An Observational Study of Patients With Endometriosis to Evaluate the Usefulness of the MEDL Score, a New Method for Evaluating Endometriosis Using MRI

Study Overview
=================
Brief Summary
-----------------
The purpose of this study is to confirm the reproducibility that the MEDL score can be evaluated by Magnetic Resonance Imaging (MRI) in the similar way as laparoscopy, the gold standard for the evaluation of the disease state of endometriosis, in order to establish the MEDL score, a new evaluation index for endometriosis using MRI. Approximately 70-90 patients with endometriosis diagnosed by imaging and who are candidates for fertility-preserving surgery will be recruited retrospectively or prospectively, and the disease status of endometriosis will be evaluated using preoperative MR images, laparoscopic surgery videos, etc. The relationship between the condition and clinical symptoms, such as pain, is also considered.

Official Title
-----------------
A New Method for Evaluating Endometriosis Using MRI: A Study on the MEDL Score

Conditions
-----------------
Endometriosis

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients who consent to use their data in this study Patients with endometriosis diagnosed by transvaginal ultrasound (TVUS) and/or MRI Patients undergoing fertility-preserving surgery Patients with pain due to endometriosis Patients with endometriotic lesions other than ovarian cysts confirmed by MRI (concomitant ovarian cysts can be recruited) Patients with the following patient clinical information (TVUS is not mandatory when archived data is used) Patient clinical information: Preoperative MR images, videos of laparoscopic surgery, pathological evaluation of endometriosis, videos of preoperative TVUS, pain information related to endometriosis, information about infertility before surgery, information on QOL, information on postoperative recurrence, information on surgical difficulty, operating time, length of hospital stay for surgical operation, age, history of treatment (drugs, surgery), anamnesis and complication, history of endometriosis, age at menarche, menstrual cycle, date of surgery, date of MR image acquisition, operative procedure and history of pregnancy and childbirth. Exclusion Criteria: Patients who had surgery for endometriosis prior to the surgery included in this study Patients deemed inappropriate by the principal investigator Patients who obtained their voluntary consent but later withdrew their consent
Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation of MEDL score assessed by MRI and laparoscopy | Correlation coefficient of total MEDL score assessed by preoperative MRI and laparoscopy | at the time of surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Association of MRI findings by MEDL score with pain | Correlation coefficient between preoperative pain Visual Analog Scale (VAS) score and total MEDL score | preoperative | 
| Association of MRI findings by MEDL score with infertility | Relationship between presence or absence of infertility and total MEDL score | preoperative | 
| Association of MRI findings by MEDL score with SF-36 | Relationship between responses to the SF-36 questionnaire and total MEDL score | preoperative | 
| Association of MRI findings by MEDL score with Endometriosis Health Profile Questionnaire-30 (EHP-30) | Relationship between responses to the EHP-30 questionnaire and total MEDL score | preoperative | 
| Association of MRI findings by MEDL score with postoperative recurrence | Relationship between presence or absence of postoperative recurrence | from surgery to obtaining informed consent, assessed up to 3 years (for retrospective data collection) | 
| Association of MRI findings by MEDL score with Ultrasound-based Endometriosis Staging System (UBESS) | Relationship between stage of UBESS and total MEDL score | preoperative | 
| Association of MRI findings by MEDL score with operating time | Relationship between hospital stay and total MEDL score | at the time of surgery | 
| Association of MRI findings by MEDL score with hospital stay | Relationship between hospital stay and total MEDL score | at the time of surgery | 
| Agreement rate among evaluators using the MEDL score | The agreement rate for each evaluation item of MEDL score when multiple evaluators evaluated | at the time of preoperative MR imaging | 
| K coefficient among evaluators using the MEDL score | K coefficient for each evaluation item of MEDL score when multiple evaluators evaluated | at the time of preoperative MR imaging | 
| Concordance between laparoscopic findings and transvaginal ultrasound findings using the MEDL score | Correlation coefficient of total MEDL score assessed by preoperative transvaginal ultrasound and laparoscopy | at the time of surgery | 
| Association of MRI findings by MEDL score with rASRM score evaluated by laparoscopy | Correlation coefficient of total MEDL score assessed by preoperative MRI and rASRM score assessed by laparoscopy | at the time of surgery | 
| Association of MRI findings by MEDL score with ENZIAN classification evaluated by laparoscopy and MRI | Association between total MEDL score assessed by preoperative MRI and ENZIAN classification assessed by laparoscopy | at the time of surgery |