Can elastographic evaluation be a new approach in prediction of endometrial cancer prognostic markers?

Background: Pathological parameters are the main factors that determine surgical radicality and disease prognosis. Strain sonoelastography is a novel non-invasive method that can be predicted pathological prognostic factors preoperatively. This prospective cohort study study aimed to evaluate the power of strain sonoelastography in prediction of endometrial cancer pathological prognostic factors. Methods: From December 2022 to July 2023, 63 patients with pathologically confirmed endometrial carcinoma were included, prospectively. Cases were evaluated with B-mode ultrasound and strain sonoelastographic together. Strain ratios (SR) of tumors and pathological prognostic factors (tumor diameter, grade, myoinvasion, lymphovascular space invasion, lymph node metastasis and surgical stage) in final pathology reports were compared. Pearson and Spearman’s rank correlation analyzes were used for continuous variables. Student-t Test and Kruskal Wallis analysis was used to compare the continuous variables in independent groups. The diagnostic performance of strain ratio was determined with receiver operating characteristic (ROC) curve analysis. Cut-off values of strain ratios in different prognostic parameters were determined. Results: Median SR-corpus and cervix were detected as 1.55 and 0.99, respectively. SR-corpus values were correlated with all prognostic factors except lymph node metastasis and menopausal status, while SR-cervix values correlated with all of them except menopausal status. There was a correlation between low and high risk groups in SR-cervix grup, there was a correlation between all risk factors in SR-corpus group. Cut-off values of SR-corpus and cervix were determined. Conclusions: This preliminary study showed that sonoelastographic strain ratios were significantly correlated with pathologic prognostic factors. So, this method may be good option during the decision of treatment alternatives and radicality of surgery in endometrial cancer. Clinical Trial Registration: This study was recorded in the Clinicaltrial registry (NCT06623916).

Strain-elastography; Endometrial cancer; Prognostic factors; Tumor stiffness; Strain-ratio

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