{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T13:02:31Z","timestamp":1794315751817,"version":"4.9.0"},"reference-count":10,"publisher":"FapUNIFESP (SciELO)","issue":"10","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: Endometrial hyperplasia is a precursor lesion that may progress to endometrial carcinoma, particularly in cases with atypia. Early and accurate diagnosis is essential for timely intervention. The aim of the study was to evaluate the diagnostic performance of shear wave elastography in differentiating normal endometrium, non-atypical hyperplasia, and atypical hyperplasia in premenopausal women with abnormal uterine bleeding.  METHODS: This prospective study included 235 premenopausal women over 45 years of age with abnormal uterine bleeding. All patients underwent transvaginal ultrasonography and shear wave elastography using a Toshiba Aplio 500 system. Five regions of interest were placed within heterogeneous endometrial areas, and mean shear wave elastography (mean-SWE) and highest shear wave elastography (highest-SWE) values were recorded. Histopathological evaluation was performed via probe curettage, and patients were categorized into three groups: normal endometrium, non-atypical hyperplasia, and atypical hyperplasia. Receiver operating characteristic curve analysis and logistic regression were conducted.  RESULTS: Mean-SWE and highest-SWE values were significantly higher in the hyperplasia groups compared to the normal endometrium group (p=0.021, p=0.001). Highest-SWE had the highest diagnostic accuracy (cut-off: 37.71 kPa, sensitivity: 85.9%, specificity: 48.0%). Logistic regression identified body mass index, uterine free fluid, mean-SWE, and highest-SWE as independent predictors of endometrial hyperplasia (p&lt;0.05).  CONCLUSIONS: Shear wave elastography demonstrated significant potential as a non-invasive tool for diagnosing endometrial hyperplasia. Mean-SWE and highest-SWE were independent predictors, supporting shear wave elastography as a complementary method to transvaginal ultrasonography. Future research should optimize shear wave elastography protocols for gynecological assessments.<\/jats:p>","DOI":"10.1590\/1806-9282.20250237","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T15:05:27Z","timestamp":1761577527000},"source":"Crossref","is-referenced-by-count":4,"title":["Non-invasive endometrial assessment: shear wave elastography in diagnosing endometrial hyperplasia"],"prefix":"10.1590","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8912-0812","authenticated-orcid":false,"given":"U\u011furcan","family":"Zorlu","sequence":"first","affiliation":[{"name":"Ankara Bilkent City Hospital,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7162-4668","authenticated-orcid":false,"given":"Sezer Nil Y\u0131lmazer","family":"Zorlu","sequence":"additional","affiliation":[{"name":"Ankara Mamak State Hospital,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7977-4364","authenticated-orcid":false,"given":"Burak","family":"Elmas","sequence":"additional","affiliation":[{"name":"Ankara Bilkent City Hospital,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2025]]},"reference":[{"issue":"1","key":"ref1","first-page":"365","article-title":"The role of shear wave elastography in predicting endometrial cancer in patients presenting with abnormal uterine bleeding","volume":"28","author":"Guler AH","year":"2024","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"4","key":"ref2","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000032700","article-title":"Diagnostic accuracy of shear wave elastography for endometrial cancer: a meta-analysis","volume":"102","author":"Bian J","year":"2023","journal-title":"Medicine (Baltimore)"},{"issue":"6","key":"ref3","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.51253\/pafmj.v74i6.9791","article-title":"Diagnostic accuracy of transvaginal strain sonoelastography in differentiating between endometrial hyperplasia versus carcinoma among postmenopausal women","volume":"74","author":"Rauf AB","year":"2024","journal-title":"Pak Armed Forces Med J"},{"issue":"2","key":"ref4","first-page":"790","article-title":"Role of transvaginal shear wave elastography in diagnosis of benign and malignant endometrial lesions","volume":"6","author":"Soliman BK","year":"2024","journal-title":"Afr J Biol Sci"},{"issue":"1","key":"ref5","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1186\/s13244-022-01274-9","article-title":"Advances in the clinical application of ultrasound elastography in uterine imaging","volume":"13","author":"Wang XL","year":"2022","journal-title":"Insights Imaging"},{"issue":"3","key":"ref6","first-page":"516","article-title":"The role of diagnostic hysteroscopy in abnormal uterine bleeding and its histopathological correlation following blind dilatation and curettage","volume":"13","author":"Narayan S","year":"2024","journal-title":"Int J Life Sci Pharm Res"},{"issue":"1","key":"ref7","first-page":"49","article-title":"A comparison of shear wave elastography between normal myometrium, uterine fibroids, and adenomyosis: a cross-sectional study","volume":"16","author":"Pongpunprut S","year":"2022","journal-title":"Int J Fertil Steril"},{"issue":"3","key":"ref8","doi-asserted-by":"crossref","first-page":"397","DOI":"10.25122\/jml-2021-0358","article-title":"Sonoelastography evaluation in the diagnosis of endometrial pathology combined with chronic endometritis in infertile women","volume":"15","author":"Orishchak IK","year":"2022","journal-title":"J Med Life"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"2849","DOI":"10.2147\/IJGM.S312292","article-title":"Transvaginal real-time shear wave elastography in the diagnosis of endometrial lesions","volume":"14","author":"Du YY","year":"2021","journal-title":"Int J Gen Med"},{"issue":"2","key":"ref10","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1177\/87564793231212872","article-title":"The role of elastography in diagnosing endometrial pathology","volume":"40","author":"Marshall K","year":"2024","journal-title":"J Diagn Med Sonogr"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302025001000605&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T15:05:29Z","timestamp":1761577529000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302025001000605&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":10,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025]]}},"alternative-id":["S0104-42302025001000605"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.20250237","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"value":"1806-9282","type":"electronic"},{"value":"0104-4230","type":"print"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e20250237"}}