title: Elastography, a sensitive tool for the evaluation of neoadjuvant chemotherapy in patients with high-grade serous ovarian carcinoma.
abstract: The aim of the present study was to evaluate tumor stiffness by ultrasound elastography, which has the potential to provide additional information that is useful in predicting the response to neoadjuvant chemotherapy (NACT) in high-grade serous ovarian carcinoma (HGSC) patients. In total, 32 patients with International Federation of Gynecology and Obstetrics stage III and IV epithelial ovarian cancer treated with NACT underwent transvaginal and transabdominal sonography, followed by elastography and finally, by interval cytoreductive surgery. Histopathological analysis revealed 24 (75%) HGSCs. The mean elasticity score was statistically higher for the post-NACT lesions than for the pre-NACT lesions (3.13±0.57 vs. 2.04±0.51, respectively; P<0.001). The median elasticity score for the pre-NACT lesions on the four-point scale was 2, and the score for the post-NACT lesions was 4. Cases of post-NACT with scores of 3 and 4 had a higher optimal cytoreduction rate than cases with scores of 1 and 2 (93.8 vs. 25.0%, respectively; P<0.001). When the post-NACT elasticity scores of 3 and 4 were used for the prediction of optimal cytoreduction, elastography exhibited 88.2% sensitivity, 85.7% specificity, a 93.8% positive predictive value, a 75.0% negative predictive value and 87.5% accuracy. The results of the current study suggested that elastography is a sensitive tool for the evaluation of NACT in patients with HGSC and that it may aid gynecologists in choosing the optimal cytoreduction.
authors.affiliation: Department of Ultrasound, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200090, P.R. China.
authors.forename: Meng
authors.initials: M
authors.lastname: Xie
authors.affiliation: Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200090, P.R. China.
authors.forename: Xuyin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai 200050, P.R. China.
authors.forename: Zhan
authors.initials: Z
authors.lastname: Jia
authors.affiliation: Department of Ultrasound, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200090, P.R. China.
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China.
authors.forename: Wenping
authors.initials: W
authors.lastname: Wang
keywords: elastography; high-grade serous ovarian cancer; neoadjuvant chemotherapy; sonography