 Introduction/Background Endometriosis is a common condition impacting approximately 10% of individuals assigned female at birth [1]. The disorder is caused by endometrial-like tissue located outside of the endometrial cavity, associated with inflammation and fibrosis, on or extending below the peritoneal surface [2]. Endometriosis that extends below the peritoneum is often referred to as deep endometriosis (DE). Endometriosis is usually multifocal and typically occurs in predictable locations in the pelvis. The diagnosis of endometriosis is challenging due to variable presenting symptoms and nonspecific physical examination findings [5]. Historically, the diagnosis of endometriosis was made by diagnostic laparoscopy with histologic inspection. Studies have shown that preoperative imaging is associated with decreased morbidity and mortality and reduces the need for repeat surgeries by reducing the number of incomplete surgeries. The literature now supports the use of imaging before surgery, because information gained from imaging studies helps inform patient decision making, is important for surgical planning, and impacts management [1,6,7]. Expert consensus groups advise using an MRI protocol tailored for detection of DE. Moderate bladder distention and vaginal contrast are recommended to help improve lesion conspicuity involving these structures [29]. There is aCleveland Clinic, Cleveland, Ohio. bPanel Chair, University of Michigan, Ann Arbor, Michigan. cClinica Family Health, Lafayette, Colorado; American Academy of Family Physicians. dUniversity of Kentucky, Lexington, Kentucky. eAlpert Medical School of Brown University, Providence, Rhode Island; Commission on Nuclear Medicine and Molecular Imaging. fHospital of the University of Pennsylvania, Philadelphia, Pennsylvania. gEmory University School of Medicine, Atlanta, Georgia; Committee on Emergency Radiology-GSER. hNew York University Langone Health, New York, New York. iVanderbilt University Medical Center, Nashville, Tennessee.
Endometriosis.  Introduction/Background Endometriosis is a common condition impacting approximately 10% of individuals assigned female at birth [1]. The disorder is caused by endometrial-like tissue located outside of the endometrial cavity, associated with inflammation and fibrosis, on or extending below the peritoneal surface [2]. Endometriosis that extends below the peritoneum is often referred to as deep endometriosis (DE). Endometriosis is usually multifocal and typically occurs in predictable locations in the pelvis. The diagnosis of endometriosis is challenging due to variable presenting symptoms and nonspecific physical examination findings [5]. Historically, the diagnosis of endometriosis was made by diagnostic laparoscopy with histologic inspection. Studies have shown that preoperative imaging is associated with decreased morbidity and mortality and reduces the need for repeat surgeries by reducing the number of incomplete surgeries. The literature now supports the use of imaging before surgery, because information gained from imaging studies helps inform patient decision making, is important for surgical planning, and impacts management [1,6,7]. Expert consensus groups advise using an MRI protocol tailored for detection of DE. Moderate bladder distention and vaginal contrast are recommended to help improve lesion conspicuity involving these structures [29]. There is aCleveland Clinic, Cleveland, Ohio. bPanel Chair, University of Michigan, Ann Arbor, Michigan. cClinica Family Health, Lafayette, Colorado; American Academy of Family Physicians. dUniversity of Kentucky, Lexington, Kentucky. eAlpert Medical School of Brown University, Providence, Rhode Island; Commission on Nuclear Medicine and Molecular Imaging. fHospital of the University of Pennsylvania, Philadelphia, Pennsylvania. gEmory University School of Medicine, Atlanta, Georgia; Committee on Emergency Radiology-GSER. hNew York University Langone Health, New York, New York. iVanderbilt University Medical Center, Nashville, Tennessee.