Trans-vaginal sono-elastography in the differentiation of endometrial hyperplasia and endometrial carcinoma

AimTo evaluate efficiency of sono-elastography in differentiation of endometrial hyperplasia and endometrial carcinoma.Patients and methodsBetween January 2014 and January 2015, 45 perimenopausal female patients with endometrial thickness more than 6 mm were examined by TV sono-elastography procedure. Results of ultrasound and elastography were compared with pathological data (reference standard). Strain ratios were compared between typical, atypical endometrial hyperplasia and endometrial carcinoma. Accuracies of SR in differentiating hyperplasia and endometrial cancer were assessed with the Student t test, and cutoff values were determined with receiver operating curve analysis.ResultsThere was statistically significant difference between mean SR ratio of endometrial carcinoma (11.4) and endometrial hyperplasia (2.7) (P < 0.001). Mean SR of atypical endometrial hyperplasia (5.6) was significantly higher than that of typical endometrial hyperplasia (1.9) (P < 0.001). SR of 7.2 as a cutoff value resulted in 92.3% sensitivity, 100% specificity and 97.8% accuracy for differentiation between endometrial carcinoma and endometrial hyperplasia and SR of ⩽4 as a cutoff value resulted in 100% sensitivity, 85.7% specificity and 96.9% accuracy in differentiation between typical and atypical endometrial hyperplasia.ConclusionTV sono-elastography can aid in differentiation of typical, atypical endometrial hyperplasia and endometrial cancer.