Evaluation of liver parenchyma stiffness in patients with liver tumours: optimal strategy for shear wave elastography
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To determine the methodology of non-invasive test for evaluation of liver stiffness (LS) with tumours using two-dimensional (2D) shear wave elastography (SWE).
One hundred and twenty-seven patients with liver tumours underwent 2D-SWE before surgery to measure liver and spleen stiffness (SS). Two-dimensional SWE values were obtained in the liver at 0–1 cm, 1–2 cm and >2 cm from the tumour edge (PLS-1, PLS-2 and RLS, respectively). The influence of tumour-associated factors was evaluated. The area under the receiver operating characteristic curve (AUC) for each value was analysed to diagnose cirrhosis.
PLS-1 was higher than PLS-2, which was even higher than RLS (p < 0.001). The AUCs of PLS-1, PLS-2, RLS and SS for diagnosing cirrhosis were 0.760, 0.833, 0.940 and 0.676, with the specificity of 75.7%, 67.6%, 90.3% and 77.4%, respectively. Tumour sizes, locations or types showed no apparent influence on 2D-SWE values except for RLS, which was higher in patients with primary hepatic carcinomas (p < 0.05).
LS with tumours is best measured at >2 cm away from the tumour edge. SS measurement could be used as an alternative to LS measurement in the event of no available liver for detection.
• Tumour-associated factors impact background liver stiffness assessment.
• Background liver stiffness is best measured at >2 cm from tumour edge.
• Spleen stiffness can be an alternative to assess background liver stiffness.
KeywordsElasticity imaging techniques Ultrasonography Liver neoplasms Liver cirrhosis Spleen
Two-dimensional shear wave elastography
Glutamate pyruvate transaminase
Glutamic oxaloacetic transaminase
Coefficient of variation
European Federation of Societies for Ultrasound in Medicine and Biology
Hepatitis B virus
Metastatic hepatic carcinoma
Post-hepatectomy liver failure
Peritumoural liver stiffness,
Peritumoural liver stiffness measured at 0–1 cm from the tumour edge
Peritumoural liver stiffness measured at 1–2 cm from the tumour edge
Remnant liver stiffness
Supersonic shear imaging
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is An-hua Li.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional review board approval was obtained.
• diagnostic or prognostic study
• performed at one institution
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