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Meta-Analysis
. 2025 Jun 23;30(1):516.
doi: 10.1186/s40001-025-02777-z.

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

Lu Zhang  1 , Jinge Li  1 , Yuhong Shang  2 , Qing Yang  3
Affiliations
Meta-Analysis

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

Lu Zhang et al. Eur J Med Res. .

Abstract

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.

Keywords: Cervical cancer; Cervical intraepithelial neoplasia; Elasticity imaging technique; Meta-analysis; Systemic review.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent to publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart
Fig. 2
Fig. 2
Risk of bias and applicability of included studies. a Summary of QUADAS-2 assessments of included studies; b proportion of studies with low, high, or unclear risk
Fig. 3
Fig. 3
Forest plots of the pooled sensitivity and specificity of TVSE for differential diagnosis between cervical cancer and CIN
Fig. 4
Fig. 4
Summary receiver operating characteristic (SROC) curve on TVSE for differential diagnosis between cervical cancer and CIN
Fig. 5
Fig. 5
Deeks’ funnel plot for evaluating potential publication bias. Each solid circle represents a study in the meta-analysis. The line is the regression line
See this image and copyright information in PMC

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