Ultrasound

European Radiology

, Volume 23, Issue 4, pp 1138-1149

Evaluation of shearwave elastography for the characterisation of focal liver lesions on ultrasound

  • Aymeric GuibalAffiliated withService d’Imagerie abdominale, Hospices Civils de Lyon, Hôpital Edouard HerriotPavillon H, Hôpital Edouard Herriot Email author 
  • , Camille BoularanAffiliated withService d’Imagerie abdominale, Hospices Civils de Lyon, Hôpital Edouard Herriot
  • , Matthew BruceAffiliated withService d’Imagerie abdominale, Hospices Civils de Lyon, Hôpital Edouard HerriotSuperSonic Imagine
  • , Mélanie VallinAffiliated withFédération des Spécialités Digestives, Hospices Civils de Lyon, Hôpital Edouard Herriot
  • , Frank PilleulAffiliated withService d’Imagerie abdominale, Hospices Civils de Lyon, Hôpital Edouard Herriot
  • , Thomas WalterAffiliated withFédération des Spécialités Digestives, Hospices Civils de Lyon, Hôpital Edouard Herriot
  • , Jean Yves ScoazecAffiliated withService d’anatomo-pathologie, Hospices Civils de Lyon, Hôpital Edouard Herriot
  • , Nawele BoublayAffiliated withPôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Hôpital Edouard Herriot
  • , Jérôme DumortierAffiliated withFédération des Spécialités Digestives, Hospices Civils de Lyon, Hôpital Edouard Herriot
    • , Thibaut LefortAffiliated withService d’Imagerie abdominale, Hospices Civils de Lyon, Hôpital Edouard Herriot

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Abstract

Objectives

To determine the elasticity characteristics of focal liver lesions (FLLs) by shearwave elastography (SWE).

Methods

We used SWE in 108 patients with 161 FLLs and in the adjacent liver for quantitative and qualitative FLLs stiffness assessment. The Mann–Whitney test was used to assess the difference between the groups of lesions where a P value less than 0.05 was considered significant.

Results

SWE acquisitions failed in 22 nodules (14 %) in 13 patients. For the 139 lesions successfully evaluated, SWE values were (in kPa), for the 3 focal fatty sparings (FFS) 6.6 ± 0.3, for the 10 adenomas 9.4 ± 4.3, for the 22 haemangiomas 13.8 ± −5.5, for the 16 focal nodular hyperplasias (FNHs) 33 ± −14.7, for the 2 scars 53.7 ± 4.7, for the 26 HCCs 14.86 ± 10, for the 53 metastasis 28.8 ± 16, and for the 7 cholangiocarcinomas 56.9 ± 25.6. FNHs had significant differences in stiffness compared with adenomas (P = 0.0002). Fifty percent of the FNHs had a radial pattern of elevated elasticity. A significant difference was also found between HCCs and cholangiocarcinomas elasticity (P = 0.0004).

Conclusions

SWE could be useful in differentiating FNHs and adenomas, or HCCs and cholangiocarcinomas by ultrasound.

Key Points

Elastography is becoming quite widely used as an adjunct to conventional ultrasound

Shearwave elastography (SWE) could help differentiate adenomas from fibrous nodular hyperplasia

SWE could also be helpful in distinguishing between hepatocellular carcinomas and cholangiocarcinomas

SWE could improve the identify hepatocellular carcinomas in cirrhotic livers

Keywords

Elastography Focal liver lesion Shearwave elastography Stiffness Ultrasound