Liver elastography malignancy prediction score for noninvasive characterization of focal liver lesions.

Grgurevic, Ivica; Bokun, Tomislav; Salkic, Nermin N; Brkljacic, Boris; Vukelić-Markovic, Mirjana; Stoos-Veic, Tajana; Aralica, Gorana; Rakic, Mislav; Filipec-Kanizaj, Tajana; Berzigotti, Annalisa (2018). Liver elastography malignancy prediction score for noninvasive characterization of focal liver lesions. Liver international, 38(6), pp. 1055-1063. Wiley 10.1111/liv.13611

[img] Text
Grgurevic_et_al-2017-Liver_International.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (700kB) | Request a copy

BACKGROUND & AIMS To analyse elastographic characteristics of focal liver lesions (FLL)s and diagnostic performance of real-time two-dimensional shear-wave elastography (RT-2D-SWE) in order to differentiate benign and malignant FLLs. METHODS Consecutive patients diagnosed with FLL by abdominal ultrasound (US) underwent RT-2D-SWE of FLL and non-infiltrated liver by intercostal approach over the right liver lobe. The nature of FLL was determined by diagnostic work-up, including at least one contrast-enhanced imaging modality (MDCT/MRI), check-up of target organs when metastatic disease was suspected and FLL biopsy in inconclusive cases. RESULTS We analysed 196 patients (median age 60 [range 50-68], 50.5% males) with 259 FLLs (57 hepatocellular carcinomas, 17 cholangiocarcinomas, 94 metastases, 71 haemangiomas, 20 focal nodular hyperplasia) of which 70 (27%) were in cirrhotic liver. Malignant lesions were stiffer (P < .001) with higher variability in intralesional stiffness (P = .001). The best performing cut-off of lesion stiffness was 22.3 kPa (sensitivity 83%; specificity 86%; positive predictive value [PPV] 91.5%; negative predictive value [NPV] 73%) for malignancy. Lesion stiffness <14 kPa had NPV of 96%, while values >32.5 kPa had PPV of 96% for malignancy. Lesion stiffness, lesion/liver stiffness ratio and lesion stiffness variability significantly predicted malignancy in stepwise logistic regression (P < .05), and were used to construct a new Liver Elastography Malignancy Prediction (LEMP) score with accuracy of 96.1% in validation cohort (online calculator available at http://bit.do/lemps). CONCLUSION The comprehensive approach demonstrated in this study enables correct differentiation of benign and malignant FLL in 96% of patients by using RT-2D-SWE.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Hepatologie

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology

UniBE Contributor:

Berzigotti, Annalisa

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1478-3231

Publisher:

Wiley

Language:

English

Submitter:

Thi Thao Anh Pham

Date Deposited:

31 Jan 2018 16:19

Last Modified:

06 Jun 2018 01:31

Publisher DOI:

10.1111/liv.13611

PubMed ID:

29028279

Uncontrolled Keywords:

liver tumors non-invasive diagnosis shear wave elastography ultrasound

BORIS DOI:

10.7892/boris.109576

URI:

https://boris.unibe.ch/id/eprint/109576

Actions (login required)

Edit item Edit item
Provide Feedback