The Gynaecological research team

The gynaecological team conduct research on a broad front focused on four main themes; ultrasound diagnostics, sexual and reproductive health, pelvic floor, robotic surgery and endometriosis.

The overall goal of the ultrasound research is to explore ultrasound as a diagnostic tool in the management of gynecological cancer as well as benign disease, in order to optimize utilization of healthcare resources and to avoid over and under-treatment. We evaluate new ultrasound techniques, conduct translational research, with the aim of tailor the treatment for each woman. We also develop and evaluate game-based learning and artificial intelligence in the diagnosis of ovarian tumours.

The sexual and reproductive health project includes:1/ Evaluation of home abortion up to 70 days gestation aiming to improve management of medical abortion, 2/ Reduce menstrual pain by exploring new treatment options for dysmenorrhea and endometriosis and evaluate quality of life for women affected by menstruation related pain. 3/ Explore potential adverse events during pregnancy and labour in women with a history of female genital mutilation.

Pelvic floor, robotic surgery and endometriosis: The aim is to 1/ Identify variables that could optimize outcomes in women who undergo surgical treatment for symptoms related to pelvic floor dysfunction. 2/ Find out if surgical more complex cases have less complications using robotic hysterectomy and apical prolapse as compared to other methods in Sweden. 3/ If ultrasound can predict severity of endometriosis in order to tailor surgery.

Elisabeth Epstein

Research group leader

Group members

Anna Lundmark Drca

Anna Möller

Bita Eshraghi

Cecilia Berger

Denise Golmann

Erica Smedberg

Hampus Josefsson

Ida Bergman

Lena Marions

Lisa Söderman

Malin Brunes

Marie Westergren Söderberg

Marion Ek

Mira Rehal

Nina Betzler

Peter Anfelter

Rasmus Green

Sara Velandia Johansson

Collaborations

  • IETA (International Endometrial Tumour Analysis): Prospective international multicentre collaboration including several projects.  
  • IOTA (International Ovarian Tumour Analysis). Prospective international multicentre collaboration including several projects. 
  • IDEA (International Deep Endometriosis Analysis). Prospective international multicentre collaboration including several projects. 
  • MUSA (Morphological Uterus Sonographic Assessment). Prospective international multicentre collaboration including several projects. 
  • TITANUM (GestaTIonal TrophoblAstic NeoplasIa Ultrasound assessment). Prospective international multicentre collaboration including several projects. 
  • PCME (Personalized Cancer Medicine” in Endometrial Cancer). Translational project in collaboration with Joseph Carlson KI.
  • AI-deep learning applied on ultrasound images of ovarian in collaboration with KTH (Kevin Smith, Filip Christensen, Elliot Epstein)
  • Precision medicine, bio-image databas in ovarian tumours In collaboration with Kalloniemi research team, Brinton Seashore Ludlow, KI)
  • National network for female mutilation (Vanja Berggren KI)
  • International collaboration on endometriosis (ZEG, Berlin, Germany)

Projects

  • IETA 4: Assess the role of ultrasound in the diagnosis of endometrial caner
  • IOTA: Explore multimodel strategies including ultrasound in the diagnosis of adnexal masses.
  • IDEA: Assess the role of ultrasound in the diagnosis of deep endometriosis
  • TITANUM: The role of ultrasound in the diagnosis of GTN
  • PCME: Explore sonographic, demographic, biometric and molecular to predict recurrence and death in endometrial cancer
  • MUSA: Sonographic characteristics of Adenomyosis, Myomas and sarcomas
  • SonoQZ (mobil applikation): Value of game-based learning in the diagnosis of adnexal masses.
  • AI-machine learning: To discriminate bening form malignant adnexal masses.
  • Precision medicine Bio-image database: Combining AI of ultrasound images with bioinformatics, and tumour markers to diagnose, and tailor treatment in ovarian cancer
  • Childbirth and incontinence surgery: Association between childbirth and urinary incontinence after mid-urethral sling surgery
  • Perineorrhaphy: Reconstructive surgery versus pelvic floor therapy in women with poorly healed second degree perineal tears - A randomized controlled study.
  • Mid urethral sling surgery for urinary incontinence: long-term follow-up and complications from a population perspective
  • Robotic surgery: Perioperative data, complications, symptoms, reoperations, sexual function and prescription of analgesics, prior to surgery and after.

Research support

  • Innovationsfonden
  • ALF-medicin
  • AFA, Region Stockholm-Gotland
  • Radiumhemmets forskningsfonder

Articles

Ultrasound characteristics of endometrial cancer as defined by International Endometrial Tumor Analysis (IETA) consensus nomenclature: prospective multicenter study.
Epstein E, Fischerova D, Valentin L, Testa AC, Franchi D, Sladkevicius P, et al
Ultrasound Obstet Gynecol 2018 06;51(6):818-828

Can dynamic contrast-enhanced ultrasound (DCE-US) improve diagnostic performance in endometrial cancer staging? A proof of concept.
Green RW, Epstein E
Ultrasound Obstet Gynecol 2019 Oct;():

Risk of complications in patients with conservatively managed ovarian tumours (IOTA5): a 2-year interim analysis of a multicentre, prospective, cohort study.
Froyman W, Landolfo C, De Cock B, Wynants L, Sladkevicius P, Epstein E, et al
Lancet Oncol. 2019 Mar;20(3):448-458

Clinical and Ultrasound Characteristics of the Microcystic Elongated and Fragmented (MELF) Pattern in Endometrial Cancer According to the International Endometrial Tumor Analysis (IETA) criteria.
Eriksson LSE, Nastic D, Frühauf F, Fischerova D, Nemejcova K, Bono F, et al
Int. J. Gynecol. Cancer 2019 01;29(1):119-125

Does the choice of suture material matter in anterior and posterior colporrhaphy?
Bergman I, Söderberg MW, Kjaeldgaard A, Ek M
Int Urogynecol J 2016 Sep;27(9):1357-65

Cervical amputation versus vaginal hysterectomy: a population-based register study.
Bergman I, Söderberg MW, Kjaeldgaard A, Ek M
Int Urogynecol J 2017 Feb;28(2):257-266

Associations Between Childbirth and Urinary Incontinence After Midurethral Sling Surgery.
Bergman I, Westergren Söderberg M, Lundqvist A, Ek M
Obstet Gynecol 2018 02;131(2):297-303

Prevalence and impact of dysmenorrhea in Swedish adolescents.
Söderman L, Edlund M, Marions L
Acta Obstet Gynecol Scand 2019 02;98(2):215-221

Validity of self-reported endometriosis and endometriosis-related questions in a Swedish female twin cohort.
Saha R, Marions L, Tornvall P
Fertil. Steril. 2017 01;107(1):174-178.e2

Heritability of endometriosis.
Saha R, Pettersson HJ, Svedberg P, Olovsson M, Bergqvist A, Marions L, et al
Fertil. Steril. 2015 Oct;104(4):947-952