Noninvasive diagnostic imaging for endometriosis part 2: a systematic review of recent developments in magnetic resonance imaging, nuclear medicine and computed tomography

Jodie Avery, Jodie C Avery, Steven Knox, Alison Deslandes, Mathew Leonardi, Glen Lo, H. Wang, Hu Wang, Yuan Zhang, Sarah Jane Holdsworth-Carson, Tran Tuyet Thi Nguyen, George Stanley Condous, Gustavo Carneiro, Mary Louise Hull, M. Louise Hull, Louise Hull, Imagendo Study Group, Rebecca O’Hara, G. Condous, Catrina Panuccio, Aisha Sirop, Jason Abbott, David Alejandro González‐Chica, Tim Chen, Hsiang‐Ting Chen, Minh‐Son To, Natalie Yang, C. Uzuner, Sarah J. Holdsworth‐Carson, Tran Nguyen, Shay M. Freger, Nimantha Abeygunasekara, Misha Richards, Annie Simpson, Frank Voyvodic, Melissa Jenkins
Fertility and sterility · 2023 · vol. 121(2) , pp. 189–211 · doi:10.1016/j.fertnstert.2023.12.017 · PMID:38110143 · W4389850883
review OA: closed CC0 ⤵ 17 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This systematic review summarizes recent advancements in noninvasive diagnostic imaging for endometriosis, focusing on magnetic resonance imaging, nuclear medicine, and computed tomography techniques.

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Abstract

Endometriosis affects 1 in 9 women, taking 6.4 years to diagnose using conventional laparoscopy. Non-invasive imaging enables timelier diagnosis, reducing diagnostic delay, risk and expense of surgery. This review updates literature exploring the diagnostic value of specialist endometriosis magnetic resonance imaging (eMRI), nuclear medicine (NM) and computed tomography (CT). Searching after the 2016 IDEA consensus, 6192 publications were identified, with 27 studies focused on imaging for endometriosis. eMRI was the subject of 14 papers, NM and CT, 11, and artificial intelligence (AI) utilizing eMRI, 2. eMRI papers describe diagnostic accuracy for endometriosis, methodologies, and innovations. Advantages of eMRI include its: ability to diagnose endometriosis in those unable to tolerate transvaginal endometriosis ultrasound (eTVUS); a panoramic pelvic view, easy translation to surgical fields; identification of hyperintense iron in endometriotic lesions; and ability to identify super-pelvic lesions. Sequence standardization means eMRI is less operator-dependent than eTVUS, but higher costs limit its role to a secondary diagnostic modality. eMRI for deep and ovarian endometriosis has sensitivities of 91-93.5% and specificities of 86-87.5% making it reliable for surgical mapping and diagnosis. Superficial lesions too small for detection in larger capture sequences, means a negative eMRI doesn't exclude endometriosis. Combined with thin sequence capture and improved reader expertise, eMRI is poised for rapid adoption into clinical practice. NM labeling is diagnostically limited in absence of suitable unique marker for endometrial-like tissue. CT studies expose the reproductively aged to radiation. AI diagnostic tools, combining independent eMRI and eTVUS endometriosis markers, may result in powerful capability. Broader eMRI use, will optimize standards and protocols. Reporting systems correlating to surgical anatomy will facilitate interdisciplinary preoperative dialogues. eMRI endometriosis diagnosis should reduce repeat surgeries with mental and physical health benefits for patients. There is potential for early eMRI diagnoses to prevent chronic pain syndromes and protect fertility outcomes.

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Condition tags

endometriosis

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.

References (92)

Cited by (18)

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