Reliability of shear-wave elastography (SWE) for investigating cervix elastic properties in normal and benign pathological situations

Abstract

Reliability of shear-wave elastography (SWE) for investigating cervix elastic properties in normal and benign pathological situations Laura Castro1, *, Jose Antonio García-Mejido1,2, *, Ainhoa Holgado1 , Rocio García1 , Ana Fernández-Palacín2 , Jose Antonio Sainz1,3 1Department of Obstetrics and Gynecology, Valme University Hospital, 41014 Seville, Spain 2Department of Preventive Medicine and Public Health, Biostatistics Unit, University of Seville, 41012 Seville, Spain 3Department of Obstetrics and Gynecology, University of Seville, 41012 Seville, Spain *Correspondence: lauracastroportillo@gmail.com (Laura Castro); jagmejido@hotmail.com (Jose Antonio García-Mejido) DOI:10.31083/j.ceog.2021.03.2420 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 14 December 2020 Revised: 5 March 2021 Accepted: 8 March 2021 Published: 15 June 2021 Background: Our aim in this study is to evaluate the inter- and intraobserver correlation of the diȞferent shear-wave elastography (SWE) parameters (stiȞfness) in both control and pathological groups. Methods: Evaluations of cervical stiȞfness measurements were performed in 39 non-pregnant patients (21 cases without gynecological pathology and other 18 cases with cervical preinvasive cervical lesion susceptibletoconization)agedbetween18–65yearsold, withoutvaginal infection other than HPV and without another gynecological pathology. We used SWE (shear modulus) endovaginal ultrasound. We performed the evaluation in the midsagittal plane of the uterine cervix with measurements at 0.5, 1 and 1.5 cm from external cervical OS, in both anterior and posterior cervical lips as well as the cervical canal. Sonoelastography was performed by two examiners, each one making two separate assessments of uterine cervical stiȞfness using SWE, in one single visit. Interclass correlation coeȞficients (ICC) with 95% CIs were used to assess intra and interobserver measurements repeatability. Results: We obtained an adequate intra and interobserver correlation (ICC 0.996–0.999) of stiȞfness in all anatomical sites both in normal and pathologic cervix (p < 0.005). The stiȞfness in normal cervix is from 38.28 ± 19.76 kPa vs to 61.58 ± 27.54 kPa in the pathological cervix. Conclusion: The SWE has an adequate intra and interobserver correlation for its use in evaluating both normal and pathological cervix. Keywords Shear-wave elastography; Cervical pathology; Cervical stiȞfness; Reproducibility