Transvaginal Real‐time Shear Wave Elastography in the Diagnosis of Cervical Disease

Liu, Chun; Li, Ting Ting; Hu, Ziyue; Li, Yuan; Cheng, Xueqing; Zhu, Yi; Lu, Man

doi:10.1002/jum.15018

Cited by 22 publications

(21 citation statements)

References 26 publications

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“…In the present study, the obtained mean SWE values were similar to those in the literature [12][13][14][15]. The elasticity values were higher in the internal and posterior regions than in the external and anterior regions.…”

Section: Discussionsupporting

confidence: 91%

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Shear wave elastography of the uterine cervix under different conditions with inter-operator agreement analysis

Gemici¹,

Gulsever²,

Tunca³

et al. 2020

Pol J Radiol

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Purpose: Shear wave elastography (SWE) is a relatively new technique for measuring tissue elasticity. Its implementation for assessing the tissue of the cervix is evolving, and SWE analyses of healthy, nonpregnant cervixes is the first step in understanding other SWE changes related to cervical pathologies; nevertheless, some challenges in the use of the technique still require investigation. We aimed to target the consistency of healthy cervix shear wave elastography measurements and examine the changes induced by patient-related factors. Material and methods: Elastograms were obtained at the internal and external os in the anterior (IA, EA) and posterior (IP, EP) portions of the cervix using a transvaginal approach in eight postmenopausal and 25 premenopausal women. Measurements with a standard deviation of over 20% and patients who presented with colour loss or heterogeneity were excluded from the study. Shear wave elastography assessments were performed using a Toshiba Aplio 500 version 6. Statistical significance was defined as a p value less than 0.10, due to the small number of patients. Results: The mean speeds obtained at the external os on the anterior and posterior aspects was 3.17 ± 0.85 m/s and 3.18 ± 0.84 m/s, respectively, and at the internal os, the results on the anterior and posterior aspects were 3.38 ± 0.73 m/s and 3.53 ± 0.81 m/s, respectively. The difference in speed among all regions was statistically significant (p < 0.05). Fifteen patients were also analysed by a second radiologist with a similar experience level as that of the first. Nine measurements for IP, 13 measurements for IA, 11 measurements for EP, and 15 measurements for EA were performed. The correlation coefficients between the two sets of measurements were 0.46, 0.30, 0.67, and 0.51, respectively. There was no difference in the SWE values with respect to age, parity, and gravidity for any of the regions. The SWE values at the IA, IP, and EA regions between the postmenopausal and premenopausal women were significantly different (p = 0.038, p = 0.059, p = 0.065). Conclusions: The posterior portion of the internal os is most likely to undergo inaccurate SWE measurement among the different anatomical positions. The correlation between radiologists was found to be different for different locations in the cervix. More studies are needed to determine the SWE values of the healthy cervix and the agreement levels between radiologists.

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Section: Discussionsupporting

confidence: 91%

“…SWE has been used mostly for assessing cervical insufficiency, premature delivery, and post-term pregnancy [8][9][10][11] in the gynaecological era. Recently, it has also been used for cervical tissue characterisation and the differentiation of benign and malignant cervical tumours [12,13].…”

Section: Introductionmentioning

confidence: 99%

Shear wave elastography of the uterine cervix under different conditions with inter-operator agreement analysis

Gemici¹,

Gulsever²,

Tunca³

et al. 2020

Pol J Radiol

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“…Finally, there were six studies including 615 patients with 415 cancers and 200 benign lesions that were finalized to be performed by the systematic review for qualitative synthesis and quantitative analysis (meta‐analysis) (Figure 1). 15‐20 …”

Section: Resultsmentioning

confidence: 99%

“…This was probably because only one trial using qualitative methods was included, 17 so we did not conclude that quantitative and semiquantitative methods were superior to qualitative ones. The difference between ARFI and SSI was not evaluated, because ARFI and SSI each had only one related study 15,19 . Above all, combined with statistical analysis, no heterogeneous sources were found.…”

