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

  • Ultrasound
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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

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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

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Acknowledgements

We thank Matthew Brucce, Assistant Director of Ultrasound at Supersonic Imagine for remarks on shearwave elastography technology. The authors thank the Professor David Cosgrove for his help during the writing of this article.

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Authors and Affiliations

  1. Service d’Imagerie abdominale, Hospices Civils de Lyon, Hôpital Edouard Herriot, 69437, Lyon cedex 03, France

    Aymeric Guibal, Camille Boularan, Matthew Bruce, Frank Pilleul & Thibaut Lefort

  2. Fédération des Spécialités Digestives, Hospices Civils de Lyon, Hôpital Edouard Herriot, 69437, Lyon cedex 03, France

    Mélanie Vallin, Thomas Walter & Jérôme Dumortier

  3. Service d’anatomo-pathologie, Hospices Civils de Lyon, Hôpital Edouard Herriot, 69437, Lyon cedex 03, France

    Jean Yves Scoazec

  4. Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Hôpital Edouard Herriot, 69437, Lyon cedex 03, France

    Nawele Boublay

  5. Pavillon H, Hôpital Edouard Herriot, 69437, Lyon Cedex 03, France

    Aymeric Guibal

  6. SuperSonic Imagine, 13854, Aix en Provence, France

    Matthew Bruce

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  1. Aymeric Guibal
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Correspondence to Aymeric Guibal.

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Guibal, A., Boularan, C., Bruce, M. et al. Evaluation of shearwave elastography for the characterisation of focal liver lesions on ultrasound. Eur Radiol 23, 1138–1149 (2013). https://doi.org/10.1007/s00330-012-2692-y

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  • DOI: https://doi.org/10.1007/s00330-012-2692-y

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