A Personal Healthcare Knowledge Graph Framework for Diagnosis of Pelvic Masses Diseases.

A Personal Health Knowledge Graph (PHKG) facilitates the efficient integration of potential diagnostic clues from patients' electronic health records with medical knowledge, establishing diagnostic reasoning paths and ensuring accurate, individually interpretable results in the diagnosis of pelvic masses.

Diagnostic value of endoscopic ultrasonography in pelvic masses with bowel involvement.

Benign and malignant pelvic masses with or without intestinal invasion are common in women of childbearing age. Patients may have nonspecific symptoms and signs or experience no symptoms. Laparoscopic resection of pelvic masses is currently the mainstream treatment; therefore, accurate preoperative evaluation is not only essential for patients suspected of having intestinal invasion, but also extremely important for the selection of follow-up treatment. Procedures, including endoscopic ultrasonography (EUS), pelvic magnetic resonance imaging, abdominal computed tomography, vaginal ultrasonography, barium enema, and colonoscopy, aid in determining the presence, depth, and histology of the disease. In particular, the wide application and continuous developments in EUS techniques have improved the diagnostic accuracy for intestinal subepithelial and peripheral organ lesions. This article reviewed the clinical value of EUS in the diagnosis of benign and malignant pelvic masses with bowel involvement.

Gynecological Healthcare: Unveiling Pelvic Masses Classification through Evolutionary Gravitational Neocognitron Neural Network Optimized with Nomadic People Optimizer.

Accurate and early detection of malignant pelvic mass is important for a suitable referral, triage, and for further care for the women diagnosed with a pelvic mass. Several deep learning (DL) methods have been proposed to detect pelvic masses but other methods cannot provide sufficient accuracy and increase the computational time while classifying the pelvic mass. To overcome these issues, in this manuscript, the evolutionary gravitational neocognitron neural network optimized with nomadic people optimizer for gynecological abdominal pelvic masses classification is proposed for classifying the pelvic masses (EGNNN-NPOA-PM-UI). The real time ultrasound pelvic mass images are augmented using random transformation. Then the augmented images are given to the 3D Tsallis entropy-based multilevel thresholding technique for extraction of the ROI region and its features are further extracted with the help of fast discrete curvelet transform with the wrapping (FDCT-WRP) method. Therefore, in this work, EGNNN optimized with nomadic people optimizer (NPOA) was utilized for classifying the gynecological abdominal pelvic masses. It was executed in PYTHON and the efficiency of the proposed method analyzed under several performance metrics. The proposed EGNNN-NPOA-PM-UI methods attained 99.8%. Ultrasound image analysis using the proposed EGNNN-NPOA-PM-UI methods can accurately predict pelvic masses analyzed with the existing methods.

Multiple Intraabdominal and Pelvic Cystadenomas From Ovarian Remnant Syndrome.

Serous cystadenomas are benign epithelial neoplasms of the ovary, and they typically have an average size of around 10 cm. Our patient is a 68-year-old female who originally presented with abdominal page. Our patient's prior surgical history includes a bilateral salpingo-oophorectomy. Computed tomography scans showed five abdominal and pelvic masses of significant size. Our patient elected to undergo exploratory laparotomy and mass excision, and all five masses were able to be removed successfully. Final pathology confirmed the diagnosis of serous cystadenomas consistent with ovarian origin despite our patient undergoing a previous bilateral salpingo-oophorectomy. Our patient presented with a rare syndrome known as ovarian remnant syndrome that is thought to be caused by difficult hysterectomy procedures and prior abdominal surgeries that can unknowingly leave ovarian remnants. Second, the patient was found to have 5 abdominal and pelvic masses, and most of the masses were a very large size.

The Role of Ultrasound Guided Sampling Procedures in the Diagnosis of Pelvic Masses: A Narrative Review of the Literature.

Ultrasound-guided sampling methods are usually minimally invasive techniques applied to obtain cytological specimens or tissue samples, mainly used for the diagnosis of different types of tumors. The main benefits of ultrasound guidance is its availability. It offers high flexibility in the choice of sampling approach (transabdominal, transvaginal, and transrectal) and short duration of procedure. Ultrasound guided sampling of pelvic masses represents the diagnostic method of choice in selected patients. We carried out a narrative review of literatures regarding the ultrasound-guided methods of cytological and histological evaluation of pelvic masses as well as the positive and negative predictors for the achievement of an adequate sample.

