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

Ida Bergman

Lena Marions

Malin Brunes

Marie Westergren Söderberg

Marion Ek

Mira Rehal, mira.rehal@regionstockholm.se

Rasmus Green

Tekla Lind, tekla.lind@regionstockholm.se

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, Pawel Herman, Emir Konuk, Filip Christensen, Elliot Epstein)
  • Precision medicine, BIO-IMAGE database in ovarian tumours In collaboration with SciLife lab Johan Lindberg and Brinton Seashore-Ludlow)
  • 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

  • Cancerfonden
  • Swedish Research Counsil
  • ALF-medicin
  • ALF-Hälsa Medicin Teknik (a collaboration with KTH)
  • AFA, Region Stockholm-Gotland
  • Radiumhemmets forskningsfonder

Articles

Combination of Proactive Molecular Risk Classifier for Endometrial cancer (ProMisE) with sonographic and demographic characteristics in preoperative prediction of recurrence or progression of endometrial cancer.
Eriksson LSE, Nastic D, Lindqvist PG, Imboden S, Järnbert-Pettersson H, Carlson JW, Epstein E
Ultrasound Obstet Gynecol 2021 Sep;58(3):457-468

Ultrasound image analysis using deep neural networks for discriminating between benign and malignant ovarian tumors: comparison with expert subjective assessment.
Christiansen F, Epstein EL, Smedberg E, Åkerlund M, Smith K, Epstein E
Ultrasound Obstet Gynecol 2021 01;57(1):155-163

Validation of models to diagnose ovarian cancer in patients managed surgically or conservatively: multicentre cohort study.
Van Calster B, Valentin L, Froyman W, Landolfo C, Ceusters J, Testa AC, Wynants L, Sladkevicius P, Van Holsbeke C, Domali E, Fruscio R, Epstein E, et al
BMJ 2020 07;370():m2614

Interobserver agreement of transvaginal ultrasound and magnetic resonance imaging in local staging of cervical cancer.
Pálsdóttir K, Fridsten S, Blomqvist L, Alagic Z, Fischerova D, Gaurilcikas A, Hasselrot K, Jäderling F, Testa AC, Sundin A, Epstein E
Ultrasound Obstet Gynecol 2021 Nov;58(5):773-779

Impact of hysterectomy on analgesic, psychoactive and neuroactive drug use in women with endometriosis: nationwide cohort study.
Brunes M, Altman D, Pålsson M, Söderberg MW, Ek M
BJOG 2021 04;128(5):846-855

Effects of Obesity on Peri- and Postoperative Outcomes in Patients Undergoing Robotic versus Conventional Hysterectomy.
Brunes M, Johannesson U, Häbel H, Söderberg MW, Ek M
J Minim Invasive Gynecol 2021 02;28(2):228-236

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

Safety of Dienogest and Other Hormonal Treatments for Endometriosis in Real-World Clinical Practice (VIPOS): A Large Noninterventional Study.
Heinemann K, Imthurn B, Marions L, Gerlinger C, Becker K, Moehner S, Faustmann T
Adv Ther 2020 05;37(5):2528-2537