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

Abstract

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.