The measurement of stiffness of uterine smooth muscle tumor by elastography

Leiomyoma shows various diagnostic images, often making it difficult to differentiate from leiomyosarcoma. Recently, the utility of elastography has been reported for the differentiation of superficial tumors. We attempted to diagnose two cases of uterine smooth muscle tumors by elastography. One case was strongly suspected of leiomyosarcoma, and the other case had been diagnosed with leiomyoma. We preoperatively performed virtual tissue imaging (VTI) and virtual tissue quantification (VTQ). In VTQ, we measured shear wave velocity (Vs) five times at each point that ROI was placed. In case of suspected leiomyosarcoma, we attached the tip of convex probe 2 cm below the navel, perpendicular to the floor and measured Vs. In case of leiomyoma, we placed four ROIs randomly in leiomyomas for VTQ. For the case of suspected leiomyosarcoma, Vs and pathological findings from the VTQ were comparably examined. Significant differences were observed in the Vs in the leiomyosarcoma case, whereas not in the leiomyoma case. The comparison of VTQ and pathological findings for the case of leiomyosarcoma indicated high viability in the region where the highest Vs was measured, and strong necrosis in the region with the lowest Vs. These findings suggest that VTQ is useful for diagnosing uterine smooth muscle tumors.