European Radiology

, Volume 23, Issue 4, pp 1138–1149

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

  • Aymeric Guibal
  • Camille Boularan
  • Matthew Bruce
  • Mélanie Vallin
  • Frank Pilleul
  • Thomas Walter
  • Jean Yves Scoazec
  • Nawele Boublay
  • Jérôme Dumortier
  • Thibaut Lefort
Ultrasound

DOI: 10.1007/s00330-012-2692-y

Cite this article as:
Guibal, A., Boularan, C., Bruce, M. et al. Eur Radiol (2013) 23: 1138. doi:10.1007/s00330-012-2692-y
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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

ElastographyFocal liver lesionShearwave elastographyStiffnessUltrasound

Abbreviations

ARFI

Acoustic radiation force imaging

CCA

Cholangiocarcinoma

CEUS

Contrast-enhanced ultrasound

CECT

Contrast-enhanced computed tomography

FLL

Focal liver lesion

FFS

Focal fatty sparing

FNH

Focal nodular hyperplasia

HCC

Hepatocellular carcinoma

CEMRI

Contrast-enhanced magnetic resonance imaging

SSI

Supersonic shear imaging

SWE

Shearwave elastography

TE

Transient elastography

Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Aymeric Guibal
    • 1
    • 5
  • Camille Boularan
    • 1
  • Matthew Bruce
    • 1
    • 6
  • Mélanie Vallin
    • 2
  • Frank Pilleul
    • 1
  • Thomas Walter
    • 2
  • Jean Yves Scoazec
    • 3
  • Nawele Boublay
    • 4
  • Jérôme Dumortier
    • 2
  • Thibaut Lefort
    • 1
  1. 1.Service d’Imagerie abdominaleHospices Civils de Lyon, Hôpital Edouard HerriotLyon cedex 03France
  2. 2.Fédération des Spécialités DigestivesHospices Civils de Lyon, Hôpital Edouard HerriotLyon cedex 03France
  3. 3.Service d’anatomo-pathologieHospices Civils de Lyon, Hôpital Edouard HerriotLyon cedex 03France
  4. 4.Pôle Information Médicale Evaluation RechercheHospices Civils de Lyon, Hôpital Edouard HerriotLyon cedex 03France
  5. 5.Pavillon H, Hôpital Edouard HerriotLyon Cedex 03France
  6. 6.SuperSonic ImagineAix en ProvenceFrance