DIE Scan (Deep Infiltrating Endometriosis Ultrasound) on the Central Coast
At Intuition Private, the deep infiltrating endometriosis (DIE) ultrasound service is led by Dr Sarika Gupta.
If you have ongoing pelvic pain, painful periods, or pain with sex or bowel movements, you may have been referred for a DIE scan — a deep infiltrating endometriosis ultrasound.
It is a specialised scan that looks for endometriosis growing deeper than a routine pelvic ultrasound is designed to assess. This page explains what the scan is, what it looks for, what happens on the day, and how to arrange one.
A DIE scan — a deep infiltrating endometriosis ultrasound — is a detailed transvaginal ultrasound that systematically checks the pelvis for signs of deep endometriosis. “Deep infiltrating” endometriosis is disease that grows more than a few millimetres beneath the surface lining of the pelvis, often involving structures a standard scan does not set out to examine.
It is a longer and more structured examination than a routine pelvic ultrasound, performed by a clinician trained specifically in mapping endometriosis.
Accurate imaging is crucial in managing suspected endometriosis. A DIE scan helps the care team to:
- Better understand the cause of pelvic pain and related symptoms
- Determine whether further investigations or specialist referral are needed
- Plan appropriate medical or surgical treatment
- Support fertility care and long-term management
- Reduce the risk of unexpected findings during surgery
Until recently, many women on the Central Coast needed to travel to Sydney to access this level of subspecialist ultrasound assessment.
The scan works through the pelvis in a set order, looking for signs of endometriosis and where it may be located, including:
- the uterus, including signs of adenomyosis
- the ovaries, including endometriomas (ovarian cysts caused by endometriosis)
- the uterosacral ligaments and the area behind the uterus (the pouch of Douglas)
- the bowel, particularly the rectum and lower sigmoid colon
- the bladder and the region around the ureters
- whether the uterus, ovaries and bowel glide freely against one another (the “sliding sign”), which helps show whether structures have become stuck together by scarring
A standard pelvic ultrasound mainly assesses the uterus, the lining of the womb and the ovaries. A DIE scan does all of that and then extends into a systematic search for deep disease that a routine scan is not designed to map. It usually takes longer and requires specific training to perform and interpret. The scan examines:
- The supporting ligaments of the uterus
- The space behind the uterus
- The bowel, bladder and surrounding tissues
- How freely the pelvic organs move
This detailed assessment provides critical information that is not typically captured on routine pelvic imaging and is essential for identifying deep disease.
Your doctor may recommend a DIE scan if you have:
- painful periods, or pelvic pain that is affecting daily life
- pain during or after sex
- cyclical bowel or bladder symptoms, for example pain opening your bowels around your period
- suspected or already-diagnosed endometriosis
- difficulty becoming pregnant, as part of a wider assessment
- a planned operation, where your surgeon wants the disease mapped beforehand
Your appointment letter will tell you exactly what to do beforehand.
The scan is performed transvaginally, meaning a slim ultrasound probe is gently placed into the vagina, which gives the clearest view of the pelvic structures. The sonologist works through the pelvis systematically and, at points, applies gentle pressure or asks you to help assess whether the organs move freely.
You can ask questions throughout, and you can ask to pause or stop at any time.
A DIE scan usually takes about 30 minutes — longer than a routine pelvic ultrasound, because the pelvis is examined systematically.
A transvaginal scan is usually well tolerated, but it can be uncomfortable, particularly if the area is already tender. The sonologist will explain each step, work gently, and stop if you need them to. If you are anxious about the scan, let the team know when you book.
A DIE scan can identify many signs of deep endometriosis and help show where it is. However, a normal scan does not rule out endometriosis. Some endometriosis, particularly superficial disease on the surface of the pelvis, cannot be seen on ultrasound, and diagnosis is sometimes only confirmed at laparoscopy (keyhole surgery). Your referring doctor will interpret the scan alongside your symptoms and any other tests.
Generally within 48 hours.
Yes, you need a referral.
The fee is $509 and a Medicare rebate of $216.75 applies.
Last Updated: 30th September 2026
Why Choose Intuition Private for a DIE Scan?
Dr Sarika Gupta is a gynaecological ultrasound subspecialist who performs and reports your DIE scan herself — the images are not sent off-site for separate reporting, so your results can be discussed with you at the appointment. Dr Gupta is a female sonologist.
To Book your deep infiltrating endometriosis ultrasound give our team a call.
If you have a referral for a deep infiltrating endometriosis ultrasound, call to make your appointment and make sure you have a referral from your GP or other service provider. We accept all referral requests, not just ones on our referral pads.
FAQs
What is a DIE scan?
A DIE scan is a deep infiltrating endometriosis ultrasound — a detailed transvaginal scan that systematically checks the pelvis for signs of endometriosis growing deeper than a routine pelvic ultrasound assesses.
Is a DIE scan the same as a normal pelvic ultrasound?
No. A DIE scan includes everything a standard pelvic ultrasound does, then extends into a systematic search for deep disease involving the bowel, bladder, ligaments and the mobility of the pelvic organs. It usually takes longer and needs specific training.
Does a DIE scan hurt?
It is usually well tolerated but can be uncomfortable, especially if the area is tender. The sonologist works gently, explains each step, and will stop if you ask.
Can a DIE scan rule out endometriosis?
No. A DIE scan can find many signs of deep endometriosis, but a normal result does not exclude it — some endometriosis cannot be seen on ultrasound and may only be confirmed at laparoscopy.
How long does a DIE scan take?
A DIE scan usually takes about 30 minutes — longer than a routine pelvic ultrasound, because the pelvis is examined systematically.
Do I Need a Referral, and What Will It Cost?
Yes, you need a referral.
The fee is $509 and a Medicare rebate of $216.75 applies.
Last Updated: 30th September 2026
Is a DIE scan covered by Medicare?
Yes, please see above.
How do I prepare for a DIE scan?
Your appointment letter will tell you exactly what to do beforehand.
How soon will I get my results?
Generally within 48 hours.
Sources
4 references
- Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) — Endometriosis Clinical Practice Guideline (Australian living evidence guideline). ranzcog.edu.au/womens-health/endometriosis
- Jean Hailes for Women’s Health — Endometriosis. jeanhailes.org.au/health-topics/endometriosis
- healthdirect Australia — Endometriosis. healthdirect.gov.au/endometriosis
- Guerriero S, Condous G, van den Bosch T, et al. Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group. Ultrasound Obstet Gynecol. 2016;48(3):318–332. doi:10.1002/uog.15955