UCSF Radiologists Lead Work on SAR/ESUR Joint Consensus Statement for MR Imaging of Placenta Accreta Spectrum Disorders

Placenta accreta spectrum (PAS) disorders have become a significant life-threatening disease with rising incidence and high maternal-fetal morbidity and mortality. Imaging plays a crucial role in prenatal detection of these issues that allows for significant improvement in patient outcomes. Ultrasound remains the first line of imaging for detection, but tertiary centers have been using MRI for preoperative diagnosis and surgical planning purposes. However, imaging techniques and reporting of imaging findings of PAS disorders remains variable and non-uniform across the board. This heterogeneity in protocol called for a need to establish uniform technique, lexicon and structured reporting for PAS disorders.

As such, the Society of Abdominal Radiology (SAR) and European Society of Urogenital Radiology (ESUR) set out to establish joint guidelines on PAS disorders and propose strategies to standardize image acquisition, interpretation and reporting for PAS disorders with MRI. The lead authors of this important consensus work are Priyanka Jha, MBBS, assistant professor of Clinical Radiology and Liina Poder, MD, professor and director of Ultrasound in the Abdominal Imaging and Ultrasound section at the UC San Francisco Department of Radiology and Biomedical Imaging.  

Once the diagnosis is suspected on ultrasound, MRI can provide valuable information on the topography and depth of placental invasion in addition to the information readily available from ultrasound. This is helpful for counselling patients regarding diagnosis and potential effects on current pregnancy and future fertility. Surgical planning and need for multidisciplinary involvement can also be assessed. As a noninvasive, radiation-free imaging modality, MRI has the potential to serve as an important diagnostic tool. The authors provide a common denomination to allow for uniformity in MR image acquisition, interpretation, and reporting lexicon. Uniformity of reporting can allow for improved research efforts and can be applied toward future clinical trials. Overall, the authors concluded that a standardized imaging protocol and reporting system ensures recognition of imaging features of PAS disorders. These consensus recommendations should be used as a guide for the evaluation of PAS disorders with MRI.

This retrospective, observational and multicenter study was a collaboration between a global team of 11 radiologists from UCSF Medical Center, Aretaieion Hospital (Athens, Greece), Imperial College (London, UK), Mount Sinai (New York, NY), Montpellier Cancer Research Institute (France), Cochin Hospital (Paris, France), St James's University Hospital (Leeds, UK), University of Miami (Florida), Kyoto University (Japan), M llner Hauptstr (Salzburg, Austria) and Umberto I Hospital (Rome, Italy). The paper was recently published in European Radiology

The work is also being recognized by the European Society of Radiology (ESR) in their Highlights in European Radiology newsletter.

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