Shear wave elastography evaluation for differential diagnosis of focal liver lesions

Abstract

Objective To evaluate the value of shear wave elastography (SWE) on differential diagnosis of local liver lesions (FLLs).Methods A total of 148 patients with 155 lesions including hepatocellular carcinoma (HCC,n =75),intrahepatic cholangiocarcinoma (ICC,n =14),metastasis liver cancer (MLC,n =24),hemangioma (n =31),focal nodular hyperplasia (FNH,n =11) were studied.Mean,max and standard deviation SWE values (Emean,Emax,ESD) of both lesion and adjacent liver parenchyma were measured.All parameters were expressed as kPa.Compared the difference between malignant and benign group as well as between each two groups,and ROC curve was used to determine the optimal cut-off point for differential diagnosis malignant and benign lesions.Results ①Emean,Emax and EsD of malignant lesions were higher than those of benign ones (45.40 ± 20.83 vs 18.12 ± 11.80,77.75 ± 40.67 vs 23.55 ± 13.82,12.08 ± 9.01 vs 2.75 ± 1.85) (P ＜0.001).②Emean,Emax and ESD of ICC (57.86 ± 15.45,104.70 ± 36.87,14.45 ± 7.70) and MLC (59.28 ± 33.00,100.70 ± 52.46,18.23 ± 13.60) were higher than those of HCC (38.63± 11.75,64.64 ± 30.05,9.61 ± 5.97) (P ＜0.01),whereas no significant difference was found between MLC and ICC for all three parameters.Emax and ESD of HCC were higher than those of FNH (37.52 ± 12.78,3.54 ± 1.96) (P ＜0.001),whereas Emean did not show significant difference.Emean (30.62± 11.93) and Emax of FNH were higher than those of hemangioma (13.68 ± 8.07,18.89 ± 10.79) (P ＜ 0.001),whereas ESD did not show significant difference.③ Adjacent liver parenchyma of HCC was stiffer than which of MLC,hemangioma and FNH (P ＜0.05).④For differentiation malignant from benign FLLs,area under ROC curve of Emean,Emax and SSD of lesion were 0.909,0.957,0.956,respectively.Taking Emean 24.82 kPa,Emax 39.28 kPa,ESD5.35 kPa as cut-off point,sensitivity and specificity were 93.81％ and 76.19％,90.57％ and 85.00％,84.62％ and 92.50％,respectively.Conclusions SWE could quantitatively analyze elasticity characteristics of FLLs,especially Emax and ESD could provide more information for differential diagnosis between malignant and benign lesions as well as between HCC and other types of tumour. Key words: Ultrasonography; Liver tumour; Shear wave elastography