A giant sacrococcygeal teratoma in adult female: A case report.

INTRODUCTION: Sacrococcygealteratoma is very rare in adults with only few cases reported in literature. It is a slow growing benign cystic tumor with 1-2% chance for malignant transformation and may attain a huge size causing pressure effect on pelvic and intra-abdominal organs. When grows caudally, it causes discomfort, skin excoriation and cosmetic disfigurement. PRESENTATION OF CASE: We present a giant, long standing Sacrococcygeal teratoma in an adult female patient which caused her significant obstructing lower gastrointestinal and urinary symptoms besides the discomfort and disfigurement of the sacral region. DISCUSSION: Sacrococcygeal teratomas are commonly present early in life but are very rare to be seen in adults with such a huge size in such a place where it interfered with patient sitting and sleeping. Diagnosis of our case was suspected by clinical examination, ultrasound and MRI while histopathology confirmed the diagnosis. It was completely excised along with the coccyx with primary wound closure and had a good postoperative recovery. Up till now, 18 months follow-up using clinical, biochemical and radiological assessment revealed no evidence of recurrence. CONCLUSION: Sacococcygeal teratoma should be considered in the differential diagnosis of large pelvic masses in adults. In the presence of an extra-corporal and deep intra pelvic extension, we recommend the posterior perineal approach for excision as it has convenient control over the mass during surgery and good cosmetic results.

Endoscopic ultrasound-guided FNA of pelvic lesions: A large single-center experience.

BACKGROUND: Pelvic endoscopic ultrasound-guided fine-needle aspiration (PEUS-FNA) of rectal or perirectal lesions is safe, minimally invasive, and well tolerated. It provides valuable information, which can greatly influence patient management. Herein, the authors present what to their knowledge is the largest series to date of PEUS-FNA. METHODS: PEUS-FNA specimens were retrieved from the archives of the study institution from January 2001 to March 2015. Only patients with solid pelvic lesions were examined. The cytopathology findings, immunohistochemistry, corresponding histology, and clinical data were collected. For analysis of accuracy, atypical or suspicious results were classified as "negative." The sensitivity and specificity of PEUS-FNA were calculated in a subset of patients with available surgical pathology. RESULTS: A total of 127 cases meeting the current study criteria were obtained from patients who underwent PEUS-FNA at the study institution between January 2001 and March 2015. The mean age of the patients was 60 years, and 53% were female. Pelvic lesions were comprised of 72% masses and 28% lymph nodes, with a mean mass diameter of 27.38 mm (range, 5-100 mm). PEUS-FNA was positive for malignancy in 45% of cases, atypical/suspicious in 4.7% of cases, and negative for malignancy in 50.3% of cases. Surgical pathology was available for 44 patients. PEUS-FNA demonstrated 89.3% sensitivity, 100% specificity, a diagnostic accuracy of 93.2%, a positive predictive value of 100%, and a negative predictive value of 84.2%. No complications were noted. CONCLUSIONS: PEUS-FNA is safe and effective for the investigation of pelvic lesions. Cancer Cytopathol 2016;124:836-41. © 2016 American Cancer Society.

Magnetic resonance imaging of pediatric pelvic masses.

Both benign and malignant pelvic masses are encountered in the pediatric population. Although ultrasonography remains the modality of choice for initial evaluation of a pediatric pelvic mass, in selected cases magnetic resonance (MR) imaging can add important diagnostic information. MR imaging has several advantages over ultrasonography and computed tomography, including superior contrast resolution and an ability to characterize abnormalities based on unique tissue characteristics. MR evaluation assists in lesion characterization, presurgical planning, and staging when a malignancy is suspected. MR imaging also offers a nonionizing imaging modality for long-term follow-up of patients undergoing therapy for malignant pelvic masses.

Ultrasound guided fnac of abdominal-pelvic masses-the pathologists' perspective.

