Method<\/h3>\t\t\t\n\t\t\t\t
The Oxford Endometriosis CaRe Centre recruited 20 women with suspected or confirmed endometriosis who were already listed for laparoscopy or thoracoscopy. Each had a SPECT-CT scan after an intravenous injection of 99mTc-maraciclatide. This radiotracer binds \u03b1v\u03b23 integrin, which is upregulated in vessels undergoing inflammation-driven angiogenesis. The patient is injected with the radioactive tracer, and a gamma camera rotates around the patient, detecting the photons the tracer gives off. It builds a 3D map of where it has collected. A low-dose CT is taken at the same time and overlaid, so that “hot spots” can be pinned to a specific anatomical site, such as a uterosacral ligament rather than nearby bowel.<\/p>\n
Surgery was the reference standard, a mean of 19 days after the scan. Lesions were recorded on WERF EPHect surgical forms. A single nuclear medicine radiologist then compared the images with the surgical findings.<\/p>\n\t\t\t
Findings<\/h3>\t\t\t\n\t\t\t\t
Of the 19 women who completed both scan and surgery, imaging agreed with surgery in 16 (84%). Sensitivity was 82% (95% CI 57-96), and specificity was 100%, though its CI ran from 16% to 100%. The scan detected all three pelvic subtypes and both cases of thoracic disease.<\/p>\n
Interestingly, the scan found SPE in 9 of 12 women (75%), and none of the 10 who had been imaged in the previous year had SPE reported on ultrasound or MRI. Uptake was strongest in clear and red lesions and was rare in blue-black or fibrotic white ones. Half the cohort were on hormonal treatment, including one on a GnRH agonist.<\/p>\n\t\t\t
Weaknesses<\/h3>\t\t\t\n\t\t\t\t
The radiologist was not blinded and identified regions of interest after surgery, so this was retrospective matching rather than prospective diagnosis. The authors are candid that this was needed to learn how lesions look on the scan, but it inflates agreement.
Only two women had no endometriosis, so false positives were not rigoursly tested. All patients came from a tertiary centre and were already booked for surgery, which is a high-prevalence population. The scan also missed disease near the bladder, where urinary tracer activity masked uptake, and on one pelvic sidewall next to ureteric activity. Lastly, the manufacturer co-funded the study and employs two of the authors.<\/p>\n\t\t\t
Conclusion<\/h3>\t\t\t\n\t\t\t\t
DETECT is an early exploratory study, not a test ready for clinical use. Even so, it is exciting: it offers a novel way to diagnose SPE, a subtype that has long eluded imaging, and it is the first method to show it without surgery. Its preference for active over fibrotic lesions may also prove an advantage, allowing recurrence to be monitored without a second-look laparoscopy and giving trials of medical therapy an objective endpoint.<\/p>\n
Gibbons T, Ghesani M, Burch D et al. Assessment of endometriosis angiogenesis using\u00a099mTc-maraciclatide imaging (DETECT): a single-centre, exploratory, open-label, non-randomised, phase 2 study. The Lancet Obstetrics, Gynaecology, & Women’s Health, 2026; 2, e503-e512<\/p>\n Dr Pippa Robertson Even so, it is exciting: it offers a novel way to diagnose SPE, a subtype that has long eluded imaging, and it is the first method to show it without surgery.<\/p>\n","protected":false},"author":1,"featured_media":72,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"site-sidebar-layout":"no-sidebar","site-content-layout":"","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[1],"tags":[],"class_list":["post-164","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorised"],"acf":[],"_links":{"self":[{"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/posts\/164","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/comments?post=164"}],"version-history":[{"count":4,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/posts\/164\/revisions"}],"predecessor-version":[{"id":219,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/posts\/164\/revisions\/219"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/media\/72"}],"wp:attachment":[{"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/media?parent=164"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/categories?post=164"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/escope.ages.com.au\/november-2026\/wp-json\/wp\/v2\/tags?post=164"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"pippa-robertson-001\"](\"https:\/\/escope.ages.com.au\/november-2026\/wp-content\/uploads\/sites\/14\/2026\/10\/pippa-robertson-001.avif\" "\\"pippa-robertson-001\\"")
\n\t<\/figure>\n\t\t\t\t
<\/strong>BMed(Dist), FRANZCOG, AGES
Obstetrician and Gynaecologist<\/p>\n\n","protected":false},"excerpt":{"rendered":"