In the second episode of our endometriosis imaging arc, we sit down with world class excision surgeon and leading pelvic sonologist Dr Matthew Leonardi to explore how high quality pelvic ultrasound transforms the way we understand endometriosis. Matthew explains how advanced ultrasound maps disease in three dimensions, reveals deep lesions that laparoscopy can miss, and helps patients build a clearer, more accurate story of what is happening in their pelvis.

We break down the full spectrum of ovarian cysts, from follicular and haemorrhagic cysts to dermoids and endometrioma, and unpack why the term “complex cyst” causes unnecessary fear and needs to disappear. Matthew also shares how recognising an endometrioma is often just the start, and how detailed ultrasound guides safer, more precise surgical planning.

We finish with his interdisciplinary Endometriosis 360 model, where imaging, pelvic physio, dietetics and psychology work together to support better long term endo care.