0411: Acoustic Radiation Force Impulse Elastography for the Evaluation of Focal Solid Hepatic Lesions: Preliminary Results

Abstract

PurposeTo investigate usefulness of acoustic radiation force impulse (ARFI) elastography in the evaluation of focal solid hepatic lesions.Materials and Methods47 focal hepatic lesions of 41 patients underwent ARFI elastography; consisted of 15 hemangiomas, 15 HCCs, 14 metastases, and three cholangiocarcinomas. The lesions were classified into three groups: Group I, malignant lesions except HCC (liver metastases and cholangiocarcinomas); Group II, HCC; and group III, hemangiomas. The echogenicity and conspicuity of tumor on ARFI elastography and corresponding B-mode images were analyzed. In 29 focal hepatic lesions, shear stiffness was obtained: 11 hemangiomas, 11 HCCs, and other 7 malignant lesions.ResultsGroup 1 tumors (n=17) showed stiffer echogenicity in 13 lesions (76%); identical stiffness in two; and softer echogenicity in two. In group 2 tumors (n=15), seven lesions (47%) were stiffer than the liver; the other seven lesions softer; and the remaining one equally stiffer. In group 3 tumors (n=15), six lesions appeared stiffer; the other six lesions softer; and the remained three equally stiffer. Ten of 13 lesions showing unclear margin on B-mode images displayed clear margin on ARFI elastography. On lesion shear stiffness, in group 1, mean value + SD was 1.93 + 0.77; in group 2, 2.57 + 0.82; and in group 3, 1.5 + 0.7 (p=0.012). With a cut-off value of 2, positive predictive value and specificity for malignancy was 83% and 91%.ConclusionARFI elastography showed promise in discriminating malignant from benign lesions and improving conspicuity of unclearly marginated lesions on B mode image. PurposeTo investigate usefulness of acoustic radiation force impulse (ARFI) elastography in the evaluation of focal solid hepatic lesions. To investigate usefulness of acoustic radiation force impulse (ARFI) elastography in the evaluation of focal solid hepatic lesions. Materials and Methods47 focal hepatic lesions of 41 patients underwent ARFI elastography; consisted of 15 hemangiomas, 15 HCCs, 14 metastases, and three cholangiocarcinomas. The lesions were classified into three groups: Group I, malignant lesions except HCC (liver metastases and cholangiocarcinomas); Group II, HCC; and group III, hemangiomas. The echogenicity and conspicuity of tumor on ARFI elastography and corresponding B-mode images were analyzed. In 29 focal hepatic lesions, shear stiffness was obtained: 11 hemangiomas, 11 HCCs, and other 7 malignant lesions. 47 focal hepatic lesions of 41 patients underwent ARFI elastography; consisted of 15 hemangiomas, 15 HCCs, 14 metastases, and three cholangiocarcinomas. The lesions were classified into three groups: Group I, malignant lesions except HCC (liver metastases and cholangiocarcinomas); Group II, HCC; and group III, hemangiomas. The echogenicity and conspicuity of tumor on ARFI elastography and corresponding B-mode images were analyzed. In 29 focal hepatic lesions, shear stiffness was obtained: 11 hemangiomas, 11 HCCs, and other 7 malignant lesions. ResultsGroup 1 tumors (n=17) showed stiffer echogenicity in 13 lesions (76%); identical stiffness in two; and softer echogenicity in two. In group 2 tumors (n=15), seven lesions (47%) were stiffer than the liver; the other seven lesions softer; and the remaining one equally stiffer. In group 3 tumors (n=15), six lesions appeared stiffer; the other six lesions softer; and the remained three equally stiffer. Ten of 13 lesions showing unclear margin on B-mode images displayed clear margin on ARFI elastography. On lesion shear stiffness, in group 1, mean value + SD was 1.93 + 0.77; in group 2, 2.57 + 0.82; and in group 3, 1.5 + 0.7 (p=0.012). With a cut-off value of 2, positive predictive value and specificity for malignancy was 83% and 91%. Group 1 tumors (n=17) showed stiffer echogenicity in 13 lesions (76%); identical stiffness in two; and softer echogenicity in two. In group 2 tumors (n=15), seven lesions (47%) were stiffer than the liver; the other seven lesions softer; and the remaining one equally stiffer. In group 3 tumors (n=15), six lesions appeared stiffer; the other six lesions softer; and the remained three equally stiffer. Ten of 13 lesions showing unclear margin on B-mode images displayed clear margin on ARFI elastography. On lesion shear stiffness, in group 1, mean value + SD was 1.93 + 0.77; in group 2, 2.57 + 0.82; and in group 3, 1.5 + 0.7 (p=0.012). With a cut-off value of 2, positive predictive value and specificity for malignancy was 83% and 91%. ConclusionARFI elastography showed promise in discriminating malignant from benign lesions and improving conspicuity of unclearly marginated lesions on B mode image. ARFI elastography showed promise in discriminating malignant from benign lesions and improving conspicuity of unclearly marginated lesions on B mode image.