Abstract
Traditionally, laparoscopy was considered to be the gold standard for the examination of endometriotic lesions, because it allows their direct visualization. Several international and national guidelines have now shifted their focus to non-invasive imaging-based diagnosis of deep endometriosis in preference to surgery, while laparoscopy is used to diagnose superficial endometriosis in patients with painful symptoms and negative ultrasound and/or magnetic resonance imaging findings for ovarian or deep endometriosis. In recent years, however, the role of gynecological ultrasound in the diagnosis of superficial endometriosis has been studied more extensively. The purpose of this addendum to the International Deep Endometriosis Analysis consensus opinion is to describe a standardized ultrasound protocol for the diagnosis of superficial endometriosis and to highlight the sonographic characteristics of these lesions. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.