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

Abstract

Our aim in this study is to evaluate the inter- and intraob server correlation of the different shear-wave elastography (SWE) pa rameters (stiffness) in both control and pathological groups. Methods: Evaluations of cervical stiffness measurements were performed in 39 non-pregnant patients (21 cases without gynecological pathology and other 18 cases with cervical preinvasive cervical lesion sus ceptibletoconization) agedbetween18–65yearsold, without vaginal infection other than HPV and without another gynecological pathol ogy. We used SWE (shear modulus) endovaginal ultrasound. We per formed 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 mak ing two separate assessments of uterine cervical stiffness using SWE, in one single visit. Interclass correlation coeȞficients (ICC) with 95% CIs were used to assess intra and interobserver measurements re peatability. Results: We obtained an adequate intra and interob server 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.