Evaluation of 2D-shear wave elastography for characterisation of focal liver lesions running title: 2D-SWE and liver lesions

• Published in: Ultraschall in der Medizin - European Journal of Ultrasound
• Main Authors: Fitting, D, Gerber, L, Srikantharajah, K, Luhne, S, Klein, S, Weiler, N, Kyriakidou, G, Bojunga, JB, Hansmann, ML, Bon, D, Albert, J, Zeuzem, S, Friedrich-Rust, M
• Format: Conference Proceeding
• Language: English; German
• Published: 18.08.2016
• ISSN: 0172-4614; 1438-8782
• DOI: 10.1055/s-0036-1587745

Purpose: The aim of this prospective study was to evaluate 2D-shear-wave-elastography (2D-SWE) for characterisation and differentiation of benign and malignant focal liver lesions (FLLs). Material & methods: Patients referred to our ultrasound unit for surveillance of chronic liver disease or work-up of incidentally detected FLLs were prospectively included. B-mode ultrasound and 2D-SWE (Aixplorer® France) was performed for one FLL in each patient. Liver histology obtained by biopsy and/or contrast-enhanced imaging was used as reference method. The Mann-Whitney and Kruskal-Wallis test was used to assess the stiffness difference between the groups. Results: 140 patients with FLL were included. SWE acquisitions failed in 34 FLLs (24%). Therefore, 106 patients with FLL could be analysed, 42/106 (40%) with benign and 64/106 (60%) with malignant FLLs. 58/106 (55%) FFLs were localized in the right liver lobe. The median stiffness for benign FLLs was 16.4 (2.1 – 71.9) kPa (in detail: 16.55 kPa for 18 focal nodular hyperplasia (FNH), 16.35 kPa for 18 hemangioma, 9.8 kPa for 3 focal fatty sparings (FFS), 8.9 kPa for 1 adenoma, 20 kPa for one regenerative node and 29 kPa for one cholangiofibroma) and for the malignant FLLs 36 (4.1 – 142.9) kPa (in detail: 44.8 kPa for 16 hepatocellular carcinoma (HCC), 70.7 kPa for 7 cholangiocarcinoma (CCC) and 29.5 kPa for the 41 metastasis) (p < 0.001). Malignant FLLs were significantly stiffer than benign FLLs (p < 0.0001). CCCs were the stiffest malignant FFLs with significantly higher values as compared to HCCs and metastases (p = 0.033 and p = 0.0079). No significant difference in stiffness could be observed between the different benign FLL entities. No significant difference was observed whether 2D-SWE included the whole FLL, only the periphery or only the hardest area of the FLL. Conclusions: 2D-SWE provides further characterising information for interpretation of FLLs and may be useful at least in differentiation of CCCs and HCCs.