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Tom Holland: Endometriosis Diagnosis, Why Biomarkers Can’t Replace Imaging?
Tom Holland/LinkedIn
Jun 15, 2026, 11:08

Tom Holland: Endometriosis Diagnosis, Why Biomarkers Can’t Replace Imaging?

Tom Holland, Gynaecologist, robotic and advanced laparoscopic surgeon, endometriosis researcher at Guy’s and St Thomas’​ NHS Foundation Trust, shared a post on LinkedIn:

“NICE met yesterday to evaluate non-invasive lab based tests for endometriosis diagnosis.

This is a good thing.

Anything that shortens the diagnostic wait and reduces surgical diagnosis deserves serious attention.

But here’s what the conversation often misses.

Even if a blood test or saliva test were 100% accurate, fully independently evaluated and cheaper than ultrasound, which they are not, there would still be a fundamental role for imaging.

Because a yes/ no diagnosis is only the beginning.

Before we can talk about treatment, we need to know:

Which organs are involved. Ovaries. Bowel. Bladder. Ureters.

How severe the disease is. Superficial peritoneal disease is a different surgical conversation to deep disease with bowel infiltration.

What the risks and benefits of the different treatments including surgery would be.

Whether surgery is even necessary.

A patient with ureteric or bowel stenosis needs a very different discussion to one without. Sometimes imaging changes the plan entirely.

What the effects on fertility are. For many patients, this is the question that matters most.

A positive biomarker test tells you something is there.

Imaging tells you what you’re dealing with.

Also if the spit test is negative what is causing the symptoms? Is it adenomyosis or fibroids or something else? High quality imaging is still useful even when the findings are normal.

Today’s NICE committee meeting is a step in the right direction.

The next step is making sure high quality imaging is available to all who need it.”

Tom Holland: Endometriosis Diagnosis, Why Biomarkers Can’t Replace Imaging?

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adenomyosis blood test bowel stenosis endometriosis Fertility Fertility News Fibroids NICE committee non-invasive lab reproductive health Reproductive Medicine saliva test surgery Surgical Diagnosis Tom Holland ureteric
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