A new study from Oxford University is raising hopes for a potential non-invasive endometriosis scan that could help give women an earlier explanation for their symptoms.
And while the research is still in very early stages, endometriosis experts say it’s part of a growing body of research on finding better ways to diagnose the roughly one in 10 women in Canada who have the condition, where the lining of the uterus grows outside of it, causing significant and chronic pain.
Nineteen people with confirmed or suspected endometriosis were evaluated through a specialized SPECT-CT scan, along with an injection of a molecular tracer called maraciclatide. It attached to areas where new blood vessels were forming — believed to be a key part of early endometriosis growth.
As a result, the new technique was able to correctly detect the presence or absence of endometriosis in 16 women.
It was also found that the specialized CT scans are “accurately detecting endometriotic lesions” that is often “missed by conventional imaging methods.”
“There is an urgent need for advancement in non-invasive or minimally invasive imaging of endometriosis, particularly superficial peritoneal endometriosis, given the current reliance on invasive procedures for an accurate diagnosis,” the study reads.
“The DETECT study describes, for the first time to our knowledge, a minimally invasive diagnostic technique.”
The study is the second phase of research meant to “generate preliminary evidence of imaging performance characteristics.” The third phase will aim to “validate these findings in a larger group of participants.”
President-elect of the Society of Obstetricians and Gynaecologists of Canada (SOGC) Dr. Nicholas Leyland called endometriosis a “disease of symptoms.”
Endometriosis Canada lists common symptoms to be chronic pelvic pain, painful periods, pain during or after intercourse, infertility or difficulty conceiving, gastrointestinal symptoms such as bloating, constipation, or diarrhea (especially during menstruation).
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There is not yet a definitive cause for endometriosis, but those with a close relative with endometriosis have a higher chance of having the condition.
“If women experience pain for longer periods of time untreated, it can affect the nervous system to make it even more difficult to treat for these patients,” he said.
A 2021 National Library of Medicine study coined endometriosis as the “missed disease” due to the lack of information on its causes and “inconsistencies in its diagnosis and management.”
“Unlike other long-term conditions such as diabetes and asthma, endometriosis has remained largely ignored in government policy and research funding globally,” the study reads.
“It’s very validating for women to realize that the symptoms that they’re having are real and they’re related to a problem such as endometriosis, because many women have been gaslit by lots of different providers — not just doctors, but a lot of people around and family — that their symptoms are normal,” Leyland said.
According to Endometriosis Network Canada, the condition affects at least one in 10 women in Canada, with almost 2 million Canadians estimated to have endometriosis.
The Oxford University study also states that approximately 190 million people worldwide have endometriosis.
Dr. Dafna Sussman, associate professor in biomedical engineering and biomedical physics departments at Toronto Metropolitan University, called Canada’s current approach a “method of elimination.”
“Referring to different specialists, trying different treatments or interventions, effectively only to rule out other causes of the symptoms,” she said in an emailed statement to Global News. “Many patients undergo repeated untargeted investigation and treatments, including unnecessary surgeries.”
Sussman also added that “multiple specialist referrals and diagnostic investigations require significant time to schedule,” making the time to receiving a diagnosis lengthier.
“Each specialist may initiate different treatments or medications, which must be trialed over time to assess their effectiveness. Collectively, these delays accumulate, often resulting in several years before a definitive diagnosis is reached.”
Leyland also echoed the sentiment that “the problem is the delay in diagnosis.”
“Trying to train all providers, midwives, nurses, doctors, school nurses, and even the patients themselves that these symptoms when they’re interfering with their quality of life are actually not normal. So that’s unfortunately why it takes five to seven years in Canada to get proper management and diagnosis.”
Sussman cited the “current gold standard” for receiving an endometriosis diagnosis is through a “laparoscopic visualization,” a procedure where a surgeon views internal organs.
“This is an invasive surgical procedure most patients would opt to avoid,” she said.
With new technologies being developed, Leyland said that “we are not quite there yet.”
“We’ve got a lot more work to do in terms of education, but ultrasound is one of the tools that really helps, I think allows us to make the diagnosis and plan for appropriate treatment.”
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