Hepatocellular Carcinoma: Stiffness Value and Ratio to Discriminate Malignant from Benign Focal Liver Lesions

Lu, Qiang; Ling, Wenwu; Lu, Changli; Li, Jiawu; Ma, Lin; Quan, J.; He, Du; Liu, Jianping; Yang, Jiaying; Wen, Tianfu; Wu, Hong; Zhu, Hongguang; Luo, Yan

doi:10.1148/radiol.14131164

Cited by 53 publications

(40 citation statements)

References 21 publications

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“…[17] Since carcinomas were found to be stiffer than adjacent normal tissues and studies reported that histologically different tumors may display different elasticity patterns according to tissue architecture, [7,10] this technique has been successfully applied to differentiate focal lesions of testis, breast, prostate, pancreas and liver. [14,[18][19][20] Recently, shear wave elastography (SWE) which combines B-mode image with color-coded US generating a quantitative image SWE (kPa) of the tissue stiffness started to be used to exhibit different hardness among different tissue regions in real-time conditions. [21] With the use of SWE, different elasticity values dependent on testicular volume and functional properties have been demonstrated.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the diagnostic efficacy of strain elastography in infertile population with normal and abnormal semen parameters

Küçükdurmaz

Sarıca

Emre

et al. 2017

Turkish Journal of Urology

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Objective: The aim of the present study was to investigate the diagnostic value of strain elastography (SE) of testicular tissues in infertile population. We also evaluated the correlation between SE results with semen parameters and hormone profiles of the patients. Material and methods:A total of 61 patients and 122 testes were evaluated. Patients who were evaluated in an andrology outpatient clinic with the diagnosis of infertility and referred to radiology department for investigation of reproductive organs between June 2015 and January 2016 were included. Patients were divided into two groups according to semen analyses results as normal (Group 1) and abnormal (Group 2). Hormone profiles, semen analyses, B-mode, coloured Doppler ultrasonography and sonoelastography examinations were performed for each patient. Measurements of testicular volumes, resistive indices (RI) in intraparenchymal arteries, strain, strain ratio (SR) and presence of varicocele were recorded.Results: Mean age of participants was 33.7±6.3 years. Mean testicular volumes (Group 1, 19.41±4.8 mL, and Group 2, 17.64±3.62 mL) were significantly different between groups (p= 0.023). Mean SRs were also different between Groups 1 and 2 (0.12±0.08 vs. 0.22±0.18, p<0.001). Testicular volumes were directly proportional with SRs in Group 1. Strain values had inverse relationship with sperm concentration and total motile sperm counts in Group 2 (p= 0.01). SRs were found to be positively correlated with RI and sperm morphology in Group 2 (p<0.05). Although FSH values showed significant difference among groups, any correlation between FSH and elastographic parameters could not be displayed. Conclusion:Strain elastography results were found to be significantly different in patients with abnormal sperm counts. This technique may provide promising results, however, further large scale studies may help to clarify the value of this imaging modality in the assessment of male infertility.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the diagnostic efficacy of strain elastography in infertile population with normal and abnormal semen parameters

Küçükdurmaz

Sarıca

Emre

et al. 2017

Turkish Journal of Urology

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“…Study characteristics All 9 papers [13,[16][17][18][19][20][21][22][23] were prospective diagnostic cohort studies. A total of 1046 FLLs from 968 patients were identified, 679 (64.9%) lesions being malignant.…”

Section: Resultsmentioning

confidence: 99%

“…The items of flow and timing were of low quality. Three studies performed histology for final confirmation using fine needle aspiration cytology [17], targeted biopsies of lesions [21], and surgical specimens [23]. Other studies [13,16,[18][19][20]22] (fig 3).…”

