Assessment of pelvic organ prolapse with the Pelvic Inclination Correction System: defining the normal range and threshold to pathology.

Ghafoor, Soleen; Beintner-Skawran, Stephan; Betschart, Cornelia; Winklehner, Thomas; Reiner, Cäcilia S (2024). Assessment of pelvic organ prolapse with the Pelvic Inclination Correction System: defining the normal range and threshold to pathology. Abdominal radiology, 49(6), pp. 1996-2007. Springer 10.1007/s00261-024-04222-x

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PURPOSE

To define the normal range and threshold values for pathologic prolapse on MRI using the PICS line and assess its correlation with the pubococcygeal line (PCL).

METHODS

This prospective, IRB-approved study included 20 nulliparous volunteers and 18 prolapse patients (POP-Q Stage ≥ 2). Organ positions (bladder, cervix, anorectal junction) relative to PICS and PCL were measured on dynamic MRI. Differences in organ position were compared. Receiver-operating characteristic (ROC) analysis was performed to identify cutoff values for prolapse using the PICS line. The correlation between PICS and PCL measurements was tested with Spearman's rank correlation.

RESULTS

In volunteers, median bladder and cervix positions measured to the PICS at rest were - 2.7 cm and - 5.3 cm compared to - 1.9 cm and - 2.7 cm in patients (p < 0.001). During straining, bladder and cervix were at - 0.9 cm and - 3.2 cm in volunteers versus + 2.5 cm and + 2.5 cm in patients (p < 0.001). Correlation was strong for PICS and PCL measurements for all three compartments (δ = 0.883-0.970, p ≤ 0.001). AUCs of PICS for the anterior and middle compartment were 0.98 (95% confidence interval [CI] 0.96-1.00, p < 0.001) and 0.96 (95% CI 0.89-1.00, p < 0.001) for differentiating patients from healthy volunteers. AUC for the posterior compartment was 0.76 (95% CI 0.57-0.96, p = 0.034).

CONCLUSION

PICS measurements reliably differentiate patients from volunteers in the anterior and middle compartment. Future studies need to identify a reliable threshold for the posterior compartment. PICS and PCL measurements are strongly correlated.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research

UniBE Contributor:

Winklehner, Thomas

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

2366-0058

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

14 Mar 2024 15:20

Last Modified:

29 Jun 2024 00:13

Publisher DOI:

10.1007/s00261-024-04222-x

PubMed ID:

38480546

Uncontrolled Keywords:

Diagnostic imaging Magnetic resonance imaging Pelvic floor disorders Pelvic organ prolapse

BORIS DOI:

10.48350/194271

URI:

https://boris.unibe.ch/id/eprint/194271

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