Cervical shear wave elastography as an adjunct in diagnosing precancerous and cancerous lesions: a narrative review

Abstract Background Cervical cancer remains a leading cause of morbidity and mortality among women worldwide, emphasizing the need for accurate, early detection of precancerous and malignant lesions. Conventional diagnostic methods, such as colposcopy and cytology, while effective, are often subjective and dependent on the operator. Shear wave elastography (SWE), an advanced ultrasound-based technique, provides a quantitative assessment of tissue stiffness and has emerged as a promising adjunct in the evaluation of cervical lesions. This narrative review aimed to summarize the current evidence on the clinical utility, diagnostic performance, and limitations of SWE in detecting precancerous and cancerous cervical lesions. Methods A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science for studies published up to October 2025. Keywords included “cervical elastography,” “shear wave elastography,” “cervical intraepithelial neoplasia,” “cervical cancer,” and “ultrasound elastography.” Original research, clinical studies, and systematic reviews in English that evaluated SWE for cervical lesion assessment were included. Studies focusing on non-cervical pathology or lacking measurable SWE outcomes were excluded. Conclusion SWE demonstrates significant potential as a non-invasive, quantitative adjunct for differentiating normal, precancerous, and malignant cervical tissue. It enhances diagnostic accuracy, aids in lesion characterization, and may support clinical staging and treatment monitoring. Limitations include variability due to machine type, transducer, acquisition depth, cervical anatomy, patient factors, and ultrasound artifacts. Standardized protocols and careful interpretation are essential to optimize reliability. Overall, SWE complements conventional imaging and colposcopy, offering a valuable tool for early detection and management of cervical lesions.