The diagnostic value of transvaginal sonoelastography for cervical cancer and cervical intraepithelial neoplasia: a systematic review and meta-analysis.

OBJECTIVES

To assess the accuracy of transvaginal sonoelastography (TVSE) for diagnosis of cervical cancer (CC) and cervical intraepithelial neoplasia (CIN).

METHODS

A search was done inPubmed, Embase, Web of Science, Cochrane Library, Wanfang, VIP, China National Knowledge Infrastructure (CNKI), and SinoMed from inception to May 9, 2025. TVSE was compared with histopathology regarding diagnostic accuracy. The diagnostic accuracy of TVSE was assessed by calculated pooled sensitivity (SEN)/specificity (SPE), diagnostic odds ratio (DOR), and area under the curve. Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) was used for quality assessment. The relevant data were statistically analyzed using Meta-Disc 1.4 and Stata 15.0.

RESULTS

Eighteen references (studies) were included. They involved a total of 1738 patients, including 863 ones with CC and 875 ones with CIN. TVSE had a pooled SEN of 0.90 [95% confidence interval (CI) 0.87-0.92], a pooled SPE of 0.88 (95% CI 0.85-0.92), and an area under the summary receiver operating characteristic (SROC) curve (AUC) of 0.94 (95% CI 0.91-0.95). The results of subgroup analysis showed imaging modalities as a source of heterogeneity, with an AUC of 0.91 (95% CI 0.88-0.93) for shear wave elastography (SWE), and an AUC of 0.93 (95% CI 0.90-0.95) for strain elastography (SE).

CONCLUSIONS

TVSE is of relatively high value for differential diagnosis of CC and CIN. The diagnostic accuracy of SE and SWE is similar. Given the limitations of this study and to further explore the sources of heterogeneity, more multicenter high-quality studies including large numbers of participants are required to further confirm the effectiveness of TVSE.