A new tool for diagnosing and monitoring endometriosis could reduce the need for invasive operations.
Scientists have found that a molecular imaging agent, named 99mTc-maraciclatide, once injected, detects areas in the body where new blood vessels are forming, a key indicator of the condition. These spots then show up in a SPECT-CT scan, with researchers hoping the method could be an alternative to keyhole surgery.
The findings were published in a number of journals and have the potential to reduce delays in diagnosis and improve accuracy.
Tatjana Gibbons, lead author on the paper and investigator on the study from the Nuffield Department of Women’s and Reproductive Health at the University of Oxford, said: “These exciting findings indicate that maraciclatide offers a highly promising diagnostic and monitoring tool, particularly for superficial peritoneal endometriosis (SPE), which is the most common and yet the hardest type of endometriosis to identify.”
SPE, which is found in the membrane that lines the abdominal cavity and covers the abdominal organs, accounts for about 80% of all diagnoses by laparoscopy, an operation in the abdomen and pelvis.
It can only be identified accurately by surgery, but 40% of these operations don’t find the condition, meaning many women are undergoing unnecessary invasive procedures.
In the study, 19 women with suspected or confirmed pelvic or thoracic endometriosis were injected with the maraciclatide, followed by the scan.
More reliable and accurate
The imaging agent works by binding to proteins, known as αvβ3 integrins, associated with increased blood vessel formation, a feature of inflammatory diseases such as endometriosis.
The scan results matched surgical findings in 16 of 19 cases, including when the disease wasn’t present, with no false positives.
Using maraciclatide also produced more reliable and accurate results than conventional imaging methods such as MRI scans.
The study, a collaboration between London-based clinical radiopharmaceutical company Serac Healthcare and the Nuffield Department of Women’s and Reproductive Health, will move on to its next phase later this year. More research is needed before the technique can be used in routine clinical practice.
Speaking to Healthcare Today, Lizzie Tuckey, clinician and UK MD at Scan.com, said the research could be a game changer, but warned that it needs to be followed by improved, joined-up care for endometriosis sufferers.
“This research is genuinely exciting – the idea that CT imaging could transform how we detect endometriosis is the kind of progress that patients have been waiting decades for. But we have to be honest about what a breakthrough in detection actually means without a system built to act on it,” she said.
“Right now, we see patients turning to private imaging to get answers faster – and they do. But then what? They go back to the NHS for treatment and get stuck in a black hole between public and private care pathways – no clear next step, blurred clinical responsibility, and often more anxiety as symptoms worsen. Advances in early diagnosis only improve patient outcomes if required treatment can follow in a timely and efficient way. Better detection without better coordination is just a faster route to the same dead end.”
