SonoElastoColposcopy: A New Tool for Cervical Dysplasia Assessment

Abstract

Background/Objectives: Up to 30% of cervical dysplastic lesions are missed by colposcopy alone. We performed a comparative evaluation of the diagnostic capacity for identifying cervical dysplastic lesions between shear wave elastography (SWE) of the endocervix and exocervix, defined as SonoElastoColposcopy (SEC), and colposcopy. Methods: A prospective observational study was conducted in 84 patients indicated for cervical conization surgery (presence of cervical intraepithelial neoplasia 2 or 3 (CIN-2 or 3), adenocarcinoma in situ (AIS), or high-grade suspicious lesions). All patients underwent colposcopy with lesion identification and biopsy, and SEC and SWE evaluation of the endocervix and exocervix with measurement of lesion stiffness (KPa). Cervical lesions identified by colposcopy or SEC were localized in quadrants, and a comparative evaluation of the diagnostic capacity of both techniques was performed in relation to the anatomical pathology of the cone biopsy. Results: A total of 82 women were evaluated (two cases were lost). The mean age was 38.84 ± 8.44 years. Colposcopy was adequate in 95.12% of cases. In SEC, we observed an elasticity in the lesion area of 105.42 ± 36.32 KPa compared to 19.98 ± 9.29 KPa (p < 0.0001) in the healthy area of the exocervix. In the endocervix, the results were 109.8 ± 40.86 KPa versus 18.5 ± 9.07 KPa (p < 0.0001), respectively. The concordance for colposcopy was 0.456 compared to 0.815 (p < 0.05) for SEC. Conclusions: SEC demonstrates a better ability to identify the area of cervical dysplastic lesions than colposcopy.