Evaluation Short-term Efficacy of Cervical Cancer Under Radiotherapy by Shear Wave Elastography: a Preliminary Study

Abstract Background To find a reliable, safe, convenient and low-cost imaging technology in evaluation of the short-term clinical efficacy of cervical cancer. Here, we performed a preliminary examination of the value of shear wave elastography (SWE) in assessing short-term efficacy of radiotherapy in cervical cancer. Methods In this study, we used SWE to measure the elastic modulus of cervical masses and healthy paracervical tissues and record the maximum elastic modulus (Emax) and the mean elastic modulus (Emean) in 46 patients with cervical cancer. The 46 patients who were naive to treatment were monitored at 5 time points. We divided those into sensitive and non-sensitive groups based on MRI in combination with RECIST1.1. The relative changes in the elastic modulus of the mass before and after radiotherapy were calculated in all patients. MRI was also combined with gynecological examinations to determine if any residual masses remained. Results In this study, 25 patients completed all 5 time points examinations showing the elastic modulus of the cervix decreased while healthy paracervical tissues first increased and then decreased. Then, all 46 patients underwent SWE at 3 time points: prior to radiotherapy, the 15th radiotherapy session, and at completed radiotherapy. The results revealed that the relative changes in cervical masses in the sensitive group were larger than that in the non-sensitive group (P < 0.05). We further discovered the Emax and the Emean of cervical tissues in the residual group were higher than that in the non-residual group (135.69 ± 35.18, 128.25 ± 35.55 vs 104.13 ± 20.19, 98.14 ± 18.9, respectively; P < 0.05), and the area under the curve (AUCs) of the receiver operating characteristic (ROC)were 0.770 and 0.767, respectively (P < 0.05). Conclusions SWE can be used to monitor changes in cervix and paracervical stiffness, and to assist in assessments of the efficacy of radiotherapy in cervical cancer.