{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:37:49Z","timestamp":1792647469712,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Ultrasound"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the prognostic value of early multimodal ultrasound parameters in patients with locally advanced cervical cancer (LACC) undergoing definitive radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective exploratory study included 31 patients with histologically confirmed cervical squamous cell carcinoma who underwent definitive radiotherapy with or without concurrent chemotherapy. Grayscale ultrasound and shear wave elastography (SWE) were performed in all patients at baseline and approximately 2\u2009weeks after radiotherapy initiation, whereas complete contrast\u2010enhanced ultrasound (CEUS) data were available for 22 patients. Unfavorable outcomes were defined as progression, recurrence, or death during follow\u2010up after radiotherapy initiation. ROC analysis was performed to evaluate individual parameters, and a logistic regression model incorporating baseline SWE\n                      <jats:sub>mean<\/jats:sub>\n                      and tumor maximum diameter at the two\u2010week assessment was internally validated using 1000 bootstrap resamples to estimate optimism\u2010corrected performance. Exploratory time\u2010dependent ROC analyses were performed using progression\u2010free survival data to assess model discrimination at different follow\u2010up time points.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with unfavorable outcomes showed higher baseline SWE\n                      <jats:sub>mean<\/jats:sub>\n                      values (153 vs. 106.5\u2009kPa,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039) and larger residual tumor maximum diameters 2\u2009weeks after radiotherapy initiation (36 vs. 32\u2009mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). The combined model showed an apparent AUC of 0.775 and an optimism\u2010corrected AUC of 0.735. Exploratory time\u2010dependent ROC analysis yielded AUC values of 0.855, 0.840, and 0.719 at 12, 24, and 36\u2009months, respectively. Kaplan\u2013Meier analysis demonstrated shorter progression\u2010free survival in the higher\u2010risk group than in the lower\u2010risk group according to the combined model (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022). In exploratory CEUS subgroup analysis, a greater reduction in time to peak was associated with unfavorable outcomes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Baseline tumor stiffness and early residual tumor size assessed by multimodal ultrasound may offer complementary prognostic information for exploratory risk stratification in patients with LACC undergoing definitive radiotherapy. Further prospective validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcu.70449","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:43:04Z","timestamp":1792644184000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimodal Ultrasound for Early Prognostic Assessment During Definitive Radiotherapy in Locally Advanced Cervical Cancer"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0590-9851","authenticated-orcid":false,"given":"Zhen","family":"Xia","sequence":"first","affiliation":[{"name":"Department of Ultrasound Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University  Nanjing 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Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7855-7949","authenticated-orcid":false,"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University  Nanjing 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