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The characteristics of real-time transvaginal sono-elastography in endometrial cancer

1 Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
2 Division of Clinical Support Services, KK Women's and Children's Hospital, Singapore
3 Department of Radiography, Singapore General Hospital, Singapore
4 Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
5 Department of Gynaecological Oncology, KK Women's and Children's Hospital, Singapore

Correspondence Address:
Chiou Li Ong,
Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital
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Source of Support: None, Conflict of Interest: None

Background: Endometrial cancer is the most common gynecological cancer among women in developed countries. Sono-elastography is an extended ultrasonographic technique that has been shown to be useful in a wide range of conditions ranging from breast, prostate, and thyroid nodules to chronic liver disease and musculoskeletal conditions. The aim of this study is to compare the sonoelastographic features of endometrial malignancy and normal endometrium. Methods: This case–control observational study was conducted at a single institution. Participants with histologically proven endometrial cancer according to the results from microcurettage or hysteroscopic biopsy and scheduled for total hysterectomy were included as cases, while asymptomatic women scheduled for routine screening ultrasound examination were recruited as controls. Both cases and controls underwent conventional B-mode transvaginal ultrasonography and strain elastography. Demographic, ultrasonographic, and histopathologic findings were analyzed. Results: A total of 29 endometrial cancer patients (cases) and 28 normal females (controls) were included in the analysis. There was no significant difference in the mean age between the two groups, but the mean body weight was significantly higher in the case group (P < 0.001). The strain ratio and elastographic thickness ratio of the endometrium were statistically significantly different between the case and the control group (P ≤ 0.05) due to increased endometrial stiffness in cancer patients as compared to the normal group. Conclusion: Our results suggest that endometrial cancer can result in increased stiffness that is detectable by transvaginal sonoelastography. Sonoelastography may serve as an adjunct to conventional ultrasound in evaluating the endometrium of women with abnormal uterine bleeding.

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