Standardization of measurement of cervical elastography, its reproducibility, and analysis of baseline clinical factors affecting elastographic parameters (original) (raw)
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Role of Strain Elastography in Assessment of Cervical Incompetence
Fayoum University Medical Journal
Background: Obstetricians exert a lot of efforts to decrease the rate of perinatal morbidity and mortality of mothers and their offspring. Preterm delivery is known to be one of the chief causes for this burden. The aim of this study was to estimate the potential value of elastographic evaluation of cervical canal stiffness at 12-14 weeks of pregnancy in women with cervical incompetence in the prediction of spontaneous preterm delivery. Patient and Methods: This prospective observational study included 40 women presenting for the routine first trimester ultrasound scan between 12-14 weeks of pregnancy. Ultrasound examinations of the cervix were performed transvaginally (TV). The following data were recorded: elastographic color assessment of the cervical canal and ultrasound cervical length at 12-14 and weeks of pregnancy; maternal age; obstetrical history; gestational age at birth. Elastographic assessment of the cervical canal was performed using a color map: Red (soft), Yellow (medium soft), Green (medium hard) and Purple (hard). If two colors were visible in the region of the cervical canal, the softer option was noted.
Medical Ultrasonography, 2020
Aims: To assess the usefulness of real time elastography (RTE) strain ratio (SR) in diagnosing cervical cancer (CC) and cervical intraepithelial neoplasia (CIN), using a synthetic experimental device (ED) as reference material.Material and methods: Seventy-nine participants were enrolled, divided in three groups: Group 1 – benign cervix (n=39); Group 2 – CIN (n=32); Group 3 - CC (n=8). Transvaginal RTE was performed, with SR determination, as the ratio between the ED and the cervical tissue. Mean SR values of the groups were compared; diagnostic performance was assessed by tracing the receiver operating characteristic (ROC) curve. Area under the curve (AUC) was analyzed. Cut-off values were established. Pathological results were considered as reference for data interpretation.Results: SR means significantly differed in Group 1 as compared to Groups 2 and 3 (p=0.001). Excluding 2 aberrant values in Group 3, assigned to cases complicated by hemorrhagic necrosis, statistical difference...
Transient Elastography to Assess the Cervical Ripening during Pregnancy: A Preliminary Study
Ultraschall in der Medizin - European Journal of Ultrasound, 2015
Purpose To explore the feasibility of transient elastography (TE) to quantify cervical stiffness changes during normal pregnancy and its spatial variability. Materials and Methods TE was used to quantify the cervical stiffness in four anatomical regions. 42 women between 17 and 43 years of age and at 6 – 41 weeks of gestation were studied. The stiffness was related to gestational age at the time of examination, interval from ultrasound examination to delivery and cervical length to evaluate the potential of TE to assess cervical ripening. In addition, a sensitivity analysis based on Cronbach’s alpha coefficient was carried out to assess the concordance between inter/intra-operator measurements. Results There were significant correlations between cervical stiffness measured in the four regions with gestational age and the remaining time for delivery. Results confirm stiffness variability within the cervix. No significant association was found between cervical length and stiffness in ...
arXiv (Cornell University), 2023
What are the novel findings of this work? We develop a safe-in-pregnancy, operator-independent, and quantitative cervical elastography system based on transvaginal ultrasound imaging and stress measurement. The system shows high accuracy in phantom experiments and captures the expected decrease in cervical stiffness over pregnancy in a pilot population of pregnant patients. What are the clinical implications of this work? The system is safe, robust, and applicable to different ultrasound machines with minor software updates. It can be tested to define normal and abnormal cervical softening patterns in pregnancy for larger populations, which facilitates insights into cervical-elasticity-related diseases such as preterm birth with multiple potential clinical uses.
