Ultrasonic shear-wave elastography: a novel method for assessing the tumor grade in endometrial cancer: a prospective study

Ultrasonic shear-wave elastography: a novel method for assessing the tumor grade in endometrial cancer: a prospective study

Aims: To evaluate the diagnostic performance of the real time shear-wave elastography in patients with endometrial cancer in terms of tumor grade and myometrial invasion depth preoperatively. Methods: In this prospective observational study, forty-eight women who were diagnosed with endometrioid type endometrium cancer in our gynecologic oncology clinic of a tertiary hospital between September 2020-January 2021 in Turkey. All patients underwent an ultrasonographic shear-wave measurements. Mean shear-wave values were measured from the tumor itself. Mean elasticity values were assessed in terms of tumor grade and myometrial invasion depth. Results: The median [%25-%75] shearwave value of the participants was 29.45kPa (5.02-167.21). Shear-wave value for grade 3 endometrial cancer showed a statistically significant difference compared to grade 1 and 2 shear-wave values (p<0.001). To determine the myometrial invasion depth, lymph node involvement, lympho-vascular stromal invasion and cervical stromal invasion statues, shear-wave measurements did not show a significant result (p>0.05). ROC curve analysis showed significant results to determine the myometrial invasion depth and grade 3 endometrial cancer with the mean shear-wave cut-off values of 28.29 kPa and 57 kPa respectively (p<0.001). Conclusion: Real-time shear-wave elastography is a promising tool to predict the grade 3 tumors and deep myometrial invasion in endometrial cancer patients.

