European Radiology

, Volume 24, Issue 3, pp 566–573 | Cite as

Sonoelastography for qualitative and quantitative evaluation of superficial soft tissue lesions: a feasibility study

  • Nicola MagarelliEmail author
  • Chiara Carducci
  • Costanza Bucalo
  • Laura Filograna
  • Santi Rapisarda
  • Chiara De Waure
  • Claudia Dell’Atti
  • Giulio Maccauro
  • Antonio Leone
  • Lorenzo Bonomo



To evaluate the feasibility of qualitative and quantitative analysis using sonoelastography (SE) for differentiating between benign and malignant superficial soft-tissue lesions.


For this prospective study, 32 patients with superficial soft-tissue lesions detected with grey-scale ultrasound and colour and/or power Doppler ultrasound were evaluated between October 2011 and December 2012. Qualitative analysis: visual grading system was adopted according to colour variation (red-soft, green-medium, blue-hard). Quantitative analysis: median and fraction area of each colour were computed within a region of interest. Differences between fraction areas and median values in compression and decompression phases were calculated. Reference standard: histological findings.


Twelve out of 32 lesions (37.5 %) were malignant. Intraclass correlation coefficient (ICC) was 0.989 (95 % confidence interval [CI] 0.980–0.994, P < 0.01) with optimal reliability. Area under the curve was 0.823 (95 % CI 0.677–0.969) and 0.958 (95 % CI 0.989–1.019) for blue and blue area differences, and 0.777 (95 % CI 0.615–0.939) and 0.629 (95 % CI 0.426–0.833) for red and red area differences, respectively. Blue variations predicted malignancy more accurately (variation ≥0.431: 100 % sensitivity, 80 % specificity); the blue area difference was highly accurate.


Preliminary results showed good correlations between SE and reference standards. SE could be useful in the evaluation of superficial soft tissue lesions.

Key Points

• Sonoelastography helps clarify ambiguous soft-tissue lesions identified using conventional ultrasound techniques.

• Addition of this tool increases the diagnostic accuracy of ultrasound.

• Sonoelastography provides both qualitative and quantitative analysis.

• Sonoelastography may help clinicians improve patient care.


Sonoelastography Soft-tissue tumour Superficial soft-tissue lesions Musculoskeletal lesions Ultrasound 


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Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Nicola Magarelli
    • 1
    • 5
    Email author
  • Chiara Carducci
    • 1
  • Costanza Bucalo
    • 4
  • Laura Filograna
    • 1
  • Santi Rapisarda
    • 1
  • Chiara De Waure
    • 2
  • Claudia Dell’Atti
    • 1
  • Giulio Maccauro
    • 3
  • Antonio Leone
    • 1
  • Lorenzo Bonomo
    • 1
  1. 1.Department of Radiological SciencesCatholic University of the Sacred Heart, School of MedicineRomeItaly
  2. 2.Institute of HygieneCatholic University of the Sacred Heart, School of MedicineRomeItaly
  3. 3.Department of Orthopaedics and TraumatologyCatholic University of the Sacred Heart, School of MedicineRomeItaly
  4. 4.Department of RadiologyUniversity of PalermoPalermoItaly
  5. 5.Department of Radiological SciencesCatholic University of the Sacred Heart, School of MedicineRomeItaly

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