2026/07/01 by Anton A. Plekhanov, Maria M. Loginova, Anastasia A. Shepeleva +11
paper · doi:10.1002/ima.70419
ABSTRACT Currently, the diagnosis of endometrial tissue pathologies necessitates highly invasive procedures—dilation and curettage of the uterus or endometrial biopsy under visual hysteroscopic control. At present, there is no minimally invasive, non‐traumatic clinical tool to reliably identify endometrial pathology based on morphological features for subsequent targeted biopsy. In this study, we used compression optical coherence elastography (C‐OCE) technique to assess the elastic properties of uterine tissues (endometrium/myometrium) and to establish the possibility of diagnosing endometrial pathologies (hyperplasia/cancer) based on differences in their stiffness. To demonstrate the potential of the technique for clinical use, we adapted C‐OCE imaging to identify endometrial pathology in a manually operated palpation mode. In this mode, the operator's finger lightly presses the OCT‐probe against the tissue, enabling the acquisition of results comparable to those obtained with C‐OCE in controlled compression mode using an automated device to control the movement of the OCT‐probe. When comparing C‐OCE images of endometrial tissue for controlled compression and palpation modes, similar trends were observed: hyperplastic processes decreased tissue stiffness, while neoplastic (cancerous) processes increased tissue stiffness. The performance of morphological segmentation of C‐OCE images confirmed the ability to identify the topology of endometrial hyperplasia sites by stiffness values below 33 kPa and endometrial cancer sites by stiffness values above 165 kPa, which may be perspective for guiding targeted endometrial biopsy. The first results of C‐OCE imaging of uterine tissue obtained in this study highlighted the prospects for further development and optimization of C‐OCE for intrauterine hysteroscopic‐like examination of the most pathologically suspicious endometrial tissue sites and identification of endometrial pathologies.