Sonoelastographic Evaluation of Uterine Fibroids – Our Initial Experience

Abstract

Context: Real-time elastography is a novel and dynamic imaging technique that is based on the softness or hardness of tissues or organs of interest under the appropriate compression and can be used with conventional ultrasonography(US) probes after performing grayscale imaging and Doppler US. Aims: It was to find out the diagnostic ability of sonoelastography in evaluation of uterine fibroids and whether evaluation with computed tomography (CT) or magnetic resonance imaging (MRI) can be avoided. Subjects and Methods: A prospective study was conducted from August 2017 to August 2018. A total of 87 females were included and underwent sonographic examination and a diagnosis was made, and later, elastogram was obtained and strain ratios were calculated and the final diagnosis was compared to histopathological diagnoses to evaluate the diagnostic accuracy of ultrasound with and without elastography. Statistical Analysis Used:Statistical analysis was done using descriptive and inferential statistics using Chi-square test, Student's unpaired test, sensitivity, and specificity, and software used in the analysis was SPSS 22.0 version and GrafhPad Prism 6.0 version. Results: Out of the total 87 patients, 10 cases were misdiagnosed on ultrasonography compared to 7 on elastography, of which the major pathology was adenomyosis and 1 case submucosal fibroid. Sensitivity, specificity, and diagnostic accuracy of ultrasound were found to be 90.28%, 80%, and 88.5%, respectively. Sensitivity, specificity, and diagnostic accuracy of sonography with elastography were 93.06%, 86.67%, and 91.95%, respectively, showing better results. Conclusions: Sonography coupled with elastography showed better results and can be used to avoid dependency on CT and MRI avoiding radiation exposures and increase cost, especially in a developing country such as India.