New imaging study could make diagnosing endometriosis quicker, more accurate and reduce the need for invasive surgery

A new research study launches to investigate whether a 20-minute imaging scan can detect the most common types of endometriosis, which currently require surgery to diagnose.

Endometriosis is a common inflammatory condition affecting 1 in 10 women (1.5 million in the UK), associated with painful periods, chronic pelvic pain, and infertility. It is believed to be due to tissue that resembles the lining of the womb sticking to areas outside the uterus, usually in the pelvis. Even though endometriosis affects a similar number of women in the UK as diabetes (which can be diagnosed simply with blood tests), diagnosing endometriosis often results in multiple GP and A&E visits, multiple scans and often surgery to confirm the diagnosis. As a result, there is an average delay of approximately eight years to get a diagnosis of endometriosis, a figure that has not improved in the last decade. One of the main reasons for this delay is the lack of non-invasive tests capable of detecting all endometriosis subtypes (ovarian, superficial, and deep disease). This issue has resulted in the public, MPs and charities across the UK calling for research to improve doctors' ability to diagnose endometriosis more quickly and simply, allowing women to seek appropriate treatment sooner. A report by an All-Party Parliamentary Group (APPG) on Endometriosis, as well as the Vision statement for a Women's Health Strategy for England, recently highlighted these diagnostic shortcomings and commitment to drive down diagnosis times.

Endometriosis experts at the Endometriosis CaRe Centre, Nuffield Department of Women's and Reproductive Health, University of Oxford, have joined with Serac Healthcare Ltd, a British life sciences company to investigate whether an experimental imaging marker (⁹⁹ᵐTc maraciclatide) that binds to areas of inflammation can be used in endometriosis to visualise the disease on a scan. The imaging marker has been used for detecting inflammation in conditions such as rheumatoid arthritis in other research studies across the UK, EU and U.S..

Professor Christian Becker, who is Co-Director of the Endometriosis CaRe Centre (www.wrh.ox.ac.uk/research/endometriosis-care ) in Oxford together with Professor Krina Zondervan, Head of Department at the Nuffield Department of Women's and Reproductive Health, University of Oxford, will lead this initial study on women due to have planned surgery for suspected endometriosis. Two to seven days before their operation, participants will be invited for an imaging scan which will compare the suspected locations of disease detected on the scan and in surgery to confirm whether this imaging test could be an effective non-invasive method of detecting all endometriosis subtypes.

The potential strengths of the scan lie in the way the imaging marker binds to areas of inflammation, which may allow doctors to distinguish between new and old lesions and detect endometriosis in

areas not easily seen during surgery such as the lung. The development of a 20-minute imaging test would reduce the need for repeated visits to doctors, for repeated investigations, and for invasive surgery to obtain a diagnosis. This would ultimately reduce the time taken to confirm or exclude endometriosis.

Prof Becker said: "There is an urgent unmet clinical need for a non-invasive marker to identify or rule out endometriosis as it is such a very common disease affecting more than 190 million women worldwide."

Prof Zondervan added: "This study highlights that close collaborations between academics, clinicians and industry are important to combine and accelerate discovery and innovation in addressing high-priority areas in women's health, such as endometriosis."

Mr David Hail, CEO of Serac Healthcare said "We are excited about the potential of 99mTc-maraciclatide to diagnose endometriosis non-invasively and delighted to be working with the internationally renowned team at Oxford on this important first study."

Provided by University of Oxford