Purpose: To investigate the utility of real-time sonoelastography (RTE) for predicting treatment response during the course of definitive radiotherapy in patients with cervical cancer.
Methods: Cervical cancer patients were prospectively evaluated with RTE by a single operator during the course of definitive radiotherapy to analyze the associations between the change in their tumor's strain ratio (SR) and the treatment response.
Results: The SR of the cervical tumors was significantly higher than that of the normal cervical tissue (mean 3.8 vs 1.2; median 3.4 vs 1.1, p < 0.01). Treating the cervical tumors with definitive radiotherapy significantly reduced their SR to the same level as the normal cervix among patients who achieved a complete response to definitive radiotherapy. In contrast, among patients who developed residual disease after radiotherapy, the SR of the tumor did not decrease significantly after definitive radiotherapy. Moreover, the reduction in the tumor SR detected by RTE preceded the reduction in tumor volume as assessed by transvaginal ultrasonography.
Conclusion: RTE is a rapid and effective method for predicting treatment response during the course of definitive radiotherapy, potentially facilitating early and personalized treatment adaptation in patients with cervical cancer.
Keywords: Cervical cancer; Radiotherapy; Response monitoring; Sonoelastography.