INTRODUCTION: Fine Needle Aspiration(FNA) which is used for making a cytologic diagnosis has become an indispensable component of the work-up of many abnormalities.The objectives of this study were to adopt USG guided fine needle aspiration in the diagnosis of abdomino-pelvic masses, to assess its efficacy and to study the cytological features of abdominopelvic masses. MATERIALS AND METHODS: Hundred patients with clinically or sonologically diagnosed abdomino-pelvic masses were taken up for the study. FNAC was performed under real time USG guidance. The aspirates were smeared onto a minimum of 2 slides and they were routinely stained with H&E, MGG and Papanicolaou stains. OBSERVATIONS: The diagnostic accuracy rates of USG guided FNAC for benign, malignant and non-neoplastic lesions were 100%,96% and 94.4% respectively.The overall accuracy rate was 96.3%. CONCLUSION: USG guided FNAC is a rapid , economical,non-invasive, highly accurate and a safe diagnostic procedure which can pre-empt a lengthy and expensive workup in various abdomino- pelviv masses.

A short history of sonography in obstetrics and gynaecology.

The history of sonography in Obstetrics and Gynaecology dates from the classic 1958 Lancet paper of Ian Donald and his team from Glasgow. Fifty years on it is impossible to conceive of practising Obstetrics and Gynaecology without one of the many forms of ultrasound available today. Technological developments such as solid state circuitry, real time imaging, colour and power Doppler, transvaginal sonography and 3/4D imaging have been seized by clinical researchers to enhance the investigation and management of patients in areas as diverse as assessment of fetal growth and wellbeing, screening for fetal anomalies, prediction of pre-eclampsia and preterm birth, detection of ectopic gestation, evaluation of pelvic masses, screening for ovarian cancer and fertility management. Ultrasound guided procedures are now essential components of fetal therapy and IVF treatment. This concise history is written by someone who has witnessed each of these advances throughout the ultrasound era and is able to give perspective to these momentous happenings.

Diagnóstico ultrasonográfico de las masas pélvicas ginecológicas / Ultrasonographic Diagnosis of Gynecologic Pelvic Masses

Introducción: el ultrasonido constituye el examen diagnóstico ideal para el estudio de los tumores ginecológicos. Es un método efectivo, fácil de realizar, económico y no invasivo. Objetivo: caracterizar las masas pélvicas ginecológicas analizadas por ultrasonido. Métodos: se realizó un estudio observacional descriptivo transversal en el Hospital Universitario Ginecobstétrico Provincial Ana Betancourt de Mora desde enero hasta diciembre de 2013. El universo estuvo constituido por 312 féminas. El tamaño de la muestra fue de 151 pacientes seleccionadas al azar. Los datos se obtuvieron del libro de registro del salón de operaciones ginecológicas. La información se obtuvo de las historias clínicas. Se confeccionó una hoja de vaciamiento que se convirtió en el registro definitivo de la investigación y se determinaron estadísticas descriptivas. Resultados: la mayoría de las masas ginecológicas fueron fibroma uterino. Dentro de los hallazgos imagenológicos la mayoría de las masas tenían localización uterina, mostraron una tumoración única, fueron hipoecogénicos. Los diagnósticos clínicos y ultrasonográficos coincidieron por Anatomía Patológica. Conclusiones: el ultrasonido es de gran utilidad en el diagnóstico de las masas pélvicas(AU)

Introduction: Ultrasound is the ideal diagnostic test for the study of gynecologic tumors. It is an effective method, easy to perform, economical and non-invasive. Objective: Characterize gynecological pelvic masses by ultrasound. Methods: Atraverse descriptive observational study was carried out from January to December 2013; at the Provincial Obtetrics-Gynecology University Hospital. The study universe consisted of 312 women, 151 patients was the size of the sample, selected at random. The data were obtained from the registration book of the gynecological surgery room and from the clinical histories. A data sheet that became the definitive record of the investigation was constructed. Descriptive statistical was determined. Results: Most of the gynecological masses were uterine fibromas. Most of the masses, within the imaging discoveries, had uterine localization. They showed a unique tumor, they were hypoecogenic and clinical and ultrasonographic diagnosis pathologically agreed. Conclusions: ultrasound is useful in the diagnosis of pelvic masses(AU)