___

  • Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7-34. doi:10.3322/caac.21551
  • Vitale SG, Capriglione S, Zito G, et al. Management of endometrial, ovarian and cervical cancer in the elderly: current approach to a challenging condition. Arch Gynecol Obstet. 2019;299(2):299-315. doi:10.1007/s00404-018-5006-z
  • Health UNIo. National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch. Surveillance, Epidemiology, and End Results (SEER). Program Research Data (1973-2008). 2015.
  • Sorosky JI. Endometrial cancer. Obstet Gynecol. 2012;120(2 Pt 1):383-397. doi:10.1097/AOG.0b013e3182605bf1
  • Krouskop TA, Dougherty DR, Vinson FS. A pulsed Doppler ultrasonic system for making noninvasive measurements of the mechanical properties of soft tissue. J Rehabil Res Dev. 1987;24(2):1-8.
  • Lerner RM, Huang SR, Parker KJ. "Sonoelasticity" images derived from ultrasound signals in mechanically vibrated tissues. Ultrasound Med Biol. 1990;16(3):231-239. doi:10.1016/0301-5629(90)90002-t
  • Emelianov SY, Lubinski MA, Weitzel WF, Wiggins RC, Skovoroda AR, O'Donnell M. Elasticity imaging for early detection of renal pathology. Ultrasound Med Biol. 1995;21(7):871-883. doi:10.1016/0301-5629(94)00146-5
  • Ophir J, Cespedes I, Ponnekanti H, Yazdi Y, Li X.eElastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging. 1991;13(2):111-134. doi:10.1177/ 016173469101300201
  • Shiina T, Nightingale KR, Palmeri ML, et al. WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 1: basic principles and terminology. Ultrasound Med Biol. 2015;41(5):1126-1147. doi:10.1016/j.ultrasmedbio.2015.03.009
  • Liu Z, Jing H, Han X, et al. Shear wave elastography combined with the thyroid imaging reporting and data system for malignancy risk stratification in thyroid nodules. Oncotarget. 2017;8(26):43406-43416. doi:10.18632/oncotarget.15018
  • Lee HY, Lee JH, Shin JH, et al. Shear wave elastography using ultrasound: effects of anisotropy and stretch stress on a tissue phantom and in vivo reactive lymph nodes in the neck. Ultrasonography. 2017;36(1):25-32. doi:10.14366/usg.16003
  • Ariji Y, Nakayama M, Nishiyama W, Nozawa M, Ariji E. Shear-wave sonoelastography for assessing masseter muscle hardness in comparison with strain sonoelastography: study with phantoms and healthy volunteers. Dentomaxillofac Radiol. 2016;45(2):20150251. doi:10.1259/dmfr.20150251
  • Chang JM, Won JK, Lee KB, Park IA, Yi A, Moon WK. Comparison of shear-wave and strain ultrasound elastography in the differentiation of benign and malignant breast lesions. AJR Am J Roentgenol. 2013;201(2):347-356. doi:10.2214/AJR.12.10416
  • Cong Y, Fan Z, Dai Y, Zhang Z, Yan K. Application value of shear wave elastography in the evaluation of tumor downstaging for locally advanced rectal cancer after neoadjuvant chemoradiotherapy. J Ultrasound Med. 2021;40(1):81-89. doi:10.1002/jum.15378
  • Zhao HX, Du YY, Guo YJ, et al. Application value of real-time shear wave elastography in diagnosing the depth of infiltrating muscular layer of endometrial cancer. J Ultrasound Med. 2021;40(9):1851-1861. doi:10.1002/jum.15568
  • 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(12):3173-3181. doi:10.1002/jum.15018
  • Barr RG, Ferraioli G, Palmeri ML, et al. Elastography assessment of liver fibrosis: society of radiologists in ultrasound consensus conference statement. Radiology. 2015;276(3):845-861. doi:10.1148/radiol.2015150619
  • Bojunga J, Herrmann E, Meyer G, Weber S, Zeuzem S, Friedrich-Rust M. Real-time elastography for the differentiation of benign and malignant thyroid nodules: a meta-analysis. Thyroid. 2010;20(10):1145-1150. doi:10.1089/thy.2010.0079
  • Bakay OA, Golovko TS. Use of elastography for cervical cancer diagnostics. Exp Oncol. 2015;37(2):139-145.
  • Bian J, Li J, Liu Y. Diagnostic accuracy of shear wave elastography for endometrial cancer: A meta-analysis. Medicine (Baltimore). 2023;102(4):e32700. doi:10.1097/MD.0000000000032700
  • Murali R, Davidson B, Fadare O, et al. High-grade Endometrial Carcinomas: Morphologic and Immunohistochemical Features, Diagnostic Challenges and Recommendations. Int J Gynecol Pathol. 2019;38 Suppl 1(Iss 1 Suppl 1):S40-S63. doi:10.1097/PGP.0000000000000491
  • Koyama T, Tamai K, Togashi K. Staging of carcinoma of the uterine cervix and endometrium. Eur Radiol. 2007;17(8):2009-2019. doi:10.1007/s00330-006-0555-0
  • Fukuhara T, Matsuda E, Endo Y, et al. Correlation between quantitative shear wave elastography and pathologic structures of thyroid lesions. Ultrasound Med Biol. 2015;41(9):2326-2332. doi:10.1016/j.ultrasmedbio.2015.05.001
  • Concin N, Matias-Guiu X, Vergote I, et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer. 2021;31(1):12-39. doi:10.1136/ijgc-2020-002230
  • Fujimoto T, Nanjyo H, Fukuda J, et al. Endometrioid uterine cancer: histopathological risk factors of local and distant recurrence. Gynecol Oncol. 2009;112(2):342-347. doi:10.1016/j.ygyno.2008.10.019
  • Grigsby PW, Perez CA, Kuten A, et al. Clinical stage I endometrial cancer: prognostic factors for local control and distant metastasis and implications of the new FIGO surgical staging system. Int J Radiat Oncol Biol Phys. 1992;22(5):905-911. doi:10.1016/0360-3016(92)90786-h
  • Creutzberg CL, van Putten WL, Warlam-Rodenhuis CC, et al. Outcome of high-risk stage IC, grade 3, compared with stage I endometrial carcinoma patients: the postoperative radiation therapy in endometrial carcinoma Trial. J Clin Oncol. Apr 1 2004;22(7):1234-1241. doi:10.1200/JCO.2004.08.159
  • Abu-Rustum NR, Yashar CM, Bradley K, et al. NCCN Guidelines (R) Insights: uterine neoplasms, version 3.2021. J Natl Compr Canc Netw. 2021;19(8):888-895. doi:10.6004/jnccn.2021.0038
  • Gungorduk K, Muallem J, Asicioglu O, et al. Survival outcomes of women with grade 3 endometrioid endometrial cancer: the impact of adjuvant treatment strategies. Arch Gynecol Obstet. 2022;305(3):671-681. doi:10.1007/s00404-021-06187-4
  • Baek MH, Park YR, Suh DS, et al. Reliability of tumour grade 1 and endometrioid cell type on preoperative endometrial biopsy. J Obstet Gynaecol. 2015;35(1):79-81. doi:10.3109/01443615.2014.935723
  • Visser NCM, Reijnen C, Massuger L, Nagtegaal ID, Bulten J, Pijnenborg JMA. Accuracy of endometrial sampling in endometrial carcinoma: a systematic review and meta-analysis. Obstet Gynecol. 2017;130(4):803-813. doi:10.1097/AOG.0000000000002261
  • Alcazar JL, Gaston B, Navarro B, Salas R, Aranda J, Guerriero S. Transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial infiltration in patients with endometrial cancer: a systematic review and meta-analysis. J Gynecol Oncol. 2017;28(6):e86. doi:10.3802/jgo.2017.28.e86
  • Shao J, Shen Y, Lu J, Wang J. Ultrasound scoring in combination with ultrasound elastography for differentiating benign and malignant thyroid nodules. Clin Endocrinol (Oxf). 2015;83(2):254-260. doi:10.1111/cen.12589
  • Du YY, Yan XJ, Guo YJ, et al. Transvaginal real-time shear wave elastography in the diagnosis of endometrial lesions. Int J Gen Med. 2021;14:2849-2856. doi:10.2147/IJGM.S312292
  • Hohn AK, Brambs CE, Hiller GGR, May D, Schmoeckel E, Horn LC. 2020 WHO classification of female genital tumors. Geburtshilfe Frauenheilkd. 2021;81(10):1145-1153. doi:10.1055/a-1545-4279
Journal of Health Sciences and Medicine-Cover
  • Yayın Aralığı: Yılda 6 Sayı
  • Başlangıç: 2018
  • Yayıncı: MediHealth Academy Yayıncılık
Sayıdaki Diğer Makaleler

