Ultrasound Elastography in the Differential Diagnosis of Benign and Malignant Cervical Lesions

Lu, Rong; Xiao, Ying; Liu, Minhui; Shi, Dazun

doi:10.7863/ultra.33.4.667

Cited by 37 publications

(32 citation statements)

References 16 publications

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“…In study III tumours in patients with advanced stages were more easily demarcated, had higher strain ratio and a tendency for a higher elasticity score even if it was not statistically significant compared to early stages, probably due to a small patient cohort. The max strain ratio found in tumours both early (1.87) and advanced (3.06) was lower than in previously published studies where a strain ratio of 4.5 was suggested as a cut-off between benign and malignant cervical tissue (152,181). These difference are explained by different study populations as patients with benign conditions such as cervical fibroma and dysplasia were included in the other studies, another reference tissue used for the calculation of strain ratio (parametrium) and last but not least different US equipment was applied both for examination and software for the analysis.…”

Section: Locally Advanced Stagescontrasting

confidence: 63%

A Pilot Study on Diagnostic Performance of Contrast-Enhanced Ultrasonography for Detection of Early Cervical Cancer

Pálsdóttir

Epstein

2018

Ultrasound in Medicine & Biology

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Section: Locally Advanced Stagescontrasting

confidence: 63%

A Pilot Study on Diagnostic Performance of Contrast-Enhanced Ultrasonography for Detection of Early Cervical Cancer

Pálsdóttir

Epstein

2018

Ultrasound in Medicine & Biology

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“…In these cases, the malignant tissues are shown less compressible, resulting in less strain than the normal tissues under uniform stress. Recently, sonoelastography imaging was used to study the normal and abnormal cervix [16–19]. Several studies have shown the potential of sonoelastography in monitoring and predicting the therapeutic response such as the responding and non-responding malignant tissues in patients following CCRT [20, 21].…”

Section: Introductionmentioning

confidence: 99%

Strain elastography imaging for early detection and prediction of tumor response to concurrent chemo-radiotherapy in locally advanced cervical cancer: feasibility study

Xu¹,

Zhu²,

Liu³

et al. 2017

BMC Cancer

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BackgroundTo investigate the feasibility of strain elastography imaging in early detecting and predicting treatment response in patients receiving concurrent chemo-radiotherapy (CCRT) for locally advanced cervical cancer.MethodsBetween January 2015 and June 2016, 47 patients with locally advanced cervical cancer were enrolled in a feasibility study approved by the institutional review board. All patients underwent CCRT and received strain elastography examinations at 4 time points: pre-therapy (baseline), 1 week and 2 weeks during, as well as immediately post CCRT. Treatment response was evaluated by MRI at the time of diagnosis and immediately after CCRT. Based on the MRI findings, the treatment outcome was characterized as complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Strain ratio of the normal parametrial tissue vs. cervical tumor was calculated and compared with the clinical outcome.ResultsOut of the 47 patients, 36 patients who completed all 4 examinations were included in the analyses: 25 were classified as CR, 11 as PR, and 0 in the SD/PD groups. Strain ratios were significantly different among the time points in both the CR group (F = 87.004, p < 0.001) and PR group (F = 38.317, p < 0.001). Strain ratios were significantly difference between the CR and PR groups (F = 7.203 p = 0.011). Strain ratios between the CR group and PR group were significantly different at 1 week after treatment initiation (p < 0.05). Compared to the baseline, a significant decrease in the CR group was observed at week 1, week 2 and post treatment (all p < 0.001), while a significant decrease in the PR group was shown in week 2 and post treatment (both p < 0.05), but not at week 1 during CCRT (p = 0.084).ConclusionsWe have conducted a prospective longitudinal study to evaluate tumor response in women receiving CCRT for cervical cancers. This study has demonstrated the potential of strain elastography imaging in monitoring and early predicting tumor response induced by CCRT.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3411-5) contains supplementary material, which is available to authorized users.

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“…Previous studies also investigated the use of elastography in differential diagnosis of uterine disorders. It has been shown that elastography may differentiate benign and malignant cervical lesions 21 . Preis et al 8 reported that normal and atrophic endometria appear softer on elastography than endometrial polyps, hypertrophy, and cancer in perimenopausal women with an endometrial thickness of greater than 5 mm 8 .…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that elastography may differentiate benign and malignant cervical lesions. 21 Preis et al 8 reported that normal and atrophic endometria appear softer on elastogra-phy than endometrial polyps, hypertrophy, and cancer in perimenopausal women with an endometrial thickness of greater than 5 mm. 8 Similar results were obtained in a very recent study, in which the authors concluded that although elastography does not differentiate endometrial hyperplasia and endometrial polyps, it can distinguish pathologic endometrial changes from a normal endometrium in patients presenting with a sonographic finding of a thickened endometrium.…”

Section: Discussionmentioning

confidence: 99%

Elastography Improves the Diagnostic Accuracy of Sonography in Differentiating Endometrial Polyps and Submucosal Fibroids

Czuczwar

Wozniak

Szkodziak

et al. 2016

J of Ultrasound Medicine

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Objectives To assess whether strain elastography may be used to visualize the different stiffness of endometrial polyps and submucosal fibroids. Methods We conducted a prospective monocentric single‐operator study on diagnostic accuracy. Patients who qualified for hysteroscopy because of suspected endometrial polyps and submucosal fibroids were included. Before the procedure, all patients underwent routine sonographic and power Doppler examinations. Additionally, the stiffness of intrauterine lesions was assessed by strain elastography. The enhancement was adjusted to visualize hard myometrium and soft endometrium around the intrauterine lesion. Due to their histologic structure, we assumed that on strain elastography, endometrial polyps should appear as soft lesions, whereas submucosal fibroids should appear as hard lesions. Sonographic, power Doppler, and elastographic findings were verified by pathologic examinations after hysteroscopies. The diagnostic accuracy of sonography, power Doppler imaging, and strain elastography was compared by the McNemar test. Results Forty‐seven patients were included and underwent hysteroscopy. In 29 cases, endometrial polyps were found, and in 18, submucosal fibroids were found. The diagnostic accuracy rates for B‐mode sonography, power Doppler imaging, and strain elastography in distinguishing endometrial polyps and submucosal fibroids were 70.2%, 65.9%, and 89.4%, respectively. The proportion of correct findings was significantly higher for strain elastography than for B‐mode sonography (P = .0265) and power Doppler imaging (P = .0153). Conclusions Strain elastography complements sonography in differentiating intrauterine lesions. Strain elastography may be used to visualize the different stiffness of endometrial polyps and submucosal fibroids.

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Ultrasound Elastography in the Differential Diagnosis of Benign and Malignant Cervical Lesions

Cited by 37 publications

References 16 publications

A Pilot Study on Diagnostic Performance of Contrast-Enhanced Ultrasonography for Detection of Early Cervical Cancer

A Pilot Study on Diagnostic Performance of Contrast-Enhanced Ultrasonography for Detection of Early Cervical Cancer

Strain elastography imaging for early detection and prediction of tumor response to concurrent chemo-radiotherapy in locally advanced cervical cancer: feasibility study

Elastography Improves the Diagnostic Accuracy of Sonography in Differentiating Endometrial Polyps and Submucosal Fibroids

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