{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T17:33:28Z","timestamp":1783618408375,"version":"3.55.0"},"reference-count":84,"publisher":"Oxford University Press (OUP)","issue":"1180","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Endometriosis and adenomyosis are prevalent chronic inflammatory conditions that significantly impact reproductive-age women, leading to debilitating symptoms such as pelvic pain, dysmenorrhea and infertility. Endometriosis is characterized by ectopic endometrial tissue outside the uterus, while adenomyosis involves endometrial deposits within the myometrium, often causing overlapping symptoms. Accurate diagnosis is essential for effective management, yet challenges persist due to variability in lesion location and presentation. Imaging plays a crucial role in the diagnosis, staging, and management of these conditions. While transvaginal ultrasound (TVUS) remains a reliable first-line tool with high specificity, magnetic resonance imaging (MRI) offers superior sensitivity, particularly for endometriomas and deep endometriosis. Both modalities have their limitations but are complementary in preoperative assessment and treatment planning. Emerging imaging protocols, classification systems, and advancements such as dynamic TVUS and improved MRI techniques are discussed. Despite significant progress, the lack of a universally accepted classification system and standardized imaging protocols highlights the need for further research. Advancing diagnostic accuracy and treatment strategies through imaging holds promise for improving patient outcomes. This article reviews the pathophysiology, staging and subtypes of endometriosis and adenomyosis. Recent society guidelines are addressed and readers are provided with updates on imaging technologies with insights into future directions.<\/jats:p>","DOI":"10.1093\/bjr\/tqag007","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T03:31:49Z","timestamp":1767929509000},"page":"656-668","source":"Crossref","is-referenced-by-count":5,"title":["Navigating complexity: review and updates of endometriosis and adenomyosis imaging"],"prefix":"10.1093","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7995-2087","authenticated-orcid":false,"given":"Harmanjit","family":"Dev","sequence":"first","affiliation":[{"name":"Department of Radiology, Sir Charles Gairdner Hospital (SCGH) , Nedlands, WA 6009,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2528-3567","authenticated-orcid":false,"given":"Nathalie Marie","family":"Falkner","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sir Charles Gairdner Hospital (SCGH) , Nedlands, WA 6009,","place":["Australia"]},{"name":"Department of Radiology, Perth Children\u2019s Hospital (PCH) , Nedlands, WA 6009,","place":["Australia"]},{"name":"Radiology, BreastScreen WA , Perth, WA 6000,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8580-3380","authenticated-orcid":false,"given":"Emmeline","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sir Charles Gairdner Hospital (SCGH) , Nedlands, WA 6009,","place":["Australia"]},{"name":"School of Medicine, University of Western Australia , Crawley, WA 6009,","place":["Australia"]},{"name":"Department of Radiology, King Edward Memorial Hospital (KEMH) , Subiaco, WA 6008,","place":["Australia"]},{"name":"Western Ultrasound for Women , West Leederville, WA 6007,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"2026041221024709400_tqag007-B1","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/S0140-6736(21)00389-5","article-title":"Endometriosis is a chronic systemic disease: clinical challenges and novel innovations","volume":"397","author":"Taylor","year":"2021","journal-title":"Lancet"},{"key":"2026041221024709400_tqag007-B2","doi-asserted-by":"crossref","first-page":"446","DOI":"10.4103\/ijmr.IJMR_817_18","article-title":"A systematic review on the prevalence of endometriosis in women","volume":"154","author":"Moradi","year":"2021","journal-title":"Indian J Med Res"},{"key":"2026041221024709400_tqag007-B3","volume-title":"StatPearls","author":"Tsamantioti","year":"2025"},{"key":"2026041221024709400_tqag007-B4","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1111\/aogs.14099","article-title":"The #Enzian classification: a comprehensive non-invasive and surgical description system for endometriosis","volume":"100","author":"Keckstein","year":"2021","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2026041221024709400_tqag007-B5","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.jpag.2019.11.011","article-title":"Adolescent endometriosis: an update","volume":"33","author":"Shim","year":"2020","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"2026041221024709400_tqag007-B6","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.ejogrb.2020.01.045","article-title":"Endometriosis in adolescence: early manifestation of the traditional disease or a unique variant?","volume":"247","author":"Tsonis","year":"2020","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2026041221024709400_tqag007-B7","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1007\/s00261-019-02309-4","article-title":"Endometriosis in the postmenopausal female: clinical presentation, imaging features, and management","volume":"45","author":"Cope","year":"2020","journal-title":"Abdom Radiol (NY)"},{"key":"2026041221024709400_tqag007-B8","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1016\/j.fertnstert.2018.06.031","article-title":"A sonographic classification of adenomyosis: interobserver reproducibility in the evaluation of type and degree of the myometrial involvement","volume":"110","author":"Lazzeri","year":"2018","journal-title":"Fertil Steril"},{"key":"2026041221024709400_tqag007-B9","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1002\/uog.14834","article-title":"Transvaginal sonographic features of diffuse adenomyosis in 18-30-year-old nulligravid women without endometriosis: association with symptoms","volume":"46","author":"Pinzauti","year":"2015","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2026041221024709400_tqag007-B10","doi-asserted-by":"crossref","first-page":"3432","DOI":"10.1093\/humrep\/des332","article-title":"How common is adenomyosis? 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