A preliminary study on the application of sono-elastography in differentiating endometrial carcinoma from benign endometrial lesions in a tertiary government hospital in the Philippines

Abstract

[Objective]

To evaluate the diagnostic value of sonoelastography to distinguish endometrial cancer from benign endometrial lesions.

[Methods]

A cross-sectional study was conducted and included 31 subjects with abnormal uterine bleeding who required endometrial sampling. Sonoelastography assessment was done qualitatively and quantitatively using Tsukuba elasticity score and strain ratio, respectively. Results were compared between those with endometrial cancer and those with benign endometrial lesions (hyperplasia and polyp) using Kruskal-Wallis test and Mann-Whitney U test. Diagnostic accuracies of Tsukuba elasticity score and strain ratio in differentiating endometrial cancer from benign endometrial lesions were determined with cut-off values derived from ROC analysis.

[Discussion]

Both the Tsukuba elasticity score and strain ratio value were significantly higher among patients with endometrial cancer (n = 15; mean age: 55.07 ± 8.53 years) compared to those with benign endometrial lesions (n = 16; mean age: 41.63 ± 8.02 years) (P < 0.0001). A Tsukuba elasticity score of ≥3 showed the highest diagnostic accuracy at 93.5%(95%CI: 79.3%–98.2%), with sensitivity of 86.7%(95%CI: 62.1%–96.3%), specificity of 100%(95%CI: 80.6%–100%), PPV of 100%(95%CI: 77.2%–100%), NPV of 88.9%(95%CI: 67.2%–96.9%), positive LR of undefined indicating high value and negative LR of 0.10(95%CI: 0.05–0.40). A Strain ratio value of ≥2 showed the highest diagnostic accuracy at 93.5%(95%CI: 79.3%–98.2%), with sensitivity of 93.3%(95%CI: 70.2%–98.8%), specificity of 93.8%(95%CI: 71.7%–98.9%), PPV of 93.3% (95%CI: 70.2%–98.8%), NPV of 93.8%(95%CI: 71.7%–98.9%), positive LR 14.9(95%CI: 2.1–107.1), and negative LR of 0.07(95%CI: 0.01–0.51).

[Conclusion]

The results indicate that sonoelastography can distinguish endometrial cancer from benign endometrial lesions.