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.
Similar content being viewed by others
References
Ophir J, Céspedes I, Ponnekanti H, Yazdi Y, Li X (1991) Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging 13:111–134
Pedersen M, Fredberg U, Langberg H (2012) Sonoelastography as a diagnostic tool in the assessment of musculoskeletal alterations: a systematic review. Ultraschall Med 33:441–446
Nazarian LN (2007) Science to practice: can sonoelastography enable reliable differentiation between benign and metastatic cervical lymph nodes? Radiology 243:1–2
Garra BS, Cespedes EI, Ophir J et al (1997) Elastography of breast lesion: initial clinical result. Radiology 202:79–86
Lyshchik A, Higashi T, Asato R et al (2005) Thyroid gland tumor diagnosis at US elastography. Radiology 237:202–211
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 22:2397–2406
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 22:2130–2137
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 23:156–162
Botar Jid C, Vasilescu D, Damian L et al (2012) Musculoskeletal sonoelastography. Pictorial essay. Med Ultrason 14:239–245
Lalitha P, Reddy MC, Reddy KJ (2011) Musculoskeletal applications of elastography: a pictorial essay of our initial experience. Korean J Radiol 12:365–375
Drakonaki EE, Allen GM, Wilson DJ (2012) Ultrasound elastography for musculoskeletal applications. Br J Radiol 85:1435–1445
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 39:1356–1361
Wu CH, Chang KV, Mio S, Chen WS, Wang TG (2011) Sonoelastography of the plantar fascia. Radiology 259:502–507
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 19:1337–1346
Itoh A, Ueno E, Tohno E et al (2006) Breast disease: clinical application of US elastography for diagnosis. Radiology 239:341–350
Scaperrotta G, Ferranti C, Costa C et al (2008) Role of sonoelastography in non-palpable breast lesions. Eur Radiol 18:2381–2389
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Magarelli, N., Carducci, C., Bucalo, C. et al. Sonoelastography for qualitative and quantitative evaluation of superficial soft tissue lesions: a feasibility study. Eur Radiol 24, 566–573 (2014). https://doi.org/10.1007/s00330-013-3069-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00330-013-3069-6