New Approaches in Endometriosis Diagnosis: What's Next?

Early diagnosis of endometriosis can use symptom-based criteria to determine who should undergo testing and then set optimal cut-points to maximize sensitivity and specificity. Over 11% of women in the United States and 190 million women globally of reproductive age suffer from endometriosis, a common, painful, chronic disease (1^✔ ✔Trusted Source
Emerging Diagnostic Tools for the Early Diagnosis of Endometriosis

Go to source). Diagnosis of endometriosis is still a concern in clinical and public health. Endometriosis is caused by the spread and growth of tissues inside the uterus to other organs, like the fallopian tubes, ovaries, and other organs. These conditions could have permanently detrimental effects - infertility and chronic pain on one's quality of life. Symptoms, which include cramps and pain in the abdomen before, during, and after menstruation, usually go unnoticed for seven years.

From Symptoms to Solutions: Rethinking Endometriosis Diagnosis

In a commentary published in The Journal of Reproductive Medicine, Gynaecology & Obstetrics, researchers from Florida Atlantic University’s Schmidt College of Medicine and collaborators, conducted a PubMed search to identify promising approaches for early diagnosis of endometriosis.

“Currently, diagnosing endometriosis involves a thorough review of the patient’s medical history and physical examination,” said Panagiota “Yiota” Kitsantas, Ph.D., first and corresponding author as well as professor and chair of the Department of Population Health and Social Medicine, FAU Schmidt College of Medicine. “The most commonly used and accurate diagnostic methods are pelvic exams, abdominal ultrasound, MRI, and laparoscopy. Laparoscopic surgery is considered the gold standard for diagnosing endometriosis by gynecologists, but it can be expensive and carries potential risks of surgical complications. Moreover, the accuracy of laparoscopy can vary based on the surgeon’s experience and the stage of the disease.”

A test with high predictive value would accurately confirm endometriosis if positive and exclude it if negative. Although less ideal tests may not provide definitive results, they can be useful in reducing the number of patients who need to proceed to more invasive procedures, like laparoscopy.

Endometriosis involves hormonal imbalances that trigger angiogenesis, apoptosis, immune responses, and inflammation. Diagnostic tools for endometriosis have been developed to detect biomarkers, such as mRNA fragments in blood and saliva, but these have shown low accuracy.

Hidden Costs of Endometriosis Diagnosis

“Non-invasive methods like MRI and transvaginal ultrasound are only effective for advanced stages of endometriosis,” said Charles H. Hennekens, M.D., co-author, the first Sir Richard Doll Professor of Medicine and Preventive Medicine in the Departments of Medicine and Population Health and Social Medicine and senior academic advisor, FAU Schmidt College of Medicine. “Recent research has focused on a novel noninvasive method of detecting myoelectric activity in the gastrointestinal tract as a potential diagnostic tool. Electroviscerography or EVG could detect unique myoelectric patterns associated with endometriosis, though this approach is promising but unproven.”

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Currently, there is no FDA-approved non-invasive test for endometriosis, and further analytic studies leading to peer-reviewed publications are needed to refine these emerging technologies and establish effective diagnostic criteria.

“Early diagnosis of endometriosis remains a challenge, with a succession of promising approaches ultimately not bearing fruit thus far,” said Kitsantas. “Once new technologies such as EVG are more fully evaluated, they may give clinicians the post-test certainty they need to transition from symptom-based to diagnosis-based treatment.”

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Reference:

1. Emerging Diagnostic Tools for the Early Diagnosis of Endometriosis - (https://www.fau.edu/newsdesk/articles/early-diagnosis-endometriosis#:~:text=%E2%80%9CRecent%20research%20has%20focused%20on,approach%20is%20promising%20but%20unproven.%E2%80%9D)