Shear wave elastography imaging for detecting malignant lesions of the liver: a systematic review and pooled meta-analysis

Jiao, Yang; Dong, Fajin; Wang, Hui; Zhang, Lei; Xu, Jinfeng; Zheng, Jing; Fan, Haibo; Gan, Hanjing; Chen, Lixin; Li, Min

doi:10.11152/mu-925

Cited by 23 publications

(12 citation statements)

References 32 publications

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“…The results of a prior meta-analysis was also encouraging [45], with the sensitivity, the specificity, and the AUC of 0.86, 0.89, and 0.94, respectively, yet only 8 studies assessing diagnostic the performance of pSWE were included. Another meta-analysis [46] discussing the efficiency of SWE imaging for detecting malignant lesions of the liver also showed good results, with sensitivity, specificity and AUC of 0.82, 0.80 and 0.87, respectively; however, the 9 studies included were all to evaluate the diagnostic performance of pSWE while 2D-SWE studies were not included in this meta-analysis.…”

Section: Discussionmentioning

confidence: 95%

Diagnostic effect of shear wave elastography imaging for differentiation of malignant liver lesions: a meta-analysis

Huang

Chen

et al. 2019

BMC Gastroenterol

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Background Shear wave elastography (SWE) imaging have been proposed for characterization of focal liver lesions. We conducted a meta-analysis to evaluate the accuracy and clinical utility of SWE imaging for differentiation of malignant and benign hepatic lesions. Methods PubMed, Embase, Web of Science, and the Cochrane Library were systematically reviewed to search for studies published between January 1, 1990, and November 30, 2018. The studies published in English relating to the evaluation the diagnostic accuracy of SWE imaging for distinguishing malignant and benign liver lesions were retrieved and examined for pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratios, using bivariate random-effects models. The hierarchical summary receiver operating characteristic (HSROC) curve was estimated to assess the SWE imaging accuracy. The clinical utility of SWE imaging for differentiation of malignant liver lesions was evaluated by Fagan plot. Results A total of 15 studies, involving 1894 liver lesions in 1728 patients, were eligible for the meta-analysis. The pooled sensitivity and specificity for identification of malignant liver lesions were 0.82 (95% CI: 0.77–0.86) and 0.82 (95% CI: 0.76–0.87), respectively. The AUC was 0.89 (95% CI: 0.86–0.91). When the pre-test probability was 50%, after SWE imaging measurement over the cut-off value (positive result), the corresponding post-test probability for the presence of malignant liver lesions was 82%; the post-test probability was 18% after negative measurement. Conclusions SWE imaging showed high sensitivity and specificity in differentiating malignant and benign liver lesions and may be promising for noninvasive evaluation of liver lesions. Trial registration The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42018104510 . Electronic supplementary material The online version of this article (10.1186/s12876-019-0976-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 95%

Diagnostic effect of shear wave elastography imaging for differentiation of malignant liver lesions: a meta-analysis

Huang

Chen

et al. 2019

BMC Gastroenterol

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“…Elastography has been shown to be useful in distinguishing between benign and malignant focal liver lesions [ 6 , 8 , 18 , 19 ]. Whilst classification of malignant liver lesions might be accurate with RT 2D-SWE, almost 50% of lesions cannot be classified due to high variability in stiffness, which is the most significant elastographic feature of HCC [ 8 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…While contrast-enhanced imaging is the first-line approach in the diagnosis of HCC, recent reports show that the non-invasively measured stiffness of hepatic nodules could help to distinguish between malignant and benign liver lesions. Interestingly, the higher the stiffness of a lesion, the higher the probability of malignancy [ 6 – 8 ]. The treatment of HCC depends on the stage of liver disease and in many cases, curative resection is not possible.…”

Section: Introductionmentioning

confidence: 99%

Evolution of nodule stiffness might predict response to local ablative therapy: A series of patients with hepatocellular carcinoma

et al. 2018

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BackgroundEarly information on treatment response of HCC to local ablative therapy is crucial. Elastography as a non-invasive method has recently been shown to play a potential role in distinguishing between benign and malignant liver lesions. Elastography of hepatocellular carcinoma (HCC) in early response to local ablative therapy has not been studied to date.MethodsWe prospectively included a cohort of 14 patients with diagnosis of HCC who were treated with local ablative therapy (transarterial chemoembolization, TACE and/or radiofrequency ablation, RFA). We used 2D shear-wave elastography (RT 2D-SWE) to examine stiffness of HCC lesion before and 3, 30 and 90 days after local ablative therapy. Contrast-enhanced imaging after 90 days was performed to evaluate treatment response. Primary endpoint was stiffness of HCC in response to local ablative therapy. Secondary end point was tumor recurrence.ResultsStiffness of HCC nodules and liver showed no significant difference prior to local ablative therapy. As early as three days after treatment, stiffness of responding HCC was significantly higher compared to non-responding. Higher stiffness before treatment was significantly associated with tumor recurrence.ConclusionNodule stiffness in general and RT 2D-SWE in particular could provide a useful tool for early prediction of HCC response to local ablative therapy.

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“…29 Ultrasound (US) imaging is extensively used to assess the elastic properties of tissues. [30][31][32][33][34] Its low cost and relative easy access when compared with magnetic resonance imaging (MRI) could explain its application in different fields of medicine, for example hepatology 30 and mastology. 33 A recent review has specifically addressed the use of US imaging to quantify masseter muscle hardness.…”

Section: A Ss E Ss Ment Of Muscle Hardne Ssmentioning

confidence: 99%

Muscle hardness and masticatory myofascial pain: Assessment and clinical relevance

Costa

Ariji

Ferreira

et al. 2018

J of Oral Rehabilitation

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The impression of increased muscle hardness in painful muscles is commonly reported in the clinical practice but may be difficult to assess. Therefore, the aim of this review was to present and discuss relevant aspects regarding the assessment of muscle hardness and its association with myofascial temporomandibular disorder (TMD) pain. A non-systematic search for studies of muscle hardness assessment in patients with pain-related TMDs was carried out in PubMed, Cochrane Library, Embase and Google Scholar. Mechanical devices and ultrasound imaging (strain and shear wave elastography) have been consistently used to measure masticatory muscle hardness, although an undisputable reference standard is yet to be determined. Strain elastography has identified greater masseter hardness of the symptomatic side in patients with unilateral myofascial TMD pain when compared to the contralateral side and healthy controls (HC). Likewise, shear wave elastography has shown greater masseter elasticity modulus in patients with myofascial TMD pain when compared to HC, which may be an indication of muscle hardness. Although assessment bias could partly explain these preliminary findings, future randomised controlled trials are encouraged to investigate this relationship. This qualitative review indicates that the muscle hardness of masticatory muscles is still a rather unexplored field of investigation with a good potential to improve the assessment and potentially also the management of myofascial TMD pain. Nonetheless, the current evidence in favour of increased hardness in masticatory muscles in patients with myofascial TMD pain is weak, and the pathophysiological importance and clinical usefulness of such information remain unclear.

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Shear wave elastography imaging for detecting malignant lesions of the liver: a systematic review and pooled meta-analysis

Cited by 23 publications

References 32 publications

Diagnostic effect of shear wave elastography imaging for differentiation of malignant liver lesions: a meta-analysis

Diagnostic effect of shear wave elastography imaging for differentiation of malignant liver lesions: a meta-analysis

Evolution of nodule stiffness might predict response to local ablative therapy: A series of patients with hepatocellular carcinoma

Muscle hardness and masticatory myofascial pain: Assessment and clinical relevance

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