Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Acoustic Radiation Force Impulse Elastography for Focal Hepatic Tumors: Usefulness for Differentiating Hemangiomas from Malignant Tumors

  • Kim, Ji Eun (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Lee, Jae Young (Department of Radiology and Radiation Medicine, Seoul National University College of Medicine) ;
  • Bae, Kyung Soo (Department of Radiology, Gyeongsang National University School of Medicine) ;
  • Han, Joon Koo (Department of Radiology and Radiation Medicine, Seoul National University College of Medicine) ;
  • Choi, Byung Ihn (Department of Radiology and Radiation Medicine, Seoul National University College of Medicine)
  • Received : 2012.12.27
  • Accepted : 2013.06.11
  • Published : 2013.09.01
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Abstract

Objective: The purpose of this study is to investigate whether acoustic radiation force impulse (ARFI) elastography with ARFI quantification and ARFI 2-dimensional (2D) imaging is useful for differentiating hepatic hemangiomas from malignant hepatic tumors. Materials and Methods: One-hundred-and-one tumors in 74 patients were included in this study: 28 hemangiomas, 26 hepatocellular carcinomas (HCCs), three cholangiocarcinomas (CCCs), 20 colon cancer metastases and 24 other metastases. B-mode ultrasound, ARFI 2D imaging, and ARFI quantification were performed in all tumors. Shear wave velocities (SWVs) of the tumors and the adjacent liver and their SWV differences were compared among the tumor groups. The ARFI 2D images were compared with B-mode images regarding the stiffness, conspicuity and size of the tumors. Results: The mean SWV of the hemangiomas was significantly lower than the malignant hepatic tumor groups: hemangiomas, 1.80 ${\pm}$ 0.57 m/sec; HCCs, 2.66 ${\pm}$ 0.94 m/sec; CCCs, 3.27 ${\pm}$ 0.64 m/sec; colon cancer metastases, 3.70 ${\pm}$ 0.61 m/sec; and other metastases, 2.82 ${\pm}$ 0.96 m/sec (p < 0.05). The area under the receiver operating characteristics curve of SWV for differentiating hemangiomas from malignant tumors was 0.86, with a sensitivity of 96.4% and a specificity of 65.8% at a cut-off value of 2.73 m/sec (p < 0.05). In the ARFI 2D images, the malignant tumors except HCCs were stiffer and more conspicuous as compared with the hemangiomas (p < 0.05). Conclusion: ARFI elastography with ARFI quantification and ARFI 2D imaging may be useful for differentiating hepatic hemangiomas from malignant hepatic tumors.

Keywords

References

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