The role of disease activity as a determinant of body awareness and central sensitization in patients with axial spondyloarthritis: a cross-sectional study

Hakan APAYDIN, Zilan BAZANCİR APAYDIN

Evaluation of the relationship between mitral annular calcification and triglyceride-glucose index

Gökhan GÖKALP, Nail Burak ÖZBEYAZ, Murat Oguz ÖZİLHAN

Analysis of consultations requested from the tertiary intensive care unit and response times: a retrospective study

Mehmet Çağatay GÜRKÖK, Ozlemoner ÖNER, Ferhan DEMİRER AYDEMİR, Özge KUZGUN, Alkan DURMUŞ, Sabri ERDEM, Necati GÖKMEN

Miliary cerebral metastases: prevalence and radiological findings

Ezel YALTIRIK BİLGİN, Özkan ÜNAL

Histopathological evaluation of the effects of sildenafil on organ damage in a diabetic rat model

Mehmet KARA, Halit BAYKAN, Esra ÖNAL, Ayşegül Burçin YILDIRIM, Derya KARABULUT

The transition from gel separatory serum tubes to lithium heparin gel tubes in the clinical laboratory

Oğuzhan ZENGİ

A detailed analysis of thyroid disorders in autoimmune liver diseases

Çağlar KESKİN, Asena GÖKÇAY CANPOLAT, Şule CANLAR, Murat CİNEL, Özgür DEMİR, Mustafa ŞAHİN, Rıfat EMRAL, Onur KESKİN, Demet ÇORAPÇIOĞLU

The change of antibiotic resistance rates over the years in Enterococcus spp. isolated from clinical specimens

Tuğba GEDİK, Nuri KİRAZ, Hülya DURAN

Deep brain stimulation from past to future: research trends and global outcomes with bibliometric analysis during 1980-2022

Sinan ELİAÇIK, Serdar AYKAÇ

The effect of COVID-19 pandemic on stroke admissions to a city

Salih METİN, Hüseyin AYGÜN, Cemile HAKİ