Ali AYHAN, Meriç YAVUZ ÇOLAK, Hale TURNAOĞLU, Asuman Nihan HABERAL REYHAN, Latife ATASOY KARAKAŞ, Kemal Murat HABERAL

The role of acoustic radiation force impulse imaging in thediagnosis of cervical carcinoma

Aim: To investigate the diagnostic value of acoustic radiation force impulse imaging in the detection of cervical cancer, and toassess the contribution of this imaging method in distinguishing histological subtypes of cervical carcinoma. Materials and Methods: Twenty four patients with malignant cervical mass and 25 healthy volunteers were included in this prospectivestudy. Ultrasonographic evaluation were performed using a 3.5–6-MHz convex abdominal transducer and adequate software forperforming elastographic examinations in quantitative acoustic radiation force impulse mode (Virtual Touch Quantification®). Everyexamination consisted of at least three independent shear wave velocity measurements. The mean shear wave velocity values werecalculated, and used for statistical analysis. Postoperative pathology results of the lesions were used as the reference standard. Results: The mean shear wave velocity values were calculated as 2.79±1.03 m/s in cervical carcinomas, and as 1.86±0.62 m/s incontrol group. The mean shear wave velocity value of cervical carcinomas was significantly higher than the control group (p=0.003).The mean shear wave velocity values in squamous carcinoma, adenocarcinoma, and adenosquamous carcinoma subtypes werecalculated as 2.78±0.93 m/s, 3.16±1.46 m/s, and 1.90±0.21 m/s, respectively. There were no significant differences between cervicalcarcinoma subtypes in terms of their shear wave velocity values (p=0.247). Conclusion: Acoustic radiation force impulse imaging is a non-invasive and cost-effective, promising adjunct modality that enablesobjective quantitative measurement, which may contribute to the diagnosis of malignant cervical masses.

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1. Ferlay J, Colombet M, Soerjomataram I, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 2019;144:1941-53.
2. Katanyoo K, Sanguanrungsirikul S, Manusirivithaya S. Comparison of treatment outcomes between squamous cell carcinoma and adenocarcinoma in locally advanced cervical cancer. Gynecol Oncol 2012;125:292-6.
3. Fischerova D, Cibula D, Stenhova H, et al. Transrectal ultrasound and magnetic resonance imaging in staging of early cervical cancer. Int J Gynecol Cancer 2008;18:766-72.
4. Mainenti PP, Pizzuti LM, Segreto S, et al. Diffusion volume (DV) measurement in endometrial and cervical cancer: a new MRI parameter in the evaluation of the tumor grading and the risk classification. Eur J Radiol 2016;85:113-24.
5. Kuang F, Ren J, Zhong Q, et al. The value of apparent diffusion coefficient in the assessment of cervical cancer. Eur Radiol 2013;23:1050-8.
6. Liu Y, Ye Z, Sun H, et al. Grading of uterine cervical cancer by using the ADC difference value and its correlation with microvascular density and vascular endothelial growth factor. Eur Radiol 2013;23:757-65.
7. Su Y, Du L, Wu Y, al. Evaluation of cervical cancer detection with acoustic radiation force impulse ultrasound imaging. Exp Ther Med 2013;5:1715-9.
8. Sporea I, Sirli R, Popescu A, et al. Acoustic Radiation Force Impulse (ARFI)-a new modality for the evaluation of liver fibrosis. Med Ultrason 2010;12:26-31.
9. Samier-Guérin A, Saraux A, Gestin S, et al. Can ARFI elastometry of the salivary glands contribute to the diagnosis of Sjögren's syndrome? Joint Bone Spine 2016;83:301-6.
10. Matsuzuka T, Suzuki M, Saijo S, et al. Stiffness of salivary gland and tumor measured by new ultrasonic techniques: Virtual touch quantification and IQ. Auris Nasus Larynx 2015;42:128-33.
11. Barr RG. Elastography in clinical practice. Radiol Clin North Am 2014;52:1145-1162.
12. D’Onofrio M, Crosara S, De Robertis R, et al. Acoustic radiation force impulse of the liver. World J Gastroenterol 2013;19:4841-9.
13. Sporea I, Sirli R, Bota S, et al. ARFI elastography for the evaluation of diffuse thyroid gland pathology: Preliminary results. World J Radiol 2012;4:174-8.
14. Tozaki M, Isobe S, Sakamoto M. Combination of elastography and tissue quantification using the acoustic radiation force impulse (ARFI) technology for differential diagnosis of breast masses. Jpn J Radiol 2012;30:659-70.
15. Liu C, Li TT, Hu Z, et al. Transvaginal Real-time Shear Wave Elastography in the Diagnosis of Cervical Disease. J Ultrasound Med 2019;38:3173-81.
16. Thomas A, Kummel S, Gemeinhardt O, et al. Realtime sonoelastography of the cervix: tissue elasticity of the normal and abnormal cervix. Acad Radiol 2007;14:193-200.
17. Bakay OA, Golovko TS. Use of elastography for cervical cancer diagnostics. Exp Oncol 2015;37:139-45.
18. Lu R, Xiao Y, Liu M, et al. Ultrasound elastography in the differential diagnosis of benign and malignant cervical lesions. J Ultrasound Med 2014;33:667-71.
19. Sun LT, Ning CP, Liu YJ, et al. Is transvaginal elastography useful in pre-operative diagnosis of cervical cancer? Eur J Radiol 2012;81:888-92.
20. Houelleu Demay ML, Monghal C, Bertrand P, et al. An assessment of the performance of elastography for the investigation of BI-RADS 4 and BI-RADS 5 breast lesions: correlations with pathological anatomy findings. Diagn Interv Imaging 2012;93:757-66.
21. Downey K, Riches SF, Morgan VA, et al. Relationship between imaging biomarkers of stage I cervical cancer and poor-prognosis histologic features: quantitative histogram analysis of diffusion-weighted MR images. AJR Am J Roentgenol 2013;200:314-20.
22. Cohen JG, Kapp DS, Shin JY, et al. Small cell carcinoma of the cervix: treatment and survival outcomes of 188 patients. Am J Obstet Gynecol 2010;203:341-6