A team of researchers is working on a more comfortable method for diagnosing endometriosis by combining ultrasound, magnetic resonance imaging (MRI), and artificial intelligence. This approach is anticipated to be available within the next two years.
Key Points:
In the past, keyhole surgery has been regarded as the most effective approach to identifying endometriosis.
Researchers use imaging and artificial intelligence to create a more lenient diagnostic technique.
The development of new technology and more extensive training have increased the precision of scanning in diagnosing endometriosis.
For many years, medical experts have thought that keyhole surgery is the only reliable way to accurately diagnose a condition affecting one in nine Australian females and those assigned female at birth by age 44.
Endometriosis is a medical condition that results when tissue like the lining of the uterus grows in other areas of the body. This can lead to severe pain and sometimes cause difficulty with conception.
Obstacles in obtaining specialized treatment have resulted in individuals with the illness having to wait anywhere from seven to twelve years on average before receiving a diagnosis.
The ‘Imagendo research team from the University of Adelaide is merging the diagnostic qualities of pelvic ultrasounds and MRIs with artificial technology to make more precise identifications of endometriosis lesions and create innovative algorithms for diagnosing the condition.
Dr. Louise Hull, a Gynaecologist and Fertility Specialist, stated that if the proposed diagnosis model proves successful, it could be distributed worldwide to be available in medical clinics within two years.
Dr. Louise Hull says:
“The ultrasound machines as well as the MRIs have just got better and better over time, but the techniques have also got better,” she said.
“What’s happened is there has been an interest in endometriosis and funding for endometriosis that we have just never had before.
“It means that we can have really well-qualified sonographers whose main role is to do endometriosis scanning and they can see lesions and ligaments outside the uterus which a standard gynaecological scan just wouldn’t detect.”
Last November, the federal government added pelvic MRIs to the Medicare Benefits Scheme as a diagnostic tool for endometriosis and other conditions affecting fertility. This was largely due to Professor Louise Hull’s work as a principal investigator on the Imagendo study, which demonstrated that MRIs were an affordable option for diagnosing these conditions.
Recently, the European Society of Human Reproduction and Embryology (ESHRE), the National Institute for Health and Care Excellence (NICE), and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) have all revised their criteria for diagnosing endometriosis.
Professor Hull went on to say:
“They have all agreed that very specialist scans for endometriosis either ultrasound scans or MRIs can often pick up endometriosis quite accurately, although a negative scan can’t rule it out,”
“We’ve be able to work with the Australian Institute of Machine Learning in a big collaboration where we can use lots and lots of scans, ultrasounds and MRIs and put all of the digital data together to add up the diagnostics to get much more accurate results for people, so they don’t have to have surgery as a first step.”
Proven Ways To Protect Your Fertility & Reproductive Health
Professor Hull mentioned that studies have indicated approximately one-third of individuals who underwent diagnostic surgery for endometriosis did not require the operation.
Professor Hull continues to say:
“The second thing is — it’s a pain trigger and if you have pain it will up-regulate all of the neural responses in your body which includes back pain, pain in the pelvis, stabbing pain, headaches and fatigue and it will trigger that again,”
The Imagendo study has been enrolling individuals to take part in it. In some cases, the surgery to diagnose endometriosis demonstrated that there was more of it than anticipated.
Professor Hull adds to say:
“They would have to stop the surgery and plan another surgery a few weeks down the track and have bowel surgeons or prepare your body differently, so you would end up having two surgeries,”
The new diagnostic model could help decrease infertility in those with endometriosis by allowing for earlier diagnosis, allowing them to freeze their eggs at a younger age.
Professor adds:
“If we know that you’ve got endo, people can actually protect their fertility when they’re younger,”
Making A Difference: Ideas To Create Impactful Change
Jodie Avery, a Senior Research Fellow and the Program Manager for Imagendo declared that they had been gathering data from ultrasounds, MRIs, and operation notes given to them by women to craft a diagnostic algorithm.
Jodie Avery says:
“We are really interested if anyone wants to donate their scans, particularly if they’ve had a transvaginal endometriosis scan, because they are the scans that we actually really need,”
Dr. Jodie Avery’s research team has developed a new diagnostic model that could save women from having multiple surgeries to obtain a diagnosis. To validate the algorithm, they have been recruiting women for testing purposes.
Jodie Avery went on to say:
“It’s pretty amazing knowing that we are really going to be making a difference in the lives of women with endometriosis because they quite often have to go through many different surgeries just to find out if they’ve got the condition or not,”
“If we can go in and say, ‘here’s a really easy, non-invasive way that doesn’t cause any pain and doesn’t cause taking too much time off work or education’, it’s just going to make such a difference to the lives of women.”
The team is investigating different approaches to launching the model after it has been evaluated and accepted for operation.
The algorithm could be incorporated into an online platform, enabling patients and physicians to upload medical imaging and gain a probability score of endometriosis. Additionally, it could also be integrated into ultrasounds for rapid diagnosis.
Belle Burgess had laparoscopic surgery two years ago to diagnose and remove her endometriosis. Before the procedure, she strongly suspected that she had endometriosis, but it was only through the surgery that her suspicions were confirmed.
The 23-year-old expressed how a less intrusive diagnostic practice would be highly advantageous for people with endometriosis, giving them a more comprehensive view of their illness before an operation.
Belle Burgess says:
“The surgery itself was quite an intense surgery, but having the aftermath of nerve damage and the recovery time affected my quality of life immensely, like I have never had before,”
“Being able to know that I have endometriosis before heading into such a big surgery and experience would be amazing so that I can prepare better for it, also to know how I can manage it before the surgery.
“And obviously saving the money, you know surgeries aren’t cheap and I don’t think they are affordable for a lot of people who have endometriosis. It’s not accessible to majority of women.”
Breaking The Established Norm: Innovative Ideas For Change
At this time in Australia, sonographers with the expertise to recognize endometriosis through ultrasound are scarce.
Alison Deslandes, a specialist Sonographer who is also undertaking a Ph.D. as part of the study,
Alison Deslandes says:
“We have been a little bit slow on the uptake,”
“In part when you’ve got an established norm which is that a pelvic ultrasound is done by doing a scan of the uterus and a scan of the ovaries, it takes a bit of time for people to change their thinking and move beyond that.
“We also have a problem where in Australia scans are mostly done through the private sector and funded through Medicare and Medicare pay a fairly minimal rebate really for a pelvic ultrasound and people are disincentivised to then extend the scan which is what they need to do to look for endometriosis.”
Alison Deslandes specializes in teaching sonographers the necessary skills to conduct scans that detect endometriosis. She noted a high demand among sonographers to acquire these particular scanning abilities, as there has been an increasing number of referrals for the scan.
Alison Deslandes went on to say:
“The learning curve is not that great to start to learn to scan for endometriosis and a few studies have found that within about 50 scans most people can get to a level of confidence doing that,”
The integration of imaging and AI can potentially revolutionize the diagnosis of endometriosis, offering a non-invasive and objective approach. The advancements in this field can potentially transform the lives of millions of women by enabling earlier and more precise diagnoses, leading to better management and improved patient outcomes. Continued research, validation, and responsible implementation of imaging and AI technologies can contribute to advancing women’s healthcare and improving the quality of care for individuals with endometriosis.
Source: @abcnews
