Elusive adenomyosis: a plea for an international classification system to allow artificial intelligence approaches to reset our clinical management
Reflections
Published
Volume 110, Issue 6, Pages 1039–1040
Authors:
Michel Canis, M.D., Ph.D., Anne Sophie Gremeau, M.D., Nicolas Bourdel, M.D., Ph.D.
Abstract:
Reflections on "A sonographic classification of adenomyosis: interobserver reproducibility in the evaluation of type and degree of the myometrial involvement" by Lazzeri et al.
Comments
This reflections piece and the corresponding original research article address the important topic of standardization of radiologic diagnosis of adenomyosis. Research on adenomyosis has traditionally been impaired by a lack of consensus on diagnostic criteria. In terms of pathologic criteria, inconsistent definitions existed on what depth of glandular invasion beneath the endomyometrial junction constitutes adenomyosis. It is difficult to study a new approach to the diagnosis of a condition (radiologic diagnosis) when confusion still exists regarding the "gold standard" of diagnosis (pathology).
It would be a huge breakthrough for patients and physicians if a reliable classification system was validated and widely accepted. As of today, the implications of a diagnosis of adenomyosis and its extent are very high, and providers make treatment decisions largely "in the dark".
Treatment recommendations may range from GnRHa pre-treatment prior to IVF/ET, surgical interventions to even recommending the use of a gestational carrier.
Can the authors predict when an internationally agreed upon "objective, scientifically based classification of adenomyosis" will be a reality?