Comparison of Ultrasound Elastography in Early and Advanced Stages of Cervical Cancer

Cervical cancer (CC) is a significant global health issue. Its accurate staging is crucial for appropriate management. Ultrasound elastography (UE), a non-invasive tool, measures the tissue deformation under stress, revealing differences between normal and cancerous areas, which tend to be stiffer. It can also aid in the staging of CC by determining the extent of tumour invasion into the cervical stroma and adjacent structures. To compare Ultrasound Elastography in early and advanced stages of cervical cancer using strain ratio (SR), size ratio, and elasticity score. This prospective observational study comprised 40 biopsy-proven cases of cervical cancer, categorised clinically into early and advanced FIGO stages (IIb and above). SR, size ratio, and elasticity scores were recorded on transvaginal ultrasound strain elastography. Statistical analysis was done to compare the cut-off values and diagnostic efficacy of these parameters in differentiating early and advanced stages of cervical cancer. The strain ratio was significantly higher in advanced-stage (mean 4.1 ± 1.5) compared to early (2.9 ± 1.4), p-value 0.010. While the size ratio (early: 1.2 ± 0.1; advanced: 1.2 ± 0.2) and elasticity score (early: 2.9 ± 0.5; advanced: 3.2 ± 0.9) were also higher in advanced stages, the differences were not statistically significant. At a cutoff of ≥2.38, the predicted SR had a sensitivity and specificity of 100% and 45%, respectively. Ultrasound elastography can serve as a valuable adjunct tool for cervical cancer staging and treatment planning, especially in settings with limited access to MRI. Its real-time and non-invasive characterisation highlights its potential in improving diagnostic accuracy and patient management.