Maritza Hobson MS, Presenter: Nothing to Disclose

Miklos Z. Kiss PhD, Abstract Co-Author: Nothing to Disclose

Tomy Varghese, Abstract Co-Author: Nothing to Disclose

Mark Alan Kliewer MD, Abstract Co-Author: Nothing to Disclose

Josephine Harter MD, Abstract Co-Author: Nothing to Disclose

James Anthony Zagzebski PhD, Abstract Co-Author: Equipment support, Ultrasonix Medical Corporation, Burnaby, BC, Canada

Timothy J. Hall PhD, Abstract Co-Author: Institutional research collaboration, Siemens AG Equipment support, Siemens AG

Ellen M Hartenbach MD, Abstract Co-Author: Nothing to Disclose

Ernest Louis Madsen PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Uterine abnormalities, such as leiomyomas (fibroids), endometrial polyps, endometrial hyperplasia, adenomyosis, and endometrial cancer, are often clinically associated with dysfunctional uterine bleeding. These abnormalities can have similar B-mode appearances, but require different clinical treatment. The purpose is to develop diagnostic techniques based on ultrasound strain imaging supplemented by mechanical testing results of excised tissue that would allow in-vivo visualization and characterization of endometrial and myometrial uterine abnormalities, enabling physicians to obtain an accurate diagnosis and provide the correct treatment.

Ultrasound strain imaging was performed on uteri removed via elective hysterectomy from 25 patients. A Siemens Antares and a VFX 13-5 linear array transducer were used to acquire radiofrequency (RF) data sets during manual freehand compressions of the tissue. RF data was post-processed using a 2-D block matching algorithm to create strain images. Strain contrast between both the endometrial polyps and fibroids and the myometrial tissue was compared to the elastic contrast from independent mechanical testing on fibroids and myometrial tissue.

Uterine fibroids appear stiffer in strain images than the surrounding normal myometrium and are characterized by a slipping artifact (bright stripe at the lesion boundary). Endometrial polyps appear softer than the normal surrounding myometrium. The average strain contrast in small fibroids was 1.61 ± 0.96; in large fibroids was 2.25 ± 0.80; and in endometrial polyps was 0.53 ± 0.17. The fibroid strain contrast results are on the order of elastic contrast from mechanical testing results.

Ultrasound strain imaging can detect and differentiate between uterine fibroids and endometrial polyps embedded in uterine muscle tissue. Strain contrast can differentiate between endometrial polyps and fibroids. More data will be collected to verify these results and to determine whether other pathologies can also be detected using ultrasound strain imaging.

Uterine elastography may provide an alternative to MRI, the more expensive and current standard for diagnosing uterine abnormalities.

Hobson, M, Kiss, M, Varghese, T, Kliewer, M, Harter, J, Zagzebski, J, Hall, T, Hartenbach, E, Madsen, E, et al, , Ultrasound Strain Imaging in the Evaluation of Dysfunctional Uterine Bleeding.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4430089.html