Polish Journal of Radiology, 2020
Purpose: Shear wave elastography (SWE) is a relatively new technique for measuring tissue elasticity. Its implementation for assessing the tissue of the cervix is evolving, and SWE analyses of healthy, nonpregnant cervixes is the first step in understanding other SWE changes related to cervical pathologies; nevertheless, some challenges in the use of the technique still require investigation. We aimed to target the consistency of healthy cervix shear wave elastography measurements and examine the changes induced by patient-related factors. Material and methods: Elastograms were obtained at the internal and external os in the anterior (IA, EA) and posterior (IP, EP) portions of the cervix using a transvaginal approach in eight postmenopausal and 25 premenopausal women. Measurements with a standard deviation of over 20% and patients who presented with colour loss or heterogeneity were excluded from the study. Shear wave elastography assessments were performed using a Toshiba Aplio 500 version 6. Statistical significance was defined as a p value less than 0.10, due to the small number of patients. Results: The mean speeds obtained at the external os on the anterior and posterior aspects was 3.17 ± 0.85 m/s and 3.18 ± 0.84 m/s, respectively, and at the internal os, the results on the anterior and posterior aspects were 3.38 ± 0.73 m/s and 3.53 ± 0.81 m/s, respectively. The difference in speed among all regions was statistically significant (p < 0.05). Fifteen patients were also analysed by a second radiologist with a similar experience level as that of the first. Nine measurements for IP, 13 measurements for IA, 11 measurements for EP, and 15 measurements for EA were performed. The correlation coefficients between the two sets of measurements were 0.46, 0.30, 0.67, and 0.51, respectively. There was no difference in the SWE values with respect to age, parity, and gravidity for any of the regions. The SWE values at the IA, IP, and EA regions between the postmenopausal and premenopausal women were significantly different (p = 0.038, p = 0.059, p = 0.065). Conclusions: The posterior portion of the internal os is most likely to undergo inaccurate SWE measurement among the different anatomical positions. The correlation between radiologists was found to be different for different locations in the cervix. More studies are needed to determine the SWE values of the healthy cervix and the agreement levels between radiologists.
Real-Time Tissue Elastography in Gynecology and Obstetrics
2015
Reports on the use of elastography in gynecology and obstetrics remain scare, and most have used static sonoelastography. In gynecology, most studies are related to the field of oncology. In obstetrics, the primary research object has been to estimate cervical stiffness during pregnancy. The accuracy and reliability of the quantitative evaluation of cervical stiffness using elastography has not yet been established due to the lack of comparative reference materials. More studies are needed to determine the utility of the technique in these fields.
Cervix elastography: a bibliometric analysis
Clinical and Experimental Obstetrics & Gynecology, 2017
Introduction: The aim of this study was to assess the global contribution to cervical elastography research in PubMed, Scopus, and Web of Science databases. Materials and Methods: PubMed, Scopus, and Web of Science databases were queried without language restrictions for records present up to January 2016. All indexed publications under cervix elastography were retrieved. All meta-informations present in the databases were locally stored and used for the analyses. Results: The absolute number of publications included was 107. The top four countries to publish on the argument were USA (23 publications), UK (16 publications), Germany (5), and Poland (5). Finally the most researched areas were cervical ripening in labor induction, pre-term delivery prediction, and cervical cancer analysis. Conclusions: Although interest in this field has greatly increased in recent years, original articles on this topic are still limited.
Sensors, 2019
A torsional wave (TW) sensor prototype was employed to quantify stiffness of the cervix in pregnant women. A cross-sectional study in a total of 18 women between 16 weeks and 35 weeks + 5 days of gestation was performed. The potential of TW technique to assess cervical ripening was evaluated by the measurement of stiffness related to gestational age and cervical length. Statistically significant correlations were found between cervical stiffness and gestational age ( R 2 = 0.370 , p = 0.0074 , using 1 kHz waves and R 2 = 0.445 , p = 0.0250 , using 1.5 kHz waves). A uniform decrease in stiffness of the cervical tissue was confirmed to happen during the complete gestation. There was no significant correlation between stiffness and cervical length. A stronger association between gestational age and cervical stiffness was found compared to gestational age and cervical length correlation. As a conclusion, TW technique is a feasible approach to objectively quantify the decrease of cervica...
Preliminary Results on the Preinduction Cervix Status by Shear Wave Elastography
Mathematics
The mechanical status of the cervix is a key physiological element during pregnancy. By considering a successful induction when the active phase of labor is achieved, mapping the mechanical properties of the cervix could have predictive potential for the management of induction protocols. In this sense, we performed a preliminary assessment of the diagnostic value of using shear wave elastography before labor induction in 54 women, considering the pregnancy outcome and Cesarean indications. Three anatomical cervix regions and standard methods, such as cervical length and Bishop score, were compared. To study the discriminatory power of each diagnostic method, a receiver operating characteristic curve was generated. Differences were observed using the external os region and cervical length in the failure to enter the active phase group compared to the vaginal delivery group (p < 0.05). The area under the ROC curve resulted in 68.9%, 65.2% and 67.2% for external os, internal os and...