{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:41:15Z","timestamp":1787064075663,"version":"build-2736575974"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"1178","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Interdisciplinary Program of Shanghai Jiao Tong University","award":["YG2019ZDA27"],"award-info":[{"award-number":["YG2019ZDA27"]}]},{"DOI":"10.13039\/100007219","name":"Shanghai Natural Science Foundation","doi-asserted-by":"publisher","award":["20ZR1444600"],"award-info":[{"award-number":["20ZR1444600"]}],"id":[{"id":"10.13039\/100007219","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Key Specialty of Changning District, Shanghai, China","award":["20231004"],"award-info":[{"award-number":["20231004"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the diagnostic performance of transrectal ultrasound (TR-US) combined with contrast-enhanced TR-US (TR-CEUS) against MRI and histopathology for assessing cervical cancer local invasion, and to validate the \u201crim sign\u201d as a biomarker for parametrial exclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study of 69 cervical cancer patients (54 surgical, 15 neoadjuvant therapy recipients) undergoing TR-US, TR-CEUS, and MRI was conducted. Tumour dimensions, vaginal\/parametrial invasion, and the \u201crim sign\u201d were evaluated. Diagnostic agreement was assessed using intraclass correlation coefficients (ICC) and Cohen\u2019 s \u03ba, while the specificity and negative predictive value (NPV) of the \u201crim sign\u201d were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>TR-CEUS improved TR-US reliability in tumour measurement (ICC = 0.751 to 0.784), achieving MRI-comparable accuracy (ICC\u2009=\u20090.804 vs. histopathology). Combined TR-US\/TR-CEUS enhanced interobserver consistency for vaginal infiltration (\u03ba\u2009=\u20090.621 to 0.694) and parametrial invasion (\u03ba\u2009=\u20090.579 to 0.678) compared to TR-US alone. TR-US\/TR-CEUS showed good agreement with histopathology (\u03ba\u2009=\u20090.672) and MRI (\u03ba\u2009=\u20090.789) for parametrial assessment than TR-US (\u03ba\u2009=\u20090.563\/0.679). The \u201crim sign\u201d demonstrated 95.8% specificity and 92.0% NPV for parametrial exclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TR-US\/TR-CEUS achieves diagnostic accuracy comparable to MRI while improving observer consistency. The \u201crim sign\u201d serves as a high-specificity biomarker for preoperative parametrial exclusion, offering a cost-effective alternative to MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>This study provides quantitative evidence of TR-CEUS improving diagnostic reproducibility for cervical cancer invasion. The \u201crim sign\u201d is identified as a novel imaging biomarker with high specificity for parametrial preservation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqaf283","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T16:19:12Z","timestamp":1763569152000},"page":"400-408","source":"Crossref","is-referenced-by-count":1,"title":["Assessing local invasion in cervical cancer: the diagnostic performance of transrectal contrast-enhanced ultrasonography"],"prefix":"10.1093","volume":"99","author":[{"given":"Juan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 201620,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Fang","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong 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201620,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3550-0243","authenticated-orcid":false,"given":"Fan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200030,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"2026022702514157200_tqaf283-B1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"2026022702514157200_tqaf283-B2","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1002\/ijgo.12611","article-title":"Cancer of the cervix 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