OC26.05: *Meta‐analysis and systematic review to determine the optimum imaging modality for the detection of rectal deep infiltrative endometriosis

To review the accuracy and determine the optimum imaging modality for the detection of rectal deep infiltrative endometriosis (DIE) in women with a clinical history of endometriosis. A systematic review was conducted using MEDLINE, Embase, PubMed and Google Scholar to identify studies published between January 1990 and March 2016. Studies were considered eligible if they were prospective and used any imaging modality preoperatively to assess for the presence of rectal DIE which was then correlated with the laparoscopic gold standard. Rectal DIE included lesions in the rectosigmoid. We restricted the eligibility to studies having at least 10 affected and 10 unaffected women. The electronic searches retrieved 1034 records. After excluding the records that were clearly not eligible by reading title and abstracts, we completely evaluated 106 study groups for eligibility: 55 were excluded because they were related to studies that included less than 10 affected/unaffected women; and 12 were excluded due to potential redundant information with regards to the same population. We included 39 study groups in the analyses and the main results are reported on table 1. All assessed methods have good accuracy for diagnosing rectal DIE. As TVS is simpler, faster, more accessible, and avoids ionising radiation, we believe it should be the first line diagnostic tool for the women with suspected rectal DIE.