{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:28:42Z","timestamp":1747150122880,"version":"3.40.5"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T00:00:00Z","timestamp":1695254400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Non\u2010compressive strain elastography has been proposed as a novel quantitative imaging biomarker for assessing the structure and function of the cervix. The current study aims to assess the repeatability, and intra\u2010 and inter\u2010observer reliability of transvaginal non\u2010compressive cervical strain elastography in a clinical setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a dual\u2010phase single\u2010center prospective feasibility study of singleton gestations &gt;16\u2010weeks gestation that required a clinically\u2010indicated transvaginal ultrasound. Each study participant, n\u2009=\u200943 in phase 1 and n\u2009=\u200913 in phase 2, had elastography performed by two trained observers that each performed multiple image acquisitions. We performed a multivariable regression to adjust for changes in clinical characteristics between study phases and calculated the repeatability coefficients, limits of agreement, and intraclass correlations for each quantitative elastography parameter. We compared quantitative elastography parameters to cervical length measurements, acquired from the same images.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The repeatability coefficients and percent limits of agreement were wide for all of the quantitative elastography parameters, demonstrating poor repeatability<jats:italic>.<\/jats:italic> Intraclass correlation coefficients were poor\u2013moderate for both intra\u2010observer (0.31\u20130.77) and inter\u2010observer reliability (0.35\u20130.77) in both study phases, while cervical length showed excellent reliability with intraclass correlations consistently &gt;0.90.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Non\u2010compressive transvaginal strain cervical elastography did not demonstrate adequate repeatability or reliability. Our results highlight the importance of rigorously assessing novel quantitative imaging biomarkers before clinical application.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.16331","type":"journal-article","created":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T14:04:10Z","timestamp":1695305050000},"page":"33-43","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Non\u2010Compressive Transvaginal Cervical Elastography as a Quantitative Imaging Biomarker in Pregnancy"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2469-0021","authenticated-orcid":false,"given":"Matthew K.","family":"Janssen","sequence":"first","affiliation":[{"name":"Maternal Fetal Medicine Research Program, Department of Obstetrics and Gynecology The University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Koelper","sequence":"additional","affiliation":[{"name":"Center for Epidemiology and Biostatistics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Weatherby","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Werth","sequence":"additional","affiliation":[{"name":"Hospital of the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadav","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Maternal Fetal Medicine Research Program, Department of Obstetrics and Gynecology The University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2015.12.007"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2017.11.007"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","unstructured":"HamiltonBE.Births: provisional data for 2022.2021.","DOI":"10.15620\/cdc:116027"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5323"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.1373"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1705169"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199602293340904"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2012.05.015"},{"key":"e_1_2_8_10_1","article-title":"Cervical ultrasound elastography may hold potential to predict risk of preterm birth","volume":"60","author":"Khalil MR","year":"2013","journal-title":"Dan Med J"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.7150\/thno.18650"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280214537394"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2014.09.001"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10396-016-0723-z"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11067"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12344"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.05.017"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2019.34.e68"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/jum.15149"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015142202"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.2020.63.1.42"},{"key":"e_1_2_8_22_1","unstructured":"Cervical Length Education and Review Program.https:\/\/clear.perinatalquality.org\/wfImageCriteria.aspx. 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