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. 2026 Jan;51(1):255-260.
doi: 10.1007/s00261-025-05060-1. Epub 2025 Jun 12.

Endometriomas on routine pelvic ultrasound (US) as an indication for MRI for deep endometriosis (DE)

Priyanka Jha  1 , Colin Huang  2 , Hailey Choi  2 , Wendaline VanBuren  3 , Liina Poder  2
Affiliations

Endometriomas on routine pelvic ultrasound (US) as an indication for MRI for deep endometriosis (DE)

Priyanka Jha et al. Abdom Radiol (NY). 2026 Jan.

Abstract

Purpose: To determine whether presence of endometriomas on routine pelvic ultrasound (US) can predict presence of deep infiltrating endometriosis (DE) on magnetic resonance imaging (MRI) and correlate endometrioma size with the presence of DE on MRI.

Materials and methods: In this IRB approved, HIPAA compliant study, radiology data base was queried for MRI exams dedicated for endometriosis evaluation in patients with surgically proven endometriosis over a three-year period (2016-2019). Imaging reports were reviewed for the presence of endometriomas and DE on MRI. For the patients with endometriomas, records were reviewed for concurrent routine pelvic US imaging, which were not tailored to DE protocols. US images were reviewed for the presence of endometriomas, their total number, laterality and largest dimension. Descriptive statistics and receiver operating curve (ROC) analysis were performed. Pathology and surgical notes were used as reference standard.

Results: 253 patients with surgically confirmed endometriosis underwent MRI for DIE over a 3-year duration. 47 patients had a concurrent US exam. 33/47 patients (70.2%) had endometriomas seen on US (size range 0.9-7.0 cm). 12 had bilateral endometriomas and 13 had multiple (more than 1) endometriomas. 27/33 (82%) of these patients had DE on MRI. 6/33 (18%) patients had additional sites of DE on surgery, which was not reported preoperatively on MRI. When endometriomas more than 3 cm as were evaluated, 19/21 (90%) of patients had DE on MRI. AUC was 0.7106. Using ROC analysis, a threshold of 3.8 cm, provided a sensitivity of 71% and specificity of 78% for detection of DE on MRI.

Conclusion: Presence of endometriomas on routine pelvic US is associated with a high frequency of DE detected on MRI performed for endometriosis. The frequency of DE on MRI was higher in patients with endometrioma size > 3 cm compared to endometriomas of all size range.

Keywords: Deep endometriosis; Endometrioma; Endometriosis; Endometriosis screening ultrasound; Magnetic Resonance Imaging (MRI); SRU consensus for endometriosis; Ultrasound.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests.

References

    1. Young SW, Jha P, Chamie L, Rodgers S, Kho RM, Horrow MM, Glanc P, Feldman M, Groszmann Y, Khan Z, Young SL, Poder L, Burnett TL, Hu EM, Egan S, VanBuren W. Society of Radiologists in Ultrasound Consensus on Routine Pelvic US for Endometriosis. Radiology 2024;311(1):e232191. doi: https://doi.org/10.1148/radiol.232191 - DOI - PubMed
    1. VanBuren W, Feldman M, Shenoy-Bhangle AS, Sakala MD, Young S, Chamie LP, Giudice L, Hindman NM, Tong A, Rabban JT, Yano M, Kilcoyne A, Dave HD, Poder L, Kho RM, Burnett TL, Khan Z, King C, Shen L, Colak C, Burk KS, Andrieu PIC, Franco IVP, Glanc P, Kielar AZ, Taffel MT, Kania LM, Bonde A, Pectasides M, Arif-Tiwari H, Laifer-Narin S, Nicola R, Jha P. Radiology State-of-the-art Review: Endometriosis Imaging Interpretation and Reporting. Radiology 2024;312(3):e233482. doi: https://doi.org/10.1148/radiol.233482 - DOI - PubMed
    1. Mowers EL, Lim CS, Skinner B, Mahnert N, Kamdar N, Morgan DM, As-Sanie S. Prevalence of Endometriosis During Abdominal or Laparoscopic Hysterectomy for Chronic Pelvic Pain. Obstet Gynecol 2016;127(6):1045–1053. doi: https://doi.org/10.1097/AOG.0000000000001422 - DOI - PubMed
    1. Nezhat CR, Oskotsky TT, Robinson JF, Fisher SJ, Tsuei A, Liu B, Irwin JC, Gaudilliere B, Sirota M, Stevenson DK, Giudice LC. Real world perspectives on endometriosis disease phenotyping through surgery, omics, health data, and artificial intelligence. NPJ Womens Health 2025;3(1):8. doi: https://doi.org/10.1038/s44294-024-00052-w - DOI - PubMed - PMC
    1. Jha P, Sakala M, Chamie LP, Feldman M, Hindman N, Huang C, Kilcoyne A, Laifer-Narin S, Nicola R, Poder L, Shenoy-Bhangle A, Tong A, VanBuren W, Taffel MT. Endometriosis MRI lexicon: consensus statement from the society of abdominal radiology endometriosis disease-focused panel. Abdom Radiol (NY) 2020;45(6):1552–1568. doi: https://doi.org/10.1007/s00261-019-02291-x - DOI - PubMed

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