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Related Experiment Video

Updated: May 2, 2026

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity
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Performance of Nonaugmented Routine Pelvic Ultrasound for Deep Endometriosis Using Static 2024 SRU Consensus

Anuradha S Shenoy-Bhangle1, Soumyadeep Ghosh1, Sarah F Mercaldo2

  • 1Division of Abdminal Radiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States (A.S.S-B., S.G., S.S.R., B.U.V., A.P., A.K., L.L.T., M.G.H., T.P., A.R.K.).

Academic Radiology
|April 30, 2026
PubMed
Summary
This summary is machine-generated.

Routine pelvic ultrasound (RPU) shows limited ability to detect deep pelvic endometriosis (DE) using static criteria. Augmented pelvic ultrasound (APU) and reader training are crucial for early endometriosis detection.

Keywords:
Augmented Pelvic UltrasoundDeep Pelvic EndometriosisOvarian endometriomaSociety of Radiologists in UltrasoundTransvaginal Ultrasound

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Area of Science:

  • Radiology
  • Gynecology
  • Medical Imaging

Background:

  • Pelvic endometriosis diagnosis is often delayed.
  • The Society of Radiologists in Ultrasound (SRU) proposed consensus criteria for augmented pelvic ultrasound (APU) to improve diagnosis.
  • This study evaluates the feasibility of applying static SRU criteria to routine pelvic ultrasound (RPU).

Purpose of the Study:

  • To assess the performance of static SRU criteria on non-augmented RPU for detecting pelvic endometriosis observations.
  • To determine the diagnostic accuracy of RPU in identifying endometriosis compared to established methods.

Main Methods:

  • Retrospective analysis of RPU images from 118 women (18-55 years) with suspected endometriosis.
  • Evaluation of images using static 2024 SRU criteria, excluding dynamic maneuvers.
  • Ground truth established via MRI, laparoscopy, and histopathology; inter-reader agreement and diagnostic accuracy calculated.

Main Results:

  • RPU demonstrated moderate inter-reader agreement for ovarian endometrioma (OMA) detection (Kappa=0.742).
  • Sensitivity, specificity, and accuracy for OMA ranged from 61-77%, 84-93%, and 73-82%, respectively.
  • Low inter-reader agreement was observed for deep pelvic endometriosis (DE) observations (Kappa=0.002).

Conclusions:

  • RPU is reliable for OMA but has limited performance for DE in high-suspicion patients using static SRU criteria.
  • Augmented pelvic ultrasound (APU) and dedicated reader training are essential for improving early endometriosis detection.
  • Integrating APU with RPU can help overcome the diagnostic delay of pelvic endometriosis.