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Video case study: DEFEND

March 8, 2023

The DEFEND (Developing an US-MRI-biomarker fusion model for Endometriosis) study: AI could end the need for invasive surgery to diagnose endometriosis

Endometriosis is a common condition affecting one in ten women in the UK of childbearing age. That’s approximately one and a half million women in the UK who are living with endometriosis and having to put up with significant pelvic and abdominal pain during menstruation, painful intercourse and spontaneous pain outside their periods. In some cases, it can lead to infertility issues and in fact, the prevalence of endometriosis in women with infertility is 30 to 50%. Women with endometriosis are facing serious delays to diagnosis, with nearly two-thirds visiting their GPs over ten times, a quarter visiting doctors in hospitals ten times or more, and over half ending up in A&E due to their pain.

It takes eight years on average from the onset of symptoms to receiving a diagnosis, the same length of time as it did a decade ago. This highlights an urgent need for investment in research to drive down this time and ensure appropriate access to care when women need it. Currently, diagnosis using a conventional imaging technique isn’t always possible with keyhole surgery, also known as laparoscopy, being the present gold standard way to reach a definitive diagnosis.

However, this is an invasive procedure, meaning that it can either lead to years of uncertainty for those that have endometriosis but are reluctant to have surgery, or unnecessary surgery for those that are eventually shown not to have endometriosis. Our sincere hope is that this study will bring about the development of an algorithm to enable diagnosis through minimally invasive approaches. And this would be a huge step forward for women with endometriosis symptoms.

This is a complex process where we have to bring together two different imaging modalities, ultrasound and MRI, along with the clinical symptoms that women present with, and then verify our findings and the subsequent surgery that they have. Once all the complex data has been collected by King’s Fertility, Perspectum and GE Healthcare will start looking at and comparing the data sets.

The funding from Innovate UK has enabled us to recruit women to our study for this groundbreaking blue sky thinking project, which is currently showing extremely good results. We’re demonstrating that these endometriotic lesions have their own interesting signal. What we’re hoping to produce is a heat map that can then be read quantitatively, demonstrating where there is a potential likelihood of endometriotic lesions.