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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
Musculoskeletal

Abstract

Objectives

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

Methods

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.

Results

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.

Conclusions

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.

Keywords

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

References

  1. 1.
    Ophir J, Céspedes I, Ponnekanti H, Yazdi Y, Li X (1991) Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging 13:111–134PubMedGoogle Scholar
  2. 2.
    Pedersen M, Fredberg U, Langberg H (2012) Sonoelastography as a diagnostic tool in the assessment of musculoskeletal alterations: a systematic review. Ultraschall Med 33:441–446PubMedCrossRefGoogle Scholar
  3. 3.
    Nazarian LN (2007) Science to practice: can sonoelastography enable reliable differentiation between benign and metastatic cervical lymph nodes? Radiology 243:1–2PubMedCrossRefGoogle Scholar
  4. 4.
    Garra BS, Cespedes EI, Ophir J et al (1997) Elastography of breast lesion: initial clinical result. Radiology 202:79–86PubMedGoogle Scholar
  5. 5.
    Lyshchik A, Higashi T, Asato R et al (2005) Thyroid gland tumor diagnosis at US elastography. Radiology 237:202–211PubMedCrossRefGoogle Scholar
  6. 6.
    Bhatia KS, Tong CS, Cho CC, Yuen EH, Lee YY, Ahuja AT (2012) Shear wave elastography of thyroid nodules in routine clinical practice: preliminary observations and utility for detecting malignancy. Eur Radiol 22:2397–2406PubMedCrossRefGoogle Scholar
  7. 7.
    Syversveen T, Midtvedt K, Berstad AE, Brabrand K, Strøm EH, Abildgaard A (2012) Tissue elasticity estimated by acoustic radiation force impulse quantification depends on the applied transducer force: an experimental study in kidney transplant patients. Eur Radiol 22:2130–2137PubMedCrossRefGoogle Scholar
  8. 8.
    Motosugi U, Ichikawa T, Koshiishi T, Sano K, Morisaka H, Ichikawa S, Enomoto N, Matsuda M, Fujii H, Araki T (2013) Liver stiffness measured by magnetic resonance elastography as a risk factor for hepatocellular carcinoma: a preliminary case–control study. Eur Radiol 23:156–162PubMedCrossRefGoogle Scholar
  9. 9.
    Botar Jid C, Vasilescu D, Damian L et al (2012) Musculoskeletal sonoelastography. Pictorial essay. Med Ultrason 14:239–245PubMedGoogle Scholar
  10. 10.
    Lalitha P, Reddy MC, Reddy KJ (2011) Musculoskeletal applications of elastography: a pictorial essay of our initial experience. Korean J Radiol 12:365–375PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Drakonaki EE, Allen GM, Wilson DJ (2012) Ultrasound elastography for musculoskeletal applications. Br J Radiol 85:1435–1445PubMedCrossRefGoogle Scholar
  12. 12.
    Kuo WH, Jian DW, Wang TG et al (2013) Neck muscle stiffness quantified by sonoelastography is correlated with body mass index and chronic neck pain symptoms. Ultrasound Med Biol 39:1356–1361PubMedCrossRefGoogle Scholar
  13. 13.
    Wu CH, Chang KV, Mio S, Chen WS, Wang TG (2011) Sonoelastography of the plantar fascia. Radiology 259:502–507PubMedCrossRefGoogle Scholar
  14. 14.
    Fleury EF, Rinaldi JF, Piato S et al (2009) Appearance of breast masses on sonoelastography with special focus on the diagnosis of fibroadenomas. Eur Radiol 19:1337–1346PubMedCrossRefGoogle Scholar
  15. 15.
    Itoh A, Ueno E, Tohno E et al (2006) Breast disease: clinical application of US elastography for diagnosis. Radiology 239:341–350PubMedCrossRefGoogle Scholar
  16. 16.
    Scaperrotta G, Ferranti C, Costa C et al (2008) Role of sonoelastography in non-palpable breast lesions. Eur Radiol 18:2381–2389PubMedCrossRefGoogle Scholar

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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