title: Characterization of fortuitously discovered focal liver lesions: additional information provided by shearwave elastography.
abstract: OBJECTIVE
  To prospectively assess the stiffness of incidentally discovered focal liver lesions (FLL) with no history of chronic liver disease or extrahepatic cancer using shearwave elastography (SWE).
  
  
  METHODS
  Between June 2011 and May 2012, all FLL fortuitously discovered on ultrasound examination were prospectively included. For each lesion, stiffness was measured (kPa). Characterization of the lesion relied on magnetic resonance imaging (MRI) and/or contrast-enhanced ultrasound, or biopsy. Tumour stiffness was analysed using ANOVA and non-parametric Mann-Whitney tests.
  
  
  RESULTS
  105 lesions were successfully evaluated in 73 patients (61 women, 84%) with a mean age of 44.8 (range: 20‒75). The mean stiffness was 33.3 ± 12.7 kPa for the 60 focal nodular hyperplasia (FNH), 19.7 ± 9.8 k Pa for the 17 hepatocellular adenomas (HCA), 17.1 ± 7 kPa for the 20 haemangiomas, 11.3 ± 4.3 kPa for the five focal fatty sparing, 34.1 ± 7.3 kPa for the two cholangiocarcinomas, and 19.6 kPa for one hepatocellular carcinoma (p < 0.0001). There was no difference between the benign and the malignant groups (p = 0.64). FNHs were significantly stiffer than HCAs (p < 0.0001). Telangiectatic/inflammatory HCAs were significantly stiffer than the steatotic HCAs (p = 0.014). The area under the ROC curve (AUROC) for differentiating FNH from other lesions was 0.86 ± 0.04.
  
  
  CONCLUSIONS
  SWE may provide additional information for the characterization of FFL, and may help in differentiating FNH from HCAs, and in subtyping HCAs.
  
  
  CONCLUSIONS
  • SWE might be helpful for the characterization of solid focal liver lesions • SWE cannot differentiate benign from malignant liver lesions • FNHs are significantly stiffer than other benign lesions • Telangiectatic/inflammatory HCA are significantly stiffer than steatotic ones.
authors.affiliation: Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, Hauts-de-Seine, France, maxime.ronot@bjn.aphp.fr.
authors.forename: Maxime
authors.initials: M
authors.lastname: Ronot
authors.forename: Sara
authors.initials: S
authors.lastname: Di Renzo
authors.forename: Bettina
authors.initials: B
authors.lastname: Gregoli
authors.forename: Rafael
authors.initials: R
authors.lastname: Duran
authors.forename: Laurent
authors.initials: L
authors.lastname: Castera
authors.forename: Bernard E
authors.initials: BE
authors.lastname: Van Beers
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
mesh_terms: D018248:Adenoma, Liver Cell / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging; D003287:Contrast Media; D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000000981:diagnostic imaging; D006391:Hemangioma / Q000000981:diagnostic imaging; D006801:Humans; D033162:Incidental Findings; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D055815:Young Adult
chemical_list: D003287:Contrast Media