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

Area of Science:

• Reproductive Medicine
• Medical Imaging
• Gynecology

Background:

• Endometriosis is a common condition affecting women of reproductive age, frequently associated with significant diagnostic delays.
• Transvaginal ultrasound (US) is a primary imaging tool for pelvic pain and infertility, common endometriosis symptoms, yet subtle endometriosis is often missed.
• Current US practices may not fully identify endometriosis, leading to delayed diagnosis and treatment.

Purpose of the Study:

• To develop consensus-based recommendations for improving endometriosis screening using ultrasound.
• To standardize the detection, grading, and reporting of endometriosis via imaging.
• To reduce the diagnostic delay for endometriosis in at-risk individuals.

Main Methods:

• A multidisciplinary expert panel convened, including radiologists, sonographers, and gynecologists.
• A comprehensive literature review was performed, followed by a modified Delphi technique to reach consensus.
• Recommendations focused on targeted screening populations and augmented pelvic US techniques.

Main Results:

• Consensus was reached on specific ultrasound techniques to enhance endometriosis detection.
• Key recommendations include transvaginal US of the posterior compartment and the uterine sliding sign maneuver.
• These techniques are easily integrated into pelvic US examinations, taking 5 minutes or less.

Conclusions:

• Implementing recommended ultrasound techniques can significantly improve the detection rate of endometriosis.
• Standardized screening and reporting can lead to earlier diagnosis and potentially better patient management.
• These advancements aim to shorten the substantial diagnostic delay currently experienced by many endometriosis patients.