Acoustic radiation force impulse elastography in distinguishing hepatic haemangiomata from metastases: preliminary observations

Abstract

Objective: The increasing quality of diagnostic ultrasound has resulted in the detection of greater numbers of potentially benign hepatic lesions. Current radiological practice requires contrast enhanced ultrasound, CT or MRI to confirm the diagnosis. Acoustic radiation force impulse (ARFI) elastography is an imaging technique measuring the elasticity of biological tissues. Recent technical advances in ultrasound have made it possible to generate shear waves, whose velocity in the liver is proportional to the degree of hepatic elasticity. Methods: This shear wave velocity (SWV) may be used as a marker for both focal and diffuse liver pathology.We used this technique to examine patients with normal livers and those with haemangiomata and metastases. , the sensitivity and specificity for haemangiomata were 97.1% and 100%, respectively, with an area under the curve of 0.999. Conclusion: ARFI elastography with SWV measurements is a promising new technique which could replace invasive investigations for benign hepatic lesions.

Evaluation of Liver Tumors Using Acoustic Radiation Force Impulse Elastography and Correlation With Histologic Data

“…In opposition, Cho et al, 13 Davies and Koenen, 15 and Shuang-Ming et al 17 showed a significant difference between benign and malignant tumors with cutoff values for discriminating benign from malignant tumors of 2, 2.5, and 2.22 m/s, respectively. However, in the first two studies, 13,15 only hemangiomas were included in the benign tumor group, and in the third study, 17 the benign tumor group (n = 36) was mostly represented by hemangioma (n = 28), with only few focal nodular hyperplasia tumors (n = 7) and 1 adenoma. In addition, we clearly showed that focal nodular hyperplasia and adenoma can be associated with very high ARFI values.…”

“…[13][14][15][16][17] Kato et al 31 were among the first to determine qualitative cartography of the elasticity of different liver tumors by real-time elastography. They showed that hemangioma was a soft tumor, metastases were hard tumors, and hepatocellular carcinoma was in between.…”

“…[7][8][9][10][11][12] A few studies have already investigated the potential usefulness of ARFI elastography to evaluate focal solid hepatic lesions. 6,[13][14][15][16][17] Results are discordant and vary among studies, with, for some authors, 13,15,17 the ability to differentiate benign from malignant tumors, whereas this differentiation was not possible for others. 14 In most of these studies, either the number of cases was too small, or the different tumor types were not sufficiently represented (among the benign tumors, hemangioma often represented most cases, with only a few cases of focal nodular hyperplasia and hepatocellular adenoma).…”

Kidney Ultrasound Elastography: Review

“…The unit of ARFI is m/sec. Operator independency and the quantitative data presentation are the advantages of ARFI, but does not have capability to present data in ascites mediums like in SWE 22,[26][27][28] . TE is one of the methods that use shear-waves.…”

Acoustic Radiation Force Impulse (ARFI) elastography quantification of muscle stiffness over a course of gradual isometric contractions: a preliminary study.

“…Additionally, the characterization and/or differentiation of pathological tissues by US elastography have increasingly been evaluated by numerous up-to-date studies that aimed to reveal the diagnostic efficacy of US elastography in differentiating benign or malignant conditions. Although the visceral organs, such as the liver [8], kidney [9], spleen [10], pancreas [11], uterus [12], and prostate [13], were the main subjects in these studies, the utility of US in assessing pathologies of the thyroid glands [14][15][16] and breast tissue [17][18][19] have also been evaluated by a substantial number of researchers. In comparison, only a limited number of studies in the literature have reported the validity of using US elastography in clinical practice for patients with musculoskeletal issues.…”