title: The impact of share wave elastography in differentiation of hepatic hemangioma from malignant liver tumors in pediatric population.
abstract: OBJECTIVE
  In children it is crucial to differentiate malignant liver tumors from the most common benign tumor, hepatic hemangiomas since the treatment strategies are quite different. We aimed to evaluate the efficiency of shear wave elastography (SWE) technique in differentiation of malignant hepatic tumors and hepatic hemangiomas.
  
  
  METHODS
  Twenty patients with hepatic tumor were included in our study. Two radiologists performed SWE for 13 patients with malignant hepatic tumors including hepatoblastoma (n=7), hepatocellular carcinoma (n=3), metastasis (n=2), embryonal sarcoma (n=1) and 7 patients with hepatic hemangioma. All of our patients were between the age of 1 and 192 months (mean age: 56.88 months). Receiver operating characteristic analysis was achieved to evaluate the diagnostic accuracy of SWE and to determine the optimal cut-off value in differentiation hepatic hemangioma from malignant hepatic tumors.
  
  
  RESULTS
  The mean SWE values (in kPa) for the first observer were 46.94 (13.8-145) and 22.38 (6.6-49.6) and those for the second observer were 57.91 (11-237) and 23.87 (6.4-57.5), respectively for malignant hepatic tumors and hepatic hemangiomas. The SWE values of malignant hepatic tumors were significantly higher than those of hepatic hemangioma (p=0.02). The inter-observer agreement was almost perfect (0.81). The area under the receiver operating characteristic curve of SWE for differentiating the hepatic hemangioma from malignant hepatic tumors was 0.77 with a sensitivity of 72.7% and a specificity of 66.7% at a cutoff value of 23.62 with 95% confidence interval.
  
  
  CONCLUSIONS
  Shear wave elastography can be helpful in differentiation of malignant hepatic tumors and hepatic hemangioma.
authors.affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul, Turkey. Electronic address: evrimkilicdr@gmail.com.
authors.forename: Evrim
authors.initials: E
authors.lastname: Özmen
authors.affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul, Turkey. Electronic address: iadaletli@yahoo.com.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Adaletli
authors.affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul, Turkey. Electronic address: ysmnkurdoglu@gmail.com.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Kayadibi
authors.affiliation: Department of Pediatric Surgery, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul, Turkey. Electronic address: senolemre@hotmail.com.
authors.forename: Şenol
authors.initials: Ş
authors.lastname: Emre
authors.affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul, Turkey. Electronic address: fahrettinkilic@hotmail.com.
authors.forename: Fahrettin
authors.initials: F
authors.lastname: Kiliç
authors.affiliation: Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul, Turkey. Electronic address: selozmen@gmail.com.
authors.forename: Sergülen
authors.initials: S
authors.lastname: Dervişoğlu
authors.affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul, Turkey. Electronic address: sebuhk@yahoo.com.
authors.forename: Sebuh
authors.initials: S
authors.lastname: Kuruğoğlu
authors.affiliation: Department of Pediatric Surgery, Cerrahpasa Medical Faculty, Istanbul University, 34300, Kocamustafapasa, Istanbul, Turkey. Electronic address: ofsenyuz@gmail.com.
authors.forename: Osman Faruk
authors.initials: OF
authors.lastname: Şenyüz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008099:Liver / Q000000981:diagnostic imaging*; D008107:Liver Diseases / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Hepatic hemangioma; Hepatoblastoma; Liver tumors; Pediatric; Sharewave elastography; Sonoelastography