The Role of Ultrasound in the Evolving Landscape of Precision Imaging of Endometriosis

Purpose of Review Endometriosis is a chronic gynecological condition that affects millions of individuals assigned female at birth worldwide, often leading to severe pelvic pain and infertility. This review focuses on the current techniques, challenges and clinical applications of transvaginal ultrasound (TVS) in endometriosis diagnosis, highlighting its role in enhancing early detection and precision imaging. Recent Findings Advances in TVS, including real-time dynamic imaging, sonoPODgraphy and Doppler assessment, has emerged as a non-invasive, accessible, and highly effective tool for diagnosing endometriosis. Evolving sonographic techniques allow better visualization of superficial endometriosis, which were previously difficult to detect. Summary This review summarizes the current TVS techniques and specialized protocols for detecting endometriosis, offering clinicians valuable insights into optimizing diagnostic strategies and enhancing patient care. With ongoing advancements in ultrasound, it has the potential to revolutionize the standard diagnostic approach, minimizing delays and significantly improving patient outcomes. Similar content being viewed by others Data Availability No datasets were generated or analysed during the current study.

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M.L. was responsible for supervision of the project. Corresponding author Ethics declarations Competing interests Mathew Leonardi reports grants from Australian MRFF, AbbVie, AIMA/SOPHIE, CanSAGE, CIHR, Endometriosis Australia, Hamilton Health Sciences, Health Canada, Hyivy/MITACS/SOPHIE, Medical Research Future Fund/Imagendo, Myant Inc/MITACS, GE HealthCare/MITACS, and Pfizer; honoraria for lectures/writing from AIUM, AbbVie, Bayer, Canon, GE Healthcare, Pfizer, Samsung, TerSera; consultancy work with AbbVie, Chugai, Gesynta, Hologic, Imagendo, Pfizer, and Roche Diagnostics; and affiliations with SUGO (Specialized Ultrasound in Gynecology & Obstetrics) and Endometriosis360. He holds leadership roles in the World Endometriosis Society Early Career Board, ISUOG Next Generation, and the Gynecologic Ultrasound Society, all outside the submitted work. Human and Animal Rights This article does not contain any studies with human or animal subjects performed by any of the authors. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Shetty, R., Aharoni, S. & Leonardi, M. The Role of Ultrasound in the Evolving Landscape of Precision Imaging of Endometriosis. Curr Obstet Gynecol Rep 14, 19 (2025). https://doi.org/10.1007/s13669-025-00424-2 Accepted: Published: Version of record: DOI: https://doi.org/10.1007/s13669-025-00424-2