Section: Discussionmentioning

confidence: 99%

“…In the process of cervical cancer, the cervical tissue becomes hard significantly, which is an important point to distinguish from benign cervical lesions. Multiple previous researches have been published on the potential benefits of TVSE in detecting malignant cervical lesions 15‐20 . Both SE and SWE can be used for the diagnosis of cervical diseases.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of transvaginal sonoelastography for differential diagnosis between malignant and benign cervical lesions: A systematic review and meta‐analysis

et al. 2020

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Background To evaluate the performance of transvaginal sonoelastography (TVSE) for differential diagnosis between malignant and benign cervical lesions using a meta‐analysis. Methods An independent literature search was conducted on the English medical database, including PubMed, Embase and Medline, Cochrane Library, Web of Science, and OVID. The diagnostic accuracy of TVSE was compared with that of histopathology, which is the gold reference standard for diagnosis. The accuracy of TVSE was assessed by calculating the pooled sensitivity, specificity, diagnostic odds ratio, and area under the curve (AUC). The imaging mechanisms, assessment methods, and QUADAS scores were assessed with a meta‐regression analysis. A Deeks funnel plot was performed for evaluating publication bias. Results Six eligible studies reported a total sample of 615 cervical lesions (415 cancers, 200 benign lesions). TVSE showed a pooled diagnostic odds ratio of 21.42 (95% CI 13.65‐33.61), sensitivity of 0.87 (95% CI 0.84‐0.90), specificity of 0.79 (95% CI 0.72‐0.84), and an AUC of 0.892 (Q* = 0.822). The results of the meta‐regression analysis showed that the imaging mechanism (P = .253), the assessment method (P = .279), or QUADAS score (P = .205) did not affect the study heterogeneity. Conclusion TVSE has a relatively high and satisfactory value for differential diagnosis between malignant and benign cervical lesions. The diagnostic performance of strain elastography and shear wave elastography were similar and good. However, to accommodate heterogeneity and publication bias, high‐quality studies are required to further comparative effectiveness analyses to verify the efficacy of ultrasound detection.

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Quantitative Evaluation of the Normal Cervix, Cervical Cancer, and Cervical Precancerous Changes Via Real‐Time Shear Wave Elastography

Guo

Yan

Zhao

et al. 2022

J of Ultrasound Medicine

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Objectives-The present study aims to evaluate the clinical application values of ultrasound real-time shear wave elastography (SWE) in the diagnosis and differential diagnosis of cervical cancer (CC).Methods-A total of 285 married female patients were screened and divided into three groups according to the results of the pathological examination and the cervical ThinPrep cytologic test: 1) the CC group (n = 94); 2) the cervical intraepithelial neoplasia (CIN) group (n = 91); and 3) the normal control group (n = 100). The maximum Young's modulus (Emax), mean Young's modulus (Emean), minimum Young's modulus (Emin), and Young's modulus stability (Esd) in each group were measured and statistically analyzed.Results-There were no statistically significant differences in Emax, Emean, Emin, and Esd values between the anterior and posterior cervical walls, premenopausal and postmenopausal women, and nonparturient and parturient women in the normal control group. The Emax, Emean, Emin, and Esd values in the CIN group showed no statistically significant differences in different periods when compared with the control group. The differences between the normal control group and the CC group were statistically significant; the CC group showed no statistically significant differences in Emax, Emean, Emin, and Esd values at different clinical stages and in different pathological types. The cutoff value of Emax for CC diagnosis, which was of the highest accuracy (89.7%), was 43.48 kpa. Conclusion-Ultrasound real-time SWE can be applied to CC diagnosis.

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Transvaginal Real‐time Shear Wave Elastography in the Diagnosis of Cervical Disease

Cited by 22 publications

References 26 publications

Shear wave elastography of the uterine cervix under different conditions with inter-operator agreement analysis

Shear wave elastography of the uterine cervix under different conditions with inter-operator agreement analysis

Accuracy of transvaginal sonoelastography for differential diagnosis between malignant and benign cervical lesions: A systematic review and meta‐analysis

Quantitative Evaluation of the Normal Cervix, Cervical Cancer, and Cervical Precancerous Changes Via Real‐Time Shear Wave Elastography

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