Ultrasound as a noninvasive diagnostic tool to detect deep endometriosis using the International Deep Endometriosis Analysis terminology
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This paper investigates the utility of ultrasound, adhering to the International Deep Endometriosis Analysis terminology, as a noninvasive method for diagnosing deep endometriosis.
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This paper evaluated ultrasound as a noninvasive diagnostic approach for detecting deep endometriosis, using the International Deep Endometriosis Analysis (IDEA) terminology to standardize findings. The authors applied ultrasound terminology-based assessment in the studied population and reported performance in identifying deep lesions as characterized by the IDEA framework. A key caveat is that the bibliographic record provided does not include the paper’s detailed methods, sample size, or diagnostic accuracy metrics, which limits how precisely the reported findings can be summarized from the available text. This paper is centrally about endometriosis — it focuses on noninvasive ultrasound detection of deep endometriosis using the IDEA terminology.
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Abstract
OBJECTIVE: To evaluate the performance of transvaginal ultrasound (TVS) using the International Deep Endometriosis Analysis (IDEA) terminology in the detection of deep endometriosis (DE).
DESIGN: International multicenter prospective diagnostic accuracy study involving eight academic centers in eight countries (September 2019 - November 2023). The index test was TVS performed in accordance with the IDEA consensus statement. Reference standard was the direct visualization of endometriosis at laparoscopy.
SUBJECTS: Patients with suspicion of DE were included.
EXPOSURE: A total of 1,796 consecutive patients underwent TVS performed according to the IDEA terminology (index test) of which 1,182 subsequently underwent laparoscopic surgery (reference test). On the basis of direct surgical visualization 1,140/1,182 (96.4%) had endometriosis, of whom 923/1,182 (78.1%) presented with DE.
MAIN OUTCOME MEASURES: Area under the curve (AUC), sensitivity, specificity, positive and negative predictive value (PPV and NPV) were calculated to assess the performance of TVS to detect DE.
RESULTS: Median age was 32 years. 76% were nulliparous, 41% used hormonal therapy at baseline, and 30% had undergone previous endometriosis surgery. The vast majority (92%) experienced dysmenorrhea and 32% presented with infertility. 34% had sonographic signs of adenomyosis. For DE overall, the diagnostic performance of TVS was as follows: AUC 0.88 (95% confidence interval [CI] 0.85-0.90), sensitivity 95% (95% CI 94%-97%), specificity 80% (95% CI 75%-85%), PPV 95% (95% CI 93%-96%), NPV 82% (95% CI 77%-87%). Sensitivity was highest for bowel DE (87%, 95% CI 83%-90%) followed by left uterosacral ligament (USL) (78%, 95% CI 74%-82%). The sensitivity was lowest for the rectovaginal septum (51%, 95% CI 44%-58%). Specificity was highest for bladder DE (99%, 95% CI 99%-100%) and lowest for the left USL (87%, 95% CI 84%-89%).
CONCLUSION: Noninvasive diagnosis of DE with TVS performed in accordance with the IDEA consensus statement has a high diagnostic accuracy. Implementation of the IDEA methodology in daily gynecological practice has the potential to shorten the diagnostic delay and expedite treatment strategies. Accurate DE mapping may improve triaging referral of patients, trigger a multidisciplinary team, and potentially mitigate operative risks, resulting in a reduced financial burden.
