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Eur Radiol. 2017 Feb;27(2):723-731. doi: 10.1007/s00330-016-4427-y. Epub 2016 Jun 8.

Do quantitative and qualitative shear wave elastography have a role in evaluating musculoskeletal soft tissue masses?

Author information

1
Musculoskeletal Centre X-Ray Department, Leeds Teaching Hospitals Trust, Chapel Allerton Hospital, Leeds, UK.
2
Chapel Allerton Hospital, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK.
3
Musculoskeletal Centre X-Ray Department, Leeds Teaching Hospitals Trust, Chapel Allerton Hospital, Leeds, UK. Philip.robinson10@nhs.net.
4
Chapel Allerton Hospital, University of Leeds and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK. Philip.robinson10@nhs.net.

Abstract

OBJECTIVES:

To determine if quantitative and qualitative shear wave elastography have roles in evaluating musculoskeletal masses.

METHODS:

105 consecutive patients, prospectively referred for biopsy within a specialist sarcoma centre, underwent B-mode, quantitative (m/s) and qualitative (colour map) shear wave elastography. Reference was histology from subsequent biopsy or excision where possible. Statistical modelling was performed to test elastography data and/or B-mode imaging in predicting malignancy.

RESULTS:

Of 105 masses, 39 were malignant and 6 had no histology but benign characteristics at 12 months. Radiologist agreement for B-mode and elastography was moderate to excellent Kw 0.52-0.64; PABAKw 0.85-0.90). B-Mode imaging had 78.8% specificity, 76.9% sensitivity for malignancy. Quantitatively, adjusting for age, B-mode and lesion volume there was no statistically significant association between longitudinal velocity and malignancy (OR [95% CI] 0.40[0.10, 1.60], p=0.193), but some evidence that higher transverse velocity was associated with decreased odds of malignancy (0.28[0.06, 1.28], p=0.101). Qualitatively malignant masses tended to be towards the blue spectrum (lower velocities); 39.5% (17/43) of predominantly blue masses were malignant, compared to 14.3% (1/7) of red lesions.

CONCLUSIONS:

Quantitatively and qualitatively there is no statistically significant association between shear wave velocity and malignancy. There is no clear additional role to B-mode imaging currently.

KEY POINTS:

• Correlation between shear wave velocity and soft tissue malignancy was statistically insignificant • B-mode ultrasound is 76.9 % sensitive and 78.8 % specific • Statistical models show elastography does not significantly add to lesion assessment.

KEYWORDS:

Elasticity imaging techniques; Imaging; Sarcoma; Soft tissue neoplasms; Ultrasound

PMID:
27277260
PMCID:
PMC5209430
DOI:
10.1007/s00330-016-4427-y
[Indexed for MEDLINE]
Free PMC Article

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