Non-invasive imaging techniques for diagnosis of pelvic deep endometriosis and endometriosis classification systems: an International Consensus Statement

G Condous¹, B Gerges^{1

2}, I Thomassin-Naggara³, C Becker⁴, C Tomassetti^{5

6}, H Krentel⁷, B J van Herendael^{8

9}, M Malzoni¹⁰, M S Abrao¹¹, E Saridogan¹², J Keckstein¹³, G Hudelist^{14

15}; Intersociety Consensus Group §

Collaborators, Affiliations

Collaborators

Intersociety Consensus Group §:
K Aas-Eng, J L Alcazar, C Bafort, M Bazot, D Bielen, A Bokor, T Bourne, F Carmona, A Di Giovanni, D Djokovic, A Egekvist, J English, C Exacoustos, H Ferreira, S Ferrero, R Forstner, S Freeman, M Goncalves, G Grimbizis, A Guerra, S Guerriero, F W Jansen, D Jurkovic, S Khazali, M Leonardi, C Maciel, L Manganaro, M Mueller, M Nisolle, G Noe, S Reid, H Roman, P Rousset, M Seyer Hansen, S Singh, V Thomas, D Timmerman, U A Ulrich, T Van den Bosch, D Van Schoubroeck, A Wattiez

Affiliations

¹ Acute Gynaecology, Early Pregnancy & Advanced Endosurgery Unit, Sydney Medical School Nepean, University of Sydney, Nepean Hospital, Penrith, NSW, Australia.
² Sydney West Advanced Pelvic Surgery (SWAPS), Blacktown Hospital, Blacktown, NSW, Australia.
³ APHP Hopital Tenon, Department of Radiology, Sorbonne Université, Paris, France.
⁴ Nuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre Oxford, University of Oxford, Oxford, UK.
⁵ Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.
⁶ Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium.
⁷ Department of Gynecology, Obstetrics and Gynecological Oncology, Bethesda Hospital, Duisburg, Germany.
⁸ Department of Minimally Invasive Gynecologic Surgery, Ziekenhuis Netwerk Antwerpen Campus Stuivenberg, Antwerp, Belgium.
⁹ Università degli Studi dell'Insubria, Varese, Italy.
¹⁰ Endoscopica Malzoni, Centre for Advanced Pelvic Surgery, Avellino, Italy.
¹¹ Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.
¹² Department of Obstetrics and Gynaecology, University College London Hospital, London, UK.
¹³ Stiftung Endometrioseforschung (SEF), Westerstede, Germany.
¹⁴ Department of Gynecology, Center for Endometriosis, Hospital St John of God Vienna, Vienna, Austria.
¹⁵ Rudolfinerhaus Private Clinic & Campus, Vienna, Austria.

PMID: 38812884
PMCID: PMC11134890
DOI: 10.1093/hropen/hoae029

Non-invasive imaging techniques for diagnosis of pelvic deep endometriosis and endometriosis classification systems: an International Consensus Statement

G Condous et al. Hum Reprod Open. 2024.

. 2024 May 29;2024(3):hoae029.

doi: 10.1093/hropen/hoae029. eCollection 2024.

Authors

Collaborators

Intersociety Consensus Group §:
K Aas-Eng, J L Alcazar, C Bafort, M Bazot, D Bielen, A Bokor, T Bourne, F Carmona, A Di Giovanni, D Djokovic, A Egekvist, J English, C Exacoustos, H Ferreira, S Ferrero, R Forstner, S Freeman, M Goncalves, G Grimbizis, A Guerra, S Guerriero, F W Jansen, D Jurkovic, S Khazali, M Leonardi, C Maciel, L Manganaro, M Mueller, M Nisolle, G Noe, S Reid, H Roman, P Rousset, M Seyer Hansen, S Singh, V Thomas, D Timmerman, U A Ulrich, T Van den Bosch, D Van Schoubroeck, A Wattiez

Affiliations

¹ Acute Gynaecology, Early Pregnancy & Advanced Endosurgery Unit, Sydney Medical School Nepean, University of Sydney, Nepean Hospital, Penrith, NSW, Australia.
² Sydney West Advanced Pelvic Surgery (SWAPS), Blacktown Hospital, Blacktown, NSW, Australia.
³ APHP Hopital Tenon, Department of Radiology, Sorbonne Université, Paris, France.
⁴ Nuffield Department of Women's and Reproductive Health, Endometriosis CaRe Centre Oxford, University of Oxford, Oxford, UK.
⁵ Department of Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.
⁶ Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium.
⁷ Department of Gynecology, Obstetrics and Gynecological Oncology, Bethesda Hospital, Duisburg, Germany.
⁸ Department of Minimally Invasive Gynecologic Surgery, Ziekenhuis Netwerk Antwerpen Campus Stuivenberg, Antwerp, Belgium.
⁹ Università degli Studi dell'Insubria, Varese, Italy.
¹⁰ Endoscopica Malzoni, Centre for Advanced Pelvic Surgery, Avellino, Italy.
¹¹ Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.
¹² Department of Obstetrics and Gynaecology, University College London Hospital, London, UK.
¹³ Stiftung Endometrioseforschung (SEF), Westerstede, Germany.
¹⁴ Department of Gynecology, Center for Endometriosis, Hospital St John of God Vienna, Vienna, Austria.
¹⁵ Rudolfinerhaus Private Clinic & Campus, Vienna, Austria.