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Ultrasound as a noninvasive diagnostic tool to detect deep endometriosis using the International Deep Endometriosis Analysis terminology
Journal
Fertility and Sterility
140
Author
Volume
125
Number
5
Pages
860-869
ISSN
0015-0282
eISSN
1556-5653
Access date
2026-04-24
Remarks
Online First 2025-12-29
Language
English
Journal language
English
Scopus© citations
1
| dc.cm.idOmega | UJCM1556c26ec0aa4337b5a39548dc52e927 | pl |
| dc.contributor.author | Bafort, Celine | pl |
| dc.contributor.author | Condous, George | pl |
| dc.contributor.author | Van Schoubroeck, Dominique | pl |
| dc.contributor.author | Szabó, Gábor | pl |
| dc.contributor.author | Hudelist, Gernot - 512867 | pl |
| dc.contributor.author | Pashkunova, Daria | pl |
| dc.contributor.author | Buonomo, Francesca | pl |
| dc.contributor.author | Pascual, Maria Angela | pl |
| dc.contributor.author | Zajicek, Michal | pl |
| dc.contributor.author | Ledger, Ashleigh | pl |
| dc.contributor.author | Van den Bosch, Thierry | pl |
| dc.contributor.author | Tomassetti, Carla | pl |
| dc.contributor.author | Timmerman, Dirk | pl |
| dc.date.accession | 2026-04-24 | pl |
| dc.date.accessioned | 2026-04-27T08:01:33Z | |
| dc.date.available | 2026-04-27T08:01:33Z | |
| dc.date.createdat | 2026-04-27T08:01:33Z | en |
| dc.date.issued | 2026 | pl |
| dc.description.additional | Online First 2025-12-29 | pl |
| dc.description.number | 5 | pl |
| dc.description.physical | 860-869 | pl |
| dc.description.volume | 125 | pl |
| dc.identifier.doi | 10.1016/j.fertnstert.2025.12.021 | pl |
| dc.identifier.eissn | 1556-5653 | pl |
| dc.identifier.issn | 0015-0282 | pl |
| dc.identifier.uri | https://ruj.uj.edu.pl/handle/item/573250 | |
| dc.language | eng | pl |
| dc.language.container | eng | pl |
| dc.rights | Dodaję tylko opis bibliograficzny | * |
| dc.rights.licence | Bez licencji otwartego dostępu | pl |
| dc.subtype | Article | pl |
| dc.title | Ultrasound as a noninvasive diagnostic tool to detect deep endometriosis using the International Deep Endometriosis Analysis terminology | pl |
| dc.title.journal | Fertility and Sterility | pl |
| dc.type | JournalArticle | pl |
| dspace.entity.type | Publication |
dc.cm.idOmegapl
UJCM1556c26ec0aa4337b5a39548dc52e927 dc.contributor.authorpl
Bafort, Celine dc.contributor.authorpl
Condous, George dc.contributor.authorpl
Van Schoubroeck, Dominique dc.contributor.authorpl
Szabó, Gábor dc.contributor.authorpl
Hudelist, Gernot - 512867 dc.contributor.authorpl
Pashkunova, Daria dc.contributor.authorpl
Buonomo, Francesca dc.contributor.authorpl
Pascual, Maria Angela dc.contributor.authorpl
Zajicek, Michal dc.contributor.authorpl
Ledger, Ashleigh dc.contributor.authorpl
Van den Bosch, Thierry dc.contributor.authorpl
Tomassetti, Carla dc.contributor.authorpl
Timmerman, Dirk dc.date.accessionpl
2026-04-24 dc.date.accessioned
2026-04-27T08:01:33Z dc.date.available
2026-04-27T08:01:33Z dc.date.createdaten
2026-04-27T08:01:33Z dc.date.issuedpl
2026 dc.description.additionalpl
Online First 2025-12-29 dc.description.numberpl
5 dc.description.physicalpl
860-869 dc.description.volumepl
125 dc.identifier.doipl
10.1016/j.fertnstert.2025.12.021 dc.identifier.eissnpl
1556-5653 dc.identifier.issnpl
0015-0282 dc.identifier.uri
https://ruj.uj.edu.pl/handle/item/573250 dc.languagepl
eng dc.language.containerpl
eng dc.rights*
Dodaję tylko opis bibliograficzny dc.rights.licencepl
Bez licencji otwartego dostępu dc.subtypepl
Article dc.titlepl
Ultrasound as a noninvasive diagnostic tool to detect deep endometriosis using the International Deep Endometriosis Analysis terminology dc.title.journalpl
Fertility and Sterility dc.typepl
JournalArticle dspace.entity.type
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Bafort, Celine
Condous, George
Van Schoubroeck, Dominique
Szabó, Gábor
Hudelist, Gernot
Pashkunova, Daria
Buonomo, Francesca
Pascual, Maria Angela
Zajicek, Michal
Ledger, Ashleigh
Van den Bosch, Thierry
Tomassetti, Carla
Timmerman, Dirk
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Cited by (4)
- Does size matter? Expectations and limitations in imaging diagnosis of deep endometriosis? 2026
- Reply of the authors: 'Transvaginal ultrasound as a guiding tool in the management for deep endometriosis' 2026
- Rectovaginal septum is a real location for deep endometriosis; comment on, ‘the myth of rectovaginal septum endometriosis’ 2026
- Transdisciplinary Approach to Endometriosis-Related Chronic Pelvic Pain in Colombia: A Consensus Statement for Patient-Centered Care 2026
Cited by (4)
- Does size matter? Expectations and limitations in imaging diagnosis of deep endometriosis? 2026
- Reply of the authors: 'Transvaginal ultrasound as a guiding tool in the management for deep endometriosis' 2026
- Rectovaginal septum is a real location for deep endometriosis; comment on, ‘the myth of rectovaginal septum endometriosis’ 2026
- Transdisciplinary Approach to Endometriosis-Related Chronic Pelvic Pain in Colombia: A Consensus Statement for Patient-Centered Care 2026
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