title: Percutaneous real-time sonoelastography as a non-invasive tool for the characterization of solid focal liver lesions: A prospective study.
abstract: BACKGROUND
  Real-time sonoelastography is currently used for the characterization of superficial solid lesions such as thyroid and breast masses. This study evaluates the usefulness of percutaneous sonoelastography for the characterization of solid focal liver lesions.
  
  
  METHODS
  30 out of 43 patients with 38 known liver lesions were included in a prospective, diagnostic study. Qualitative analysis (pattern of deformation, elasticity type of liver tumour) and semi-quantitative measurements (strain ratio, hardness percentage, histogram) were evaluated. Sensitivity, specificity, positive and negative predictive values were calculated and the area under the receiver operating characteristics curve was constructed.
  
  
  RESULTS
  Patterns A and C-D are specific of benign lesions and metastases respectively. The patterns for haemangiomas, focal nodular hyperplasia and metastases were significantly different to each other in terms of strain ratio, hardness percentage and histogram (p<0.05). A statistically significant difference (p<0.001) was observed between the median values of the 3 measured parameters for benign (1.02; 12%; 47) and malignant lesions (1.66; 65%; 20.5) respectively. The area under the receiver operating characteristics curve values for strain ratio, hardness percentage and histogram were 0.88, 0.89, and 0.86 respectively for cut-off values of 1.2, 45, and 30.
  
  
  CONCLUSIONS
  By percutaneous sonoelastography it is possible to differentiate benign versus malignant focal liver lesions, metastases in particular, with good diagnostic performance.
authors.affiliation: Internal Medicine and Gatroenterology Department, UCSC, Policlinico Gemelli, Rome, Italy. Electronic address: cesario.valentina@gmail.com.
authors.forename: Valentina
authors.initials: V
authors.lastname: Cesario
authors.affiliation: Internal Medicine A Department, Ospedale Maggiore, Bologna, Italy.
authors.forename: Esterita
authors.initials: E
authors.lastname: Accogli
authors.affiliation: Internal Medicine A Department, Ospedale Maggiore, Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Domanico
authors.affiliation: Faculty of Economics and Management, Free University of Bozen, Bolzano, Italy.
authors.forename: F Marta L
authors.initials: FM
authors.lastname: Di Lascio
authors.affiliation: Internal Medicine Department, Università La Sapienza, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Napoleone
authors.affiliation: Internal Medicine and Gatroenterology Department, UCSC, Policlinico Gemelli, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.affiliation: Internal Medicine A Department, Ospedale Maggiore, Bologna, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Arienti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D054459:Elasticity Imaging Techniques; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006391:Hemangioma / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Benign and malignant focal liver lesions; Elastography; Hardness