Section: Resultsmentioning

confidence: 99%

Shear wave elastography imaging for detecting malignant lesions of the liver: a systematic review and pooled meta-analysis

et al. 2017

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Aim: To investigate the clinical utility of shear wave elastography (SWE) imaging in the identification of malignant and benign lesions of the liver lesions by conducting a meta-analysis. Material and methods: The Cochrane library, Embase and Pubmed were searched for relevant studies with publication data through February 2016. Studies evaluating the diagnostic accuracy of SWE in the identification of malignant and benign lesions of the liver using SWE technology were selected. The cytology, histology or clinical imaging was used as the reference standard. The pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio, and the area under hierarchical summary receiver operating characteristic curve (HSROC) were used to examine the diagnostic accuracy. Results: A total of 9 cohort studies involving 1046 liver lesions (malignant 679) from 968 patients were identified. All of the 9 studies were prospective studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of SWE in differentiating malignant and benign liver lesions were 82.2% (95% CI: 73.4–88.5), 80.2% (95% CI: 73.3–85.7), 4.159 (95% CI: 2.899–5.966), 0.222 (95% CI: 0.140–0.352), and 18.749 (95% CI: 8.746–40.195), respectively. The area under the HSROC curve was 87% (95% CI: 84–90). Conclusions: This meta-analysis indicates that SWE is useful in evaluating the stiffness of liver lesions and in differentiating between malignant and benign lesions. Due to the high sensitivity, specificity, and diagnostic odds ratio, SWE can be considered as a useful complement to conventional ultrasonography.

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“…Regarding the patient with multiple FLL, only the largest or the most conspicuous one on ultrasound was chosen. Ten additional ElastPQ measurements were performed in the normal surrounding liver parenchyma at least 2 cm from the lesion [24], over the same ultrasound scanning section and on the same depth of the focal liver lesions. The ratios of the elasticity of the lesions to the surrounding liver were determined.…”

Section: Elastpq Measurementsmentioning

confidence: 99%

Aim: To investigate the value of ElastPQ measurement for differential diagnosis of benign and malignant focal liver lesions (FLLs) by using histologic results as a reference standard. Material and methods: A total of 154 patients were included. ElastPQ measurement was performed for each lesion in which the shear wave speed (SWS) was measured. The difference in SWS and SWS ratio of FLL to surrounding liver were evaluated, and the cut off value was investigated. Receiver operating characteristic (ROC) curve

Wang

et al. 2017

Med Ultrason

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Aim: To investigate the value of ElastPQ measurement for differential diagnosis of benign and malignant focal liver lesions (FLLs) by using histologic results as a reference standard.Material and methods: A total of 154 patients were included. ElastPQ measurement was performed for each lesion in which the shear wave speed (SWS) was measured. The difference in SWS and SWS ratio of FLL to surrounding liver were evaluated, and the cut off value was investigated. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic performance. Histology as a gold standard was obtained by surgery in all patients.Results: A total of 154 lesions including 129 (83.7 %) malignant FLLs and 25 (16.3 %) benign ones were analysed. The SWS of malignant and benign FLLs was significantly different, 2.77±0.68 m/s and 1.57±0.55 m/s (p<0.05). The SWS ratio of each FLL to surrounding liver parenchyma was 2.23±0.49 for malignant and 1.14±0.36 for benign FLLs (p<0.05). The cut off value for differential diagnosis was 2.06 m/s for SWS and 1.67 for SWS ratio.Conclusions: ElastPQ measurement provides reliable quantitative stiffness information of FLLs and may be helpful in the differential diagnosis between malignant and benign FLLs.

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Hepatocellular Carcinoma: Stiffness Value and Ratio to Discriminate Malignant from Benign Focal Liver Lesions

Cited by 53 publications

References 21 publications

Evaluation of the diagnostic efficacy of strain elastography in infertile population with normal and abnormal semen parameters

Evaluation of the diagnostic efficacy of strain elastography in infertile population with normal and abnormal semen parameters

Shear wave elastography imaging for detecting malignant lesions of the liver: a systematic review and pooled meta-analysis

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