An investigation of the efficacy of shear wave elastography in the characterization of benign and malignant liver lesions

Introduction
To investigate whether shear wave elastography (SWE) examination, which has recently been proposed as an accessory radiological examination technique, is effective in characterizing focal liver lesions (FLLs).

Material and methods
A total of 105 patients, comprising 48 males and 57 females, underwent SWE examination. The mean age of the patients was 53.31 ± 1.59 (age range 5-87) years. The SWE measurements were obtained from FLLs that were approximately 2 to 8 cm in depth in a box that was approximately 0.5 × 1 cm wide on an ultrasonography (USG) screen from approximately 2 different locations. Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic SWE values in the differentiation of benign and malignant lesions. Sensitivity, specificity, and positive predictive and negative predictive values were calculated in the presence of significant limit values.

Results
The SWE values, in kPa and m/s, in the malignant lesions were significantly higher than those in the benign lesions (p = 0.006, p = 0.011). In the ROC curve analysis, the cut-off value was calculated as 9.005 kPa in the differentiation of malignant lesions from benign lesions. The area under the ROC curve was calculated as 0.656 in the range of 0.551-0.761 with 95% reliability. Sensitivity was calculated as 64.2%, specificity as 61.5%, positive predictive value as 63%, and negative predictive value as 62.7%.

Conclusions
In addition to providing little contribution to the differentiation of benign and malignant lesions, the SWE technique is thought to contribute to a certain extent, especially in suspected cases, during the diagnosis with cross-sectional methods.