Recto-sigmoid endoscopic-ultrasonography in the staging of deep infiltrating endometriosis

Table 1 Main “exclusive” blind endo-rectal or endoscopic ultrasonography¹ in deep infiltrating endometriosis

Author	Ref.	Year	No.	Type	se%	sp%	ppv%	npv%
Roseau1	[19]	1993	(11)	Descriptive rectal endometriosis
Hauge	[27]	1993	(1)	Descriptive, anal endometriosis
Ohba	[26]	1996	64	Descriptive, correlation thickness USL and clinical symptoms
Chapron1	[29]	1998	38 (17)	R preliminary results	Diagnosis accuracy: 100%
Fedele	[28]	1998	140 (24)	R	97	96
Roseau1	[16]	2000	46 (25)	R	100	100
Doniec	[30]	2003	65 (32)	R	97	97
Abrao1	[31]	2004	32 (6)	R	100	67
Delpy1	[32]	2005	30 (17)	P	92	66	64	92
Bahr	[33]	2006	37 (8)	R	87.5	97	87.5	97
Roman1	[34]	2007	(16)	Kappa coeff: 0.22; limited accuracy to predict layer involvement
Griffiths	[14]	2008	32	Likekihood ratio + : 10.89/-: 0.24; good results for recto-vaginal septum
Mezzi1	[35]	2011	68 (34)
Ferrari1	[36]	2012	(26)	Diagnosis accuracy: 100% with elastometry
Rossi1	[22]	2013	(38)	R	89	26	55	71

¹Main “exclusive” blind endo-rectal or endoscopic ultrasonography. ( ): Patients with digestive infiltration/type; R: Retrospective; P: Prospective; se: Sensitivity; sp: Specificity; ppv: Positive predictive value; npv: Negative predictive value; USL: Utero-sacral ligament.

Table 2 Evaluation of magnetic resonance imaging in staging deep infiltrating endometriosis

Anatomical location	se%	sp%	acc%	ppv%	npv%
Global	90.3	91	90.8	92.3	89
USL	76	83.3	80.5	74	84.7
Vagina	76	95.4	93.3	67	97
Septum	80	97.8	96.9	67	98.7
Recto-sigmoid	88	97.8	94.9	95	95
Bladder	88	98.9	97.9	88	98

Bazot et al[13], 2004: 195 patients treated by laparoscopy: n = 136 or laparotomy: n = 59; all specimens sent for histological examination as the gold standard. se: Sensitivity; sp: Specificity; ppv: Predictive positive value; npv: Negative predictive value; acc: Accuracy rate.

Table 3 Comparative studies magnetic resonance imaging vs recto-sigmoid endoscopic ultrasonography in staging deep infiltrating endometriosis

Author	Ref.	Year	No.	Type	se%		sp%		ppv%		npv%
					MRI	RS-EUS	MRI	RS-EUS	MRI	RS-EUS	MRI	RS-EUS
Dumontier	[47]	2000	48 (16)	R	75	100	100	100
Camagna	[48]	2004	50 (19)	R	53	100	82	71	69	81	19	100
Thomassin	[49]	2004	(27)	P	92	100			89	100
Chapron	[50]	2004	81 (17)	R	76.5	97	98	89.4	96	87	85	98
Bazot	[51]	2007	88 (60)	P	88.3	90	92.8	89.3	96.4	94.7	78.8	80.6
Benbara	[52]	2008	50 (40)	R	55	100			Post operative follow up
Gauche-cazalis	[53]	2012	25 (19)	R	89	94	50	66.7	MRI contributive for torus, USL and bladder

( ): Number with digestive infiltration; R: Retrospective; P: Prospective; se: Sensitivity; sp: Specificity; ppv: Predictive positive value; npv: Negative predictive value; MRI: Magnetic resonance imaging; RS-EUS: Recto-sigmoid endoscopic ultrasonography; USL: Utero-sacral ligament.

Table 4 Comparative studies trans-vaginal sonography vs recto-sigmoid endoscopic ultrasonography in staging deep infiltrating endometriosis

Author	Ref.	Year	No.	Type	se%		sp%		ppv%		npv%
					TVS	RS-EUS	TVS	RS-EUS	TVS	RS-EUS	TVS	RS-EUS
Bazot	[54]	2003	30	P	95	82	100	88	100	95	89	84
Bazot	[56]	2003	81	P	92	88.9	100	92.6	89	100	87	80.6
Piketti	[57]	2009	134	P	90.7	96	96	100	100	96	88.9	95.2
Gauche-cazalis	[53]	2011	25	R	73.7	94.7	66.7	66.7	RS-EUS : Appropriate for rectum and recto-vaginal septumTVS: Good for ovarian endometriomas

( ): Number of patients with digestive infiltration; R: Retrospective; P: Prospective; se: Sensitivity; sp: Specificity; ppv: Positive predictive value; npv: Negative predictive value; RS-EUS: Recto-sigmoid endoscopic ultrasonography; TVS: Trans-vaginal sonography.

Table 5 Retrospective comparative study between trans-vaginal sonography, recto-sigmoid endoscopic ultrasonography, and magnetic resonance imaging for diagnosis of main locations of deep pelvic endometriosis

	OV			Torus			USL			RVS			RSJ			Bladder
	TVS	RS-EUS	MRI	TVS	RS-EUS	MRI	TVS	RS-EUS	MRI	TVS	RS-EUS	MRI	TVS	RS-EUS	MRI	TVS	RS-EUS	MRI
se (%)	88	80	87	57	76	76	63	37	69	63	89	47	73	95	89	16	16	33
sp (%)	71	81	71	100	100	100	82	100	82	100	67	100	66	66	50	100	100	89

Gauche Cazalis et al[53] 2012: 25 patients included. OV: Ovary; USL: Uterosacral ligament; RVS: Rectovaginal septum; RSJ: Rectosigmoïd junction; se: Sensitivity; sp: Specificity are expressed in%.