Transabdominal Versus Transvaginal Sono-elastography, which is More Valuable in GI-RADS Classification of Different Adnexal Masses?

Background: Ovarian cancer is the most lethal gynecological malignancy and the fifth most common cause of cancer-related death in women, accounting for a wide range of histological diagnoses. Ultrasound is frequently the first-line imaging modality for evaluating masses because it is widely available, inexpensive, and noninvasive, with no radiation hazards.

The Current Study Aimed: To assess the diagnostic performance of trans-vaginal versus trans-abdominal sono-elastography in Gynecologic Imaging Reporting and Data System (GIRADS) of adnexal masses and detect cut-off values for malignancy in both methods. The current study enrolled 40 females, during the period from October 2022 to the end of January 2023, after approval of ethical committee of our institution.

Results: Forty female patients were enrolled in this study, their ages ranged from 28 to 72 years old, with mean± SD (48.6 ± 12.96). Distribution of GI-RADS scores of the studied cases was as follows; GI-RADS III was in (12 patients; 75%) and, less commonly IV in (4 patients; 25%), while malignant masses were mainly of GI-RADS V that was noted in (20 patients; 83.2%) and less commonly IV in (4 patients; 16.8%). A statistically significant correlation was detected in the present study between the GI-RADS score and the transabdominal sono-elastography and transvaginal sono-elastography with, (p-value=0.002*), (p-value=0.001*) respectively.

Conclusions: Trans-vaginal elastography has higher diagnostic performance than trans-abdominal (TA) elastography in assessment of adnexal masses, with malignancy cut-off values were, strain ratio (SR) of trans-abdominal elastography were 3.85, and for trans-vaginal (TV) were 4.75.