{"paper_id":"c211d720-e195-450f-833e-97bbb0902a7c","body_text":"EARLY DETECTION OF ENDOMETRIOSIS – A LITERATURE REVIEW OF DIAGNOSTIC METHODS AND FUTURE PERSPECTIVES\nDOI:\nhttps://doi.org/10.31435/ijitss.3(51).2026.6129Keywords:\nEndometriosis, Diagnostic Methods, Transvaginal Ultrasound, Magnetic Resonance Imaging, Biomarkers, Imaging-Based Techniques, Artificial IntelligenceAbstract\nResearch objectives: Endometriosis is a chronic disease that impairs the daily functioning and quality of life of many women. This literature review summarizes current diagnostic methods for endometriosis, their advantages and limitations, and discusses emerging approaches, particularly established and emerging imaging techniques.\nScope of review: Relevant publications were identified through searches of PubMed, Scopus, Web of Science, Google Scholar, and other scientific databases. This literature review focused on studies published between 2020 and 2025 that addressed established and emerging diagnostic approaches for endometriosis, including imaging techniques, biomarkers, and artificial intelligence.\nFindings: Endometriosis commonly presents with chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility. Current evidence indicates that imaging plays a central role in diagnosis. Transvaginal ultrasound remains the first-line imaging modality, while magnetic resonance imaging provides complementary information for disease staging and assessment of complex cases. Transrectal ultrasound may be useful in selected patients with suspected bowel involvement. Although numerous biomarkers have been investigated, none have demonstrated sufficient diagnostic accuracy for routine clinical use. Emerging technologies, including advanced imaging techniques and AI-based diagnostic models, show promising potential but still require further validation before clinical use.\nConclusions: Early diagnosis remains essential for improving patient outcomes and limiting disease progression. However, the disease is often diagnosed too late, which remains a major clinical challenge. Recent evidence supports imaging-based diagnostic strategies as the foundation of diagnosis, whereas biomarker-based approaches require further development. Future advances in AI and integrated diagnostic models may contribute to more accurate and timely detection of endometriosis.\nReferences\nChu, L.-L., Wu, M., Yang, W.-L., Cong, L.-H., & Li, L. (2025). Contrast-enhanced ultrasound findings of peritoneal polypoid endometriosis: A case report and literature review. International Journal of Women's Health, 1557–1562. https://doi.org/10.2147/IJWH.S510066\nBrosens, I., Gordts, S., & Benagiano, G. (2013). Endometriosis in adolescents is a hidden, progressive and severe disease that deserves attention, not just compassion. Human Reproduction, 28(8), 2026–2031. https://doi.org/10.1093/humrep/det243\nWorld Health Organization. (2025). Endometriosis.\nChauhan, S., More, A., Chauhan, V., & Kathane, A. (2022). Endometriosis: A review of clinical diagnosis, treatment, and pathogenesis. https://doi.org/10.7759/cureus.28864\nBarra, F., Scala, C., Leone Roberti Maggiore, U., Evangelisti, G., Alessandri, F., Vellone, V. G., Stabilini, C., & Ferrero, S. (2021). A prospective study comparing rectal water contrast-transvaginal ultrasonography with sonovaginography for the diagnosis of deep posterior endometriosis. https://doi.org/10.1111/aogs.14209\nGuerriero, S., Ajossa, S., Orozco, R., Perniciano, M., Jurado, M., Melis, G. B., & Alcazar, J. L. (2016). Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in the rectosigmoid: Systematic review and meta-analysis. Ultrasound Obstet. Gynecol., 47, 281–289. https://doi.org/10.1002/uog.15662\nBrulport, A., Bourdon, M., Vaiman, D., Drouet, C., Pocate-Cheriet, K., Bouzid, K., Marcellin, L., Santulli, P., Abo, C., Jeljeli, M., Chouzenoux, S., Chapron, C., Batteux, F., Berthelot, C., & Doridot, L. (2024). An integrated multi-tissue approach for endometriosis candidate biomarkers: A systematic review. Reproductive Biology and Endocrinology, 22, 21. https://doi.org/10.1186/s12958\nFryer, J., Mason-Jones, A. J., & Woodward, A. (2024). Understanding diagnostic delay for endometriosis: A scoping review using the social-ecological framework. https://doi.org/10.1080/07399332.2024.2413056\nLi, W., Feng, H., & Ye, Q. (2025). Factors contributing to the delayed diagnosis of endometriosis: Systematic review and meta-analysis. Front. Med., 12. https://doi.org/10.3389/fmed.2025.1576490\nHarzif, A. K., Nurbaeti, P., & Wiweko, B. (2024). Factors associated with delayed diagnosis of endometriosis: A systematic review. https://doi.org/10.1177/22840265241291120\nWróbel, M., Wielgoś, M., & Laudański, P. (2022). Diagnostic delay of endometriosis in adults and adolescence-current stage of knowledge. Advances in Medical Sciences. https://doi.org/10.1016/j.advms.2022.02.003\nKozik, E. (2025). “Invisible” pain – social exclusion of patients with endometriosis: A qualitative analysis. https://doi.org/10.14746/kse.2025.27.1.16\nJiao, H., Feng, W., & Liu, H. (2026). Clinical diagnosis and treatment of bowel endometriosis and the distribution characteristics of lesions. BMC Women's Health, 26, 62. https://doi.org/10.1186/s12905-025-04248-3\nGuerriero, S., Ajossa, S., Pagliuca, M., Borzacchelli, A., Springer, S., Pilloni, M., Taccori, V., Pascual, M. A., Deiala, F., Graupera, B., & Alcazar, J. L. (2022). Advances in imaging for assessing pelvic endometriosis. Diagnostics, 12, 2960. https://doi.org/10.3390/diagnostics12122960\nBausic, A., Coroleucă, C., Coroleucă, C., Manu, A., Frîncu, F., Comandasu, D., Matasariu, R., Mehedint, C., & Brătilă, E. (2022). Transvaginal ultrasound vs. magnetic resonance imaging (MRI) value in endometriosis diagnosis. Diagnostics, 12, 1767. https://doi.org/10.3390/diagnostics12071767\nZheng, Z., et al. (2023). Qualitative and quantitative features of deep endometriosis in contrast-enhanced ultrasound: An initial experience and literature review. https://doi.org/10.3233/CH-231843\nAlonzo, L., et al. (2024). Magnetic resonance imaging of endometriosis: The role of advanced techniques. J. Clin. Med., 13(19), 5783. https://doi.org/10.3390/jcm13195783\nNICE. (2024). Endometriosis: Diagnosis and management [Guideline].\nArezzo, F., et al. (2022). The application of sonovaginography for implementing ultrasound assessment of endometriosis and other gynaecological diseases. Diagnostics, 12(4), 820. https://doi.org/10.3390/diagnostics12040820\nDaniilidis, A., Grigoriadis, G., Dalakoura, D., D’Alterio, M. N., Angioni, S., & Roman, H. (2022). Transvaginal ultrasound in the diagnosis and assessment of endometriosis—An overview: How, why, and when. Diagnostics, 12, 2912. https://doi.org/10.3390/diagnostics12122912\nArian, A., Karimi, N., Ahmadinejad, N., Azadnajafabad, S., & Delazar, S. (2025). Refining MRI protocols for endometriosis: A comparative study of abbreviated and full MRI sequences. British Journal of Radiology, 98(1166), 287–295. https://doi.org/10.1093/bjr/tqae230\nAlcazar, J. L., et al. (2022). Diagnostic accuracy of sliding sign for detecting pouch of Douglas obliteration and bowel involvement in women with suspected endometriosis: Systematic review and meta-analysis. https://doi.org/10.1002/uog.24900\nSivajohan, B., Elgendi, M., Menon, C., et al. (2022). Clinical use of artificial intelligence in endometriosis: A scoping review. npj Digit. Med., 5, 109. https://doi.org/10.1038/s41746-022-00638-1\nZhang, X., et al. (2020). Comparison of physical examination, ultrasound techniques and magnetic resonance imaging for the diagnosis of deep infiltrating endometriosis: A systematic review and meta-analysis of diagnostic accuracy studies. https://doi.org/10.3892/etm.2020.9043\nLuz, K. P., et al. (2025). Empowering women through intelligent care: A narrative review of AI-driven digital innovations for endometriosis diagnosis, education, and equity. https://doi.org/10.1007/s44326-025-00061-2\nKliber-Gałuszka, M., Kulczyńska-Figurny, K., Jagodziński, P. P., & Pławski, A. (2025). Potential biomarkers for early detection of endometriosis: Current state of art (what we know so far). Journal of Applied Genetics. https://doi.org/10.1007/s13353-025-01021-y\nAvery, J. C., et al. (n.d.). Noninvasive diagnostic imaging for endometriosis part 1: A systematic review of recent developments in ultrasound, combination imaging, and artificial intelligence. https://doi.org/10.1016/j.fertnstert.2023.12.008\nGoncalves, M. O., et al. (2021). Systematic evaluation of endometriosis by transvaginal ultrasound can accurately replace diagnostic laparoscopy, mainly for deep and ovarian endometriosis. https://doi.org/10.1093/humrep/deab085\nRogalska, A., et al. (2025). Diagnostic tools for endometriosis in Poland: A comparative assessment of reliability and out-of-pocket costs. https://doi.org/10.3390/jcm14144935\nBecker, C. M., et al. (2022). ESHRE guideline: Endometriosis.\nXholli, A., et al. (2024). The benefit of transvaginal elastography in detecting deep endometriosis: A feasibility study. Ultraschall Med, 45(1), 69–76. https://doi.org/10.1055/a-2028-8214\nBrunelli, A. C., Brito, L. G. O., Moro, F. A. S., Jales, R. M., Yela, D. A., & Benetti-Pinto, C. L. (2023). Ultrasound elastography for the diagnosis of endometriosis and adenomyosis: A systematic review with meta-analysis. 49(3), 699–709. https://doi.org/10.1016/j.ultrasmedbio.2022.11.006\nDownloads\nPublished\nIssue\nSection\nLicense\nCopyright (c) 2026 Izabela Harpula, Natalia Bębenek, Benedykt Baljon, Justyna Bogdan, Radosław Ramotowski , Patryk Brzezicki, Paulina Frączkiewicz , Gabriela Barszcz , Monika Błądek, Karolina Karolina, Sylwia Wit\nThis work is licensed under a Creative Commons Attribution 4.0 International License.\nAll articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.\nCC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.","source_license":"CC0","license_restricted":false}