Ultrasound elastography for uterine pathologies: Preliminary reliability for clinical use
CANSAGE ePoster Library. Czyrnyj C. 09/27/19; 275241; eP-108
Cat Czyrnyj
Cat Czyrnyj
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Abstract
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Objective: Ultrasound elastography (UE), a new imaging modality for non-invasive measurement of tissue stiffness, may aid in treatment planning for uterine pathologies, yet few systematic investigations of gynecological UE exist. This preliminary analysis evaluated (1) reliability of UE stiffness measures in non-neoplastic myometrium, and (2) differentiation of uterine leiomyomas and unaffected myometrium by gynecological UE.Methods: The study was executed at the Motor Function Measurement Laboratory, University of Ottawa and used a prospective, observational design. Nine healthy women (control) and one woman (case) with two asymptomatic leiomyomas (FIGO 6) had three 2D UE cineloops acquired transvaginally in the midsagittal plane of the myometrium and leiomyomas. At the first visit, women were imaged twice (V1S1, V1S2) and completed the menstrual bleeding questionnaire (MBQ). Imaging was repeated 2-3 days later (V2S1). Reliability of UE stiffness was evaluated using intraclass correlation coefficients (ICCs) and a 95% prediction interval (PI) of normative peak myometrial stiffness (kPa) was constructed. Results: In the control group (age=30.2±4.4 years, MBQ=11±9, parity=0[0-1]), peak myometrial stiffness (V1S1=35.9±9.6 kPa, V1S2=34.1±8.8kPa, V2S1=32.7±11.9kPa) exhibited excellent within-session reliability (ICCV1S1=0.89, ICCV1S2=0.92, ICCV2S1=0.96), and good between-session (ICC=0.71) and between-day (ICC=0.76) reliability. In the case participant (age=31.4 years, MBQ=13, parity=1), both leiomyomas (Fibroid A = 111.4kPa; Fibroid B = 84.0kPa) well exceeded the 95% PI for normative myometrial stiffness computed from the control group data (18.5-50.0kPa).Conclusion: Reliability of UE was good to excellent and UE stiffness of asymptomatic fibroids exceeded that of unaffected myometrial tissue, suggesting potential clinical value in this gynecologic population.
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