PMID: 38812884
PMCID: PMC11134890
DOI: 10.1093/hropen/hoae029

Abstract

The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) and International Deep Endometriosis Analysis (IDEA) group, the European Endometriosis League (EEL), the European Society for Gynaecological Endoscopy (ESGE), ESHRE, the International Society for Gynecologic Endoscopy (ISGE), the American Association of Gynecologic Laparoscopists (AAGL) and the European Society of Urogenital Radiology (ESUR) elected an international, multidisciplinary panel of gynecological surgeons, sonographers, and radiologists, including a steering committee, which searched the literature for relevant articles in order to review the literature and provide evidence-based and clinically relevant statements on the use of imaging techniques for non-invasive diagnosis and classification of pelvic deep endometriosis. Preliminary statements were drafted based on review of the relevant literature. Following two rounds of revisions and voting orchestrated by chairs of the participating societies, consensus statements were finalized. A final version of the document was then resubmitted to the society chairs for approval. Twenty statements were drafted, of which 14 reached strong and three moderate agreement after the first voting round. The remaining three statements were discussed by all members of the steering committee and society chairs and rephrased, followed by an additional round of voting. At the conclusion of the process, 14 statements had strong and five statements moderate agreement, with one statement left in equipoise. This consensus work aims to guide clinicians involved in treating women with suspected endometriosis during patient assessment, counselling, and planning of surgical treatment strategies.

Keywords: MRI; collaboration; deep endometriosis; non-invasive diagnosis; transvaginal ultrasound.

PubMed Disclaimer

Conflict of interest statement

G.C. declares receipt of an MRFF grant to develop AI for endometriosis imaging, honoraria from Samsung and GE healthcare, is a member of the ISUOG Board of trustees, and is the WFUMB President-Elect. E.S. declares grants from National Institute for Health Research, Rosetrees Trust and Barts and the London Charity for multicenter trials on endometriosis and hysterectomy, book royalties (for the book entitled ‘Minimally Invasive Surgery in Gynecological Practice’) from De Gruyter, consulting fees from Hologic; honoraria from Medtronic, Hologic, Karl Storz, Intuitive, Arthrex, and Olympus; and is a member of the Medicines for Women’s Health Expert Advisory Group of the Medicines and Healthcare Products Regulatory Agency (MHRA). The other authors do not have any conflicts of interest to declare.

Figures

**Figure 1.**
Process for development of Consensus Statement on the use of non-invasive imaging techniques for diagnosis and classification of pelvic deep endometriosis.

See this image and copyright information in PMC

References

1. Abrao MS, Andres MP, Gingold JA, Rius M, Neto JS, Goncalves MO, Giovanni AD, Malzoni M, Carmona F.. Preoperative ultrasound scoring of endometriosis by AAGL 2021 Endometriosis Classification is concordant with laparoscopic surgical findings and distinguishes early from advanced stages. J Minim Invasive Gynecol 2023;30:363–373. - PubMed
1. Abrao MS, Andres MP, Miller CE, Gingold JA, Rius M, Neto JS, Carmona F.. AAGL 2021 Endometriosis Classification: an anatomy-based surgical complexity score. J Minim Invasive Gynecol 2021;28:1941–1950.e1. - PubMed
1. Abrao MS, Petraglia F, Falcone T, Keckstein J, Osuga Y, Chapron C.. Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management. Hum Reprod Update 2015;21:329–339. - PubMed
1. Adamson GD, Pasta DJ.. Endometriosis fertility index: the new, validated endometriosis staging system. Fertil Steril 2010;94:1609–1615. - PubMed
1. Agarwal SK, Chapron C, Giudice LC, Laufer MR, Leyland N, Missmer SA, Singh SS, Taylor HS.. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol 2019;220:354.e1–12. - PubMed

LinkOut - more resources

Full Text Sources
- Europe PubMed Central
- PubMed Central

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Non-invasive imaging techniques for diagnosis of pelvic deep endometriosis and endometriosis classification systems: an International Consensus Statement

Collaborators

Affiliations

Non-invasive imaging techniques for diagnosis of pelvic deep endometriosis and endometriosis classification systems: an International Consensus Statement

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources