{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T20:56:19Z","timestamp":1769547379653,"version":"3.49.0"},"reference-count":31,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T00:00:00Z","timestamp":1742601600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Up to 30% of cervical dysplastic lesions are missed by colposcopy alone. We performed a comparative evaluation of the diagnostic capacity for identifying cervical dysplastic lesions between shear wave elastography (SWE) of the endocervix and exocervix, defined as SonoElastoColposcopy (SEC), and colposcopy. Methods: A prospective observational study was conducted in 84 patients indicated for cervical conization surgery (presence of cervical intraepithelial neoplasia 2 or 3 (CIN-2 or 3), adenocarcinoma in situ (AIS), or high-grade suspicious lesions). All patients underwent colposcopy with lesion identification and biopsy, and SEC and SWE evaluation of the endocervix and exocervix with measurement of lesion stiffness (KPa). Cervical lesions identified by colposcopy or SEC were localized in quadrants, and a comparative evaluation of the diagnostic capacity of both techniques was performed in relation to the anatomical pathology of the cone biopsy. Results: A total of 82 women were evaluated (two cases were lost). The mean age was 38.84 \u00b1 8.44 years. Colposcopy was adequate in 95.12% of cases. In SEC, we observed an elasticity in the lesion area of 105.42 \u00b1 36.32 KPa compared to 19.98 \u00b1 9.29 KPa (p &lt; 0.0001) in the healthy area of the exocervix. In the endocervix, the results were 109.8 \u00b1 40.86 KPa versus 18.5 \u00b1 9.07 KPa (p &lt; 0.0001), respectively. The concordance for colposcopy was 0.456 compared to 0.815 (p &lt; 0.05) for SEC. Conclusions: SEC demonstrates a better ability to identify the area of cervical dysplastic lesions than colposcopy.<\/jats:p>","DOI":"10.3390\/diagnostics15070806","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T10:53:54Z","timestamp":1742900034000},"page":"806","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["SonoElastoColposcopy: A New Tool for Cervical Dysplasia Assessment"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9571-3219","authenticated-orcid":false,"given":"Jos\u00e9 Antonio","family":"Sainz-Bueno","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Seville and Gynecology, 41004 Sevilla, Spain"},{"name":"Andalusian Public Foundation for the Management of Health Research in Seville (FISEVI), 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3330-3273","authenticated-orcid":false,"given":"Cristina","family":"Fern\u00e1ndez-Conde de Paz","sequence":"additional","affiliation":[{"name":"Andalusian Public Foundation for the Management of Health Research in Seville (FISEVI), 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ainhoa","family":"Holgado","sequence":"additional","affiliation":[{"name":"Andalusian Public Foundation for the Management of Health Research in Seville (FISEVI), 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Romo","sequence":"additional","affiliation":[{"name":"Andalusian Public Foundation for the Management of Health Research in Seville (FISEVI), 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Reyes-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Andalusian Public Foundation for the Management of Health Research in Seville (FISEVI), 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3525-2924","authenticated-orcid":false,"given":"Fernando","family":"Fern\u00e1ndez-Palac\u00edn","sequence":"additional","affiliation":[{"name":"Department of Statistics and Operational Research, University of Cadiz, 11003 Cadiz, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3079-5583","authenticated-orcid":false,"given":"Jos\u00e9 Antonio","family":"Garc\u00eda-Mejido","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Seville and Gynecology, 41004 Sevilla, Spain"},{"name":"Andalusian Public Foundation for the Management of Health Research in Seville (FISEVI), 41009 Seville, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,22]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"A review of cervical cancer: Incidence and Disparities","volume":"112","author":"Buskwofie","year":"2020","journal-title":"J. Natl. Med. Assoc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0140-6736(18)32470-X","article-title":"Cervical cancer","volume":"393","author":"Cohen","year":"2019","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/2046-4053-2-35","article-title":"Screening for cervical cancer: A systematic review and meta-analysis","volume":"2","author":"Peirson","year":"2013","journal-title":"Syst. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1001\/jama.2017.19872","article-title":"Screening for Cervical Cancer in Primary Care: A Decision Analysis for the US Preventive Services Task Force","volume":"320","author":"Kim","year":"2018","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3096","DOI":"10.1111\/j.1582-4934.2012.01631.x","article-title":"Changes in type-specific human papillomavirus load predict progression to cervical cancer","volume":"16","author":"Depuydt","year":"2012","journal-title":"J. Cell. Mol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/j.jiph.2023.02.014","article-title":"Human papillomavirus in cancer: Infection, disease transmission, and progress in vaccines","volume":"16","author":"Oyouni","year":"2023","journal-title":"J. Infect. Public Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1001\/jama.2018.10400","article-title":"Screening for Cervical Cancer with High-Risk Human Papillomavirus Testing: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force","volume":"320","author":"Melnikow","year":"2018","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1007\/s13193-020-01118-2","article-title":"Diagnostic Accuracy of Cervical Pap Smear and Colposcopy in Detecting Premalignant and Malignant Lesions of Cervix","volume":"11","author":"Najib","year":"2020","journal-title":"Indian J. Surg. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/LGT.0000000000000525","article-title":"2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors","volume":"24","author":"Perkins","year":"2020","journal-title":"J. Low. Genit. Tract Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/LGT.0000000000000529","article-title":"Risk Estimates Supporting the 2019 ASCCP Risk-Based Management Consensus Guidelines","volume":"24","author":"Egemen","year":"2020","journal-title":"J. Low. Genit. Tract Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1007\/s00404-018-4714-8","article-title":"Discrepancy between colposcopy, punch biopsy and final histology of cone specimen: A prospective study","volume":"297","author":"Petousis","year":"2018","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Qin, D., Bai, A., Xue, P., Seery, S., Wang, J., Mendez, M.J.G., Li, Q., Jiang, Y., and Qiao, Y. (2023). Colposcopic accuracy in diagnosing squamous intraepithelial lesions: A systematic review and meta-analysis of the International Federation of Cervical Pathology and Colposcopy 2011 terminology. BMC Cancer, 23.","DOI":"10.1186\/s12885-023-10648-1"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.ejogrb.2019.07.003","article-title":"The diagnostic accuracy of colposcopy\u2014A review of research methodology and impact on the outcomes of quality assurance","volume":"240","author":"Brown","year":"2019","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1111\/j.1471-0528.2012.03444.x","article-title":"Accuracy of colposcopy-directed punch biopsies: A systematic review and meta-analysis","volume":"119","author":"Underwood","year":"2012","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ejogrb.2008.07.007","article-title":"Does experience in colposcopy improve identification of high grade abnormalities?","volume":"141","author":"Bekkers","year":"2008","journal-title":"Eur. J. Obstet. Gynecol. Reprod. Biol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/LGT.0b013e31819308d4","article-title":"National Institutes of Health\/American Society for Colposcopy and Cervical Pathology Research Group. The accuracy of colposcopic grading for detection of high-grade cervical intraepithelial neoplasia","volume":"13","author":"Massad","year":"2019","journal-title":"J. Low. Genit. Tract Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2419","DOI":"10.1016\/j.ultrasmedbio.2018.07.008","article-title":"Liver ultrasound elastography: An update to the world federation for ultrasound in medicine and biology guidelines and recommendations","volume":"44","author":"Ferraioli","year":"2018","journal-title":"Ultrasound Med. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.clbc.2015.01.002","article-title":"The Journey of Elastography: Background, Current Status, and Future Possibilities in Breast Cancer Diagnosis","volume":"15","author":"Faruk","year":"2015","journal-title":"Clin. Breast Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s00404-020-05671-7","article-title":"Influence of epidemiological characteristics (age, parity and other factors) in the assessment of healthy uterine cervical stiffness evaluated through shear wave elastography as a prior step to its use in uterine cervical pathology","volume":"302","author":"Castro","year":"2020","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3275","DOI":"10.1016\/j.ultrasmedbio.2021.06.021","article-title":"Evaluation of Pre-Malignant Lesions of the Uterine Cervix by Shear Wave Elastography: A New Diagnostic Tool","volume":"47","author":"Sainz","year":"2021","journal-title":"Ultrasound Med. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1056\/NEJMsr2030640","article-title":"The IARC Perspective on Cervical Cancer Screening","volume":"385","author":"Bouvard","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"321","DOI":"10.3322\/caac.21628","article-title":"Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society","volume":"70","author":"Fontham","year":"2020","journal-title":"CA Cancer J. Clin."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"74","DOI":"10.11152\/mu-2646","article-title":"Elastography of the uterine cervix in gynecology: Normal appearance, cervical intraepithelial neoplasia and cancer. A systematic review","volume":"23","author":"Dudea","year":"2021","journal-title":"Med. Ultrason."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1002\/jum.14793","article-title":"Shear wave elastography on the uterine cervix: Technical development for the transvaginal approach","volume":"38","author":"Zelesco","year":"2019","journal-title":"J. Ultrasound Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"667","DOI":"10.7863\/ultra.33.4.667","article-title":"Ultrasound elastography in the differential diagnosis of benign and malignant cervica lesions","volume":"33","author":"Lu","year":"2014","journal-title":"J. Ultrasound Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"139","DOI":"10.31768\/2312-8852.2015.37(2):139-145","article-title":"Use of elastography for cervical cancer diagnostics","volume":"37","author":"Bakay","year":"2015","journal-title":"Exp. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1002\/jum.14457","article-title":"Evaluation of the Cervix After Cervical Conization by Transvaginal Elastography","volume":"37","author":"Xie","year":"2018","journal-title":"J. Ultrasound Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3183","DOI":"10.1002\/jum.15019","article-title":"Quantitative Sonoelastographic Assessment of the Normal Uterus Using Shear Wave Elastography: An Initial Experience","volume":"38","author":"Manchanda","year":"2019","journal-title":"J. Ultrasound Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3173","DOI":"10.1002\/jum.15018","article-title":"Transvaginal Real-Time Shear Wave Elastography in the Diagnosis of Cervical Disease","volume":"38","author":"Liu","year":"2019","journal-title":"J. Ultrasound Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e888","DOI":"10.1016\/j.ejrad.2012.04.025","article-title":"Is transvaginal elastography useful in pre-operative diagnosis of cervical cancer?","volume":"81","author":"Sun","year":"2012","journal-title":"Eur. J. Radiol."},{"key":"ref_31","first-page":"4901","article-title":"Study on value of ultrasonic elastography in diagnosis of clinical staging of cervical cancer and efficacy evaluation of radiotherapy","volume":"17","author":"Zhang","year":"2019","journal-title":"Oncol. Lett."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/7\/806\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:58:20Z","timestamp":1760029100000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/7\/806"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,22]]},"references-count":31,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["diagnostics15070806"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15070806","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,22]]}}}