Women can wait years for an endometriosis diagnosis. New tech could change that

For many women, the journey to diagnose endometriosis can extend over several years. However, a recent pilot study at Oxford University introduces a promising scanning technique that may facilitate earlier detection of the condition.

This innovative approach employs specialized CT scans in conjunction with a molecular tracer designed to pinpoint early-stage endometriosis, a stage often overlooked by traditional imaging methods.

Should these findings be validated in larger trials, this technique could provide women with a timely understanding of their symptoms, according to researchers.

Endometriosis, which impacts one in every ten women in the UK, is characterized by the growth of cells resembling those that line the uterus in locations outside of the uterus. The average wait for an accurate diagnosis is approximately nine years.

The symptoms of endometriosis can be severe and diverse, ranging from heavy menstrual bleeding to debilitating fatigue and abdominal discomfort, frequently resembling other medical conditions.

As a result, individuals often undergo numerous tests, including ultrasounds and, at times, MRI scans.

While these conventional scans may not always reveal the disease, they primarily detect changes that typically occur in later stages, notes Dr. Tatjana Gibbons, the principal investigator of the study.

"This results in many individuals enduring significant symptoms despite receiving normal imaging outcomes," explains Dr. Gibbons.

"Achieving a diagnosis sooner can empower individuals to make informed decisions and plans regarding their lives," she adds.

'A very long journey'

Gabriella Pearson, co-founder of the charity Menstrual Health Project, experienced her endometriosis diagnosis at the age of 23, following over a decade of escalating symptoms and several misdiagnoses.

Now 33, Pearson expresses that had she received appropriate attention and diagnosis earlier, her current circumstances would likely be much different.

Endometriosis has impacted her bowel, bladder, and ovary, resulting in long-lasting complications.

"Due to the severe pain and associated challenges, I was unable to advance my career or pursue university education," Pearson asserts.

"There is a ripple effect concerning mental health, finances, employment, and fertility. Thus, early diagnosis could significantly enhance individuals' prospects for a better quality of life at a younger age."

Pearson's ordeal began at the age of 10, when she began suffering from intensely painful periods.

Over time, she developed severe gastrointestinal issues with every meal she consumed.

Initially dismissed as "part of being a woman," her symptoms were attributed to irritable bowel syndrome or stress.

After six years of consulting various doctors, she ultimately found a physician who suggested a likely diagnosis of endometriosis.

"It has indeed been a lengthy journey, and there is a pressing need for greater accuracy in diagnostic imaging," Pearson emphasizes.

"We merit a testing methodology that is more reliable, consistent, and non-invasive.

"I personally endured significant discomfort during an invasive ultrasound, which added to my challenges."

Her ultrasound results were interpreted differently across various medical professionals.

Years later, she opted for surgical intervention—a laparoscopy—to ascertain a definitive diagnosis, feeling a strong need to uncover the underlying cause of her symptoms.

New findings 'really exciting'

While individuals can receive certain treatments without a firm diagnosis, the only definitive method currently available is through a laparoscopy, a procedure involving the insertion of a small camera through a small incision in the abdomen. This can take several years to undertake.

In the Oxford study, 19 participants with either confirmed or suspected endometriosis underwent a specialized SPECT-CT scan, accompanied by an injection of a molecular tracer known as maraciclatide. This tracer adheres to areas where new blood vessel formations occur, believed to be integral to the early stages of endometriosis development.

The results showed that the new technique accurately identified the presence or absence of endometriosis in 16 of the participants.

Moreover, it successfully identified 14 out of 17 endometriosis cases that were subsequently confirmed through surgical intervention.

Dr. Gibbons describes the findings as "exciting."

The novel approach "provides a highly promising diagnostic and monitoring tool, particularly for superficial peritoneal endometriosis [considered an early manifestation of the disease], which is the most prevalent yet the most challenging type to identify."

Dr. Lucy Whitaker, a gynaecologist and researcher at the University of Edinburgh who did not participate in the study, highlights the urgent demand for new non-invasive imaging techniques.

"This preliminary data is genuinely exciting and warrants further investigation," she states. "If substantiated, it presents a significant opportunity to intervene at an earlier stage, assisting patients in obtaining timely diagnoses and exploring treatment options sooner."

The new scanning method may also play a significant role in examining the progression of the disease over time and evaluating the efficacy of various treatment strategies.

Dr. Whitaker notes that the scans and tracer entail exposure to radiation, a factor that must be weighed against the potential risks of undergoing a laparoscopy.

The findings are published in the journal Lancet Obstetrics, Gynaecology and Women's Health and were led by the Nuffield Department of Women's and Reproductive Health at the University of Oxford in collaboration with Serac Healthcare.

Symptoms to watch out for:

• Severe period pain that inhibits routine activities
• Heavy menstrual bleeding
• Extreme fatigue
• Pain in the lower abdomen, back, and pelvic region
• Pain during urination or bowel movements
• Discomfort during or following sexual intercourse
• Pain or bleeding in other areas, including the chest
• Challenges with conception
• Low mood