1–77.2)

0.00

0.96 (0.86–0.99)

Ureteric obstruction by DE

TVS/TAS

5 (10.2%)

0 (0.0%)

44 (89.8%)

0 (0.0%)

1.00 (0.48–1.0)

1.00 (0.92–1.00)

1.00 (1.00–1.00)

1.00 (1.00–1.00)

Infinity

0.00

1.00 (0.93–1.00)

1.000

MRI

5 (10.2%)

0 (0.0%)

44 (89.8%)

0 (0.0%)

1.00 (0.48–1.0)

1.00 (0.92–1.0)

1.00 (1.00–1.00)

100 (1.00–1.00)

Infinity

0.00

1.00 (0.93–1.00)

Posterior compartment

USL^§

TVS

25 (51%)

5 (10.2%)

10 (20.4%)

9 (18.3%)

0.74 (0.56–0.87)

0.67 (0.38–0.88)

0.83 (0.70–0.91)

0.53 (0.36–0.68)

2.21 (1.05–4.64)

0.40 (0.20–0.77)

0.71 (0.57–0.83)

0.039

MRI

32 (65.3%)

6 (12.2%)

9 (18.3%)

2 (4.1%)

0.94 (0.80–0.99)

0.60 (0.32–0.84)

0.84 (0.74–0.91)

0.82 (0.52–0.95)

2.35 (1.26–4.40)

0.10 (0.02–0.40)

0.84 (0.70–0.93)

Right USL

TVS

10 (20.4%)

5 (10.2%)

26 (53%)

8 (16.3%)

0.56 (0.31–0.78)

0.84 (0.66–0.95)

0.67 (0.45–0.83)

0.76 (0.65–0.85)

3.44 (1.40–8.50)

0.53 (0.31–0.91)

0.73 (0.59–0.85)

0.001

MRI

17 (34.7%)

11 (22.4%)

20 (40.8%)

1 (2%)

0.94 (0.73–1.00)

0.65 (0.45–0.81)

0.61 (0.49–0.72)

0.95 (0.75–0.99)

2.66 (1.63–4.33)

0.09 (0.01–0.59)

0.76 (0.61–0.87)

Left USL

TVS

21 (42.9%)

0 (0.0%)

23 (46.9%)

5 (10.2%)

0.81 (0.61–0.93)

1.00 (0.85–1.00)

1.00 (1.00–1.00)

0.82 (0.68–0.91)

0.00

0.19 (0.09–0.42)

0.90 (0.78–0.97)

0.220

MRI

23 (46.9%)

2 (4.1%)

21 (42.9%)

3 (6.1%)

0.88 (0.70–0.98)

0.91 (0.72–0.99)

0.92 (0.75–0.98)

0.88 (0.71–0.95)

10.17 (2.69–38.52)

0.13 (0.04–0.37)

0.90 (0.78–0.97)

Upper rectum

TVS

10 (20.4%)

0 (0.0%)

39 (79.6%)

0 (0.0%)

1.00 (0.69–1.00)

1.00 (0.91–1.00)

1.00 (1.00–1.00)

1.00 (1.00–1.00)

Infinity

0.00

1.00 (0.93–1.00)

1.000

MRI

10 (20.4%)

0 (0.0%)

39 (79.6%)

0 (0.0%)

1.00 (0.66–0.89)

1.00 (0.91–1.00)

1.00 (1.00–1.00)

1.00 (1.00–1.00)

Infinity

0.00

1.00 (0.93–1.00)

Rectosigmoid

TVS

16 (32.7%)

5 (10.2%)

27 (55.1%)

1 (2%)

0.94 (0.71–1.00)

0.84 (0.67–0.95)

0.76 (0.59–0.88)

0.96 (0.80–0.99)

6.20 (2.67–13.59)

0.07 (0.01–0.47)

0.88 (0.75–0.95)

1.000

MRI

16 (32.7%)

5 (10.2%)

27 (55.1%)

1 (2%)

0.94 (0.71–1.00)

0.84 (0.67–0.95)

0.76 (0.59–0.88)

0.96 (0.80–0.99)

6.20 (2.67–13.59)

0.07 (0.01–0.47)

0.88 (0.75–0.95)

RVS

TVS

4 (8.2%)

0 (0.0%)

43 (87.8%)

2 (4.1%)

0.67 (0.22–0.96)

1.00 (0.92–1.00)

1.00 (1.00–1.00)

0.96 (0.87–0.98)

Infinity

0.33 (0.11–1.03)

0.96 (0.86–1.00)

0.125

MRI

5 (10.2%)

3 (6.1%)

40 (81.6%)

1 (2%)

0.83 (0.36–1.00)

0.93 (0.81–0.99)

0.63 (0.35–0.84)

0.98 (0.87–1.00)

11.9 (3.79–37.67)

0.18 (0.03–1.07)

0.92 (0.80–0.98)

Vagina

TVS

6 (12.2%)

0 (0.0%)

38 (77.6%)

5 (10.2%)

0.55 (0.23–0.83)

1.00 (0.91–1.00)

1.00 (1.00–1.00)

0.88 (0.80 –0.94)

Infinity

0.45 (0.24–0.87)

0.90 (0.78–0.97)

0.688

MRI

8 (16.3%)

2 (4.1%)

36 (73.5%)

3 (6.1%)

0.73 (0.39–0.94)

0.95 (0.82–0.99)

0.80 (0.50–0.94)

92.31 (0.82–0.97)

13.82 (3.42–55.9)

0.29 (0.11–0.76)

0.90 (0.78–0.97)

POD obliteration

TVS

35 (71.5%)

1 (2%)

8 (16.3%)

5 (10.2%)

0.88 (0.73–0.96)

0.89 (0.52–1.00)

0.97 (0.85–1.00)

0.62 (0.41–0.79)

7.87 (1.24–50.16)

0.14 (0.06–0.33)

0.88 (0.75–0.95)

0.040

MRI

23 (46.9%)

5 (10.2%)

4 (8.2%)

17 (34.7%)

0.58 (0.41–0.73)

0.44 (0.14–0.79)

0.82 (0.71–0.90)

0.19 (0.09–0.35)

1.03 (0.54–1.97)

0.96 (0.42–2.16)

0.55 (0.40–0.69)

Pelvis

Overall pelvic DE

TVS

80 (20.4%)

10 (2.5%)

280 (71.4%)

22 (5.6%)

0.78 (0.69–0.86)

0.97 (0.94–0.98)

0.89 (0.81–0.94)

0.93 (0.90–0.95)

22.8 (12.30–42.20)

0.22 (0.15–0.32)

0.92 (0.89–0.94)

MRI

93 (23.7%)

25 (6.4%)

265 (67.6%)

9 (2.3%)

0.91 (0.84–0.96)

0.91 (0.88–0.94)

0.79 (0.72–0.84)

0.97 (0.94–0.98)

10.58 (7.24–15.46)

0.10 (0.05–0.18)

0.91 (0.88–0.94)

§At least one affected side correctly identified. Total DE lesions are the sum of all individual sites affected in all participants. CI, confidence intervals; DE, deep endometriosis; FN, false negative; FP, False positive; LR+, positive likelihood ratio; LR−, negative likelihood ratio; MRI, magnetic resonance imaging; NPV, negative predictive value; -value, probability value of ultrasound vs. MRI performance (<0.05 considered significant); POD, pouch of Douglas; PPV, positive predictive value; RVS, rectovaginal septum; USL, uterosacral ligament; TAS, transabdominal ultrasound scan; TN, true negative TP, true positive; TVS, transvaginal ultrasound scan.