Abstract
BackgroundTo explore the feasibility to identify malignant musculoskeletal soft tissue tumors using real-time shear wave elastography (rtSWE).MethodsOne hundred fifteen musculoskeletal soft tissue tumors in 92 consecutive patients were examined using both conventional ultrasonography (US) and rtSWE. For each patient, the rtSWE parameters including maximum elasticity (Emax), mean elasticity (Emean), minimum elasticity (Emin), standard deviation of the elasticity (Esd), and rtSWE image pattern were obtained. Eighty-one histopathologically confirmed tumors from 73 patients were subjected to analysis.ResultsThe 81 lesions included in the study were histopathologically classified as malignant (n = 21) or benign (n = 60). The statistically significant differences between benign and malignant lesions were found in conventional US characters including size, depth, margin, echogenicity, mass texture, and power Doppler signal. Meanwhile, the significant differences were also found in quantitative rtSWE findings including Emax, Emean, Emin, and Esd values and in qualitative rtSWE parameter named rtSWE image pattern. Multivariate analysis showed that infiltrative margin (OR, 4.470), and size (OR, 1.046) were independent predictors for malignancy in US findings, while Esd value (OR, 9.047) was independent predictors for malignancy in quantitative rtSWE parameters. Areas under the ROC curve (Azs) for US features, Esd value, and rtSWE image pattern were 0.851, 0.795, and 0.792, respectively.ConclusionsConventional US and quantitative and qualitative rtSWE parameters are useful for malignancy prediction of musculoskeletal soft tissue tumors. rtSWE can be used to supplement conventional US to diagnose musculoskeletal soft tissue tumors.
Highlights
To explore the feasibility to identify malignant musculoskeletal soft tissue tumors using real-time shear wave elastography
By multivariate logistic regression analysis, Standard deviation of the elasticity (Esd) value was the strongest independent predictor for malignancy
The Areas under the Receivers operating characteristic (ROC) curve (Az) was 0.795 for malignancy prediction with Esd value
Summary
To explore the feasibility to identify malignant musculoskeletal soft tissue tumors using real-time shear wave elastography (rtSWE). Different imaging modalities have been employed together to assess soft tissue tumors, such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomographyCT (PET-CT). None of these approaches are reliable enough for the diagnosis of all soft tissue tumors. CT is advantageous to evaluate four distinct characteristics of musculoskeletal soft tissue tumors: lesion density, mineralization patterns, bone involvement, and vascular involvement; but it is not sensitive and can not demonstrate the relationship of the mass and the adjoining neurovascular structures [7]. The diagnostic accuracy of these imaging modalities in the assessment of soft tissue tumors still needs to be improved
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