Society of Radiologists in Ultrasound Consensus on Routine Pelvic US for Endometriosis

Scott W. Young, Priyanka Jha, Luciana Pardini Chamié, Shuchi K. Rodgers, Rosanne M Kho, Mindy M. Horrow, Phyllis Glanc, Myra Feldman, Yvette S. Groszmann, Zaraq Khan, Steven L. Young, Liina Pōder, Tatnai L. Burnett, Eric Hu, Susan Egan, Wendaline M. VanBuren
Radiology · 2024 · vol. 311(1) , pp. e232191 · doi:10.1148/radiol.232191 · PMID:38591980 · PMC11070694 · W4394621711
review OA: green CC0 ⤵ 36 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Radiologists and gynecologists established consensus recommendations for targeted screening ultrasound techniques to improve endometriosis detection in at-risk patients.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This Society of Radiologists in Ultrasound consensus statement studied how to improve routine pelvic transvaginal ultrasound (US) for detecting endometriosis, focusing on deep endometriosis, by convening a multidisciplinary expert panel (radiologists, sonographers, gynecologists, reproductive endocrinologists, and minimally invasive surgeons) who performed a comprehensive literature review and used a modified Delphi process to reach agreement. The panel recommends augmented pelvic US in premenopausal or early postmenopausal individuals with symptoms or a history of endometriosis or infertility, emphasizing transvaginal imaging of the posterior compartment, assessment of uterine-ovary positioning, and performance of the uterine sliding sign maneuver, and it proposes an observational grading/reporting system (APU-0 to APU-3) tied to management recommendations. A major limitation noted is that evidence for sensitivity/specificity in average-risk symptomatic patients interpreted by sonologists is less well established than performance in high-risk populations and expert settings, with only limited data available from studies using added techniques. This paper is centrally about endometriosis — it provides consensus guideline recommendations to augment routine pelvic US for screening and detection of deep endometriosis.

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Abstract

Endometriosis is a prevalent and potentially debilitating condition that mostly affects individuals of reproductive age, and often has a substantial diagnostic delay. US is usually the first-line imaging modality used when patients report chronic pelvic pain or have issues of infertility, both common symptoms of endometriosis. Other than the visualization of an endometrioma, sonologists frequently do not appreciate endometriosis on routine transvaginal US images. Given a substantial body of literature describing techniques to depict endometriosis at US, the Society of Radiologists in Ultrasound convened a multidisciplinary panel of experts to make recommendations aimed at improving the screening process for endometriosis. The panel was composed of experts in the imaging and management of endometriosis, including radiologists, sonographers, gynecologists, reproductive endocrinologists, and minimally invasive gynecologic surgeons. A comprehensive literature review combined with a modified Delphi technique achieved a consensus. This statement defines the targeted screening population, describes techniques for augmenting pelvic US, establishes direct and indirect observations for endometriosis at US, creates an observational grading and reporting system, and makes recommendations for additional imaging and patient management. The panel recommends transvaginal US of the posterior compartment, observation of the relative positioning of the uterus and ovaries, and the uterine sliding sign maneuver to improve the detection of endometriosis. These additional techniques can be performed in 5 minutes or less and could ultimately decrease the delay of an endometriosis diagnosis in at-risk patients.

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Condition tags

endometriosisendometriomachronic_pelvic_paininfertility

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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