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Endometriosis is oestrogen-dependent and is defined as the presence of endometrial tissue outside the uterus cavity.

Digital illustration of the womb and ovaries.

Background:

Project lead: Perspectum Diagnostics with Dr Ippokratis Sarris, University of Oxford

Partner: King's Fertility

Endometriosis is predominantly found in women in their reproductive years, often disappearing spontaneously after the menopause. It is associated with: significant pelvic and abdominal pain during menstruation (dysmenorrhoea); painful intercourse (dyspareunia); and spontaneous pain outside menstrual periods. It often has an adverse effect on fertility. While minor and moderate endometriosis can be managed in all gynaecology departments, more severe cases necessitate complex surgery.

The exact prevalence of endometriosis is not certain, not least because laparoscopic examination of healthy women is rare. 

Studies show that the prevalence is approximately 33%. NHS England notes that “Using UK population statistics 2005/6, there were 10.5 million women between the ages of 15 and 45 years”, which implies an incidence in the UK of up to 3.5 million cases. 

There is also increasing public awareness of this debilitating condition.

Aim: 

This exemplar is distinguished in NCIMI in that it addresses a major healthcare issue that impacts women and aims to reduce the need for laparoscopic diagnoses. The aim of NCIMI is to progress from the starting point of “Unmet need” to at least a prototype/solution and a proof-of-concept clinical trial during the (initial) 3-year period of the project. The data to be gathered during NCIMI will be critical to realising this progress.

We have shown how to automatically detect bladder endometriosis lesions in MR images as a form of bladder wall thickening. We will further develop the method, to enable fusion with ultrasound, and to integrate the extrinsic images (MRI, US) with the local information provided laparoscopically during minimally-invasive surgery, to allow for better detection, diagnoses and support of treatment. 

Outcomes:

  • Improve patient experience through the diagnostic pathway
  • Reduce the use of laparoscopic diagnosis through advanced imaging and blood biomarkers
  • Improve diagnostic confidence for all users
  • Decrease time to diagnosis
  • Increase endometriosis awareness universally