Data from: Is strain elastography (IO-SE) sufficient for characterization of liver lesions before surgical resection - or is contrast enhanced ultrasound (CEUS) necessary?

Aim: To evaluate the diagnostic accuracy of IO-SE in comparison to IO-CEUS
for the differentiation between malignant and benign liver lesions.
Material and Methods: In a retrospective diagnostic study IO-CEUS and SE
examinations of 49 liver lesions were evaluated and compared to
histopathological examinations. Ultrasound was performed using a
multifrequency linear probe (6–9 MHz). The loops of CEUS were evaluated up
to 5 min. The qualitative characterization of IO-SE was based on a color
coding system (blue = hard, red = soft). Stiffness of all lesions was
quantified by a specific scaling of 0–6 (0 = low, 6 = high) using 7 ROIs
(2 central, 5 peripheral). Results: All malignant lesions displayed a
characteristic portal venous washout and could be diagnosed correctly by
IO-CEUS. 3/5 benign lesions could not be characterized properly either by
IO-CEUS or IO-SE prior to resection. Thus for IO-CEUS sensitivity,
specificity, positive and negative predictive value and accuracy were
100%, 40%, 94%, 100% and 94%. Lesion sizes were between 8 and 59 mm in
diameter. Regarding the IO-SE, malignant lesions showed a marked
variability. In qualitative analysis, 31 of the malignant lesions were
blue colored denoting overall induration. Thirteen malignant lesions
showed an inhomogenous color pattern with partial indurations. Two of the
benign lesions also displayed overall induration. The other benign lesions
showed an inhomogenous color mapping. Calculated sensitivity of the SE was
70.5%, specificity 60%, PPV 94%, NPV 18.75%, and accuracy 69%. Conclusion:
IO-CEUS is useful for localization and characterization of liver lesions
prior to surgical resection whereas IO-SE provided correct
characterization only for a limited number of lesions.