Aims and objectives
The objective of this study is to evaluate the elastographic patterns in soft tissue lesions based on elastographic scores (ES) for a benign vs.
malignant differential diagnosis,
in order to determine the diagnostic performance of real-time elastography.
The principle of elastography is that tissue compression produces strain (displacement) within the tissue and that the strain is smaller in harder tissue than in softer tissue.
Therefore,
by measuring the tissue strain induced by compression,
we can estimate tissue hardness,
which may be useful in diagnosing cancers....
Methods and materials
From September 2016 to July 2017,
the conventional ultrasonography examination (US),
completed by real-time free-hand elastography,
was performed in 34 consecutive patientsintheevaluationof some soft tissues lesion at "IRCCS G.
Pascale Foundation",
in Naples,
Italy.
First,
conventional US images of the soft tissues lesion were obtained and then,
after identification of a target lesion,
real-time elastography was performed using the same probe.The patients underwent both B-mode and sonoelastographic examinations with a digital sonography scanner (MyLab70 Twice Scanner,
Esaote) equipped with real-time tissue elastography software,
using a...
Results
Afterobserving all the elastograms,the radiologistassigned each image obtained,
in one of5 different elastographic scores (ES).
A score of 1 indicatedstrain in the entire lesion,
with absentorvery small hard area (blue area).
A score of 2 indicated strain inmost of the lesion,
with some hard areas (small scattered blue areasortotal blue area <45%).
A score of 3 indicated few areas of strainwith a greater hard part(large blue areas not scattered but confluent or total blue area>45%).
A score of 4 indicateda hard peripheral part with central...
Conclusion
In our preliminary experience,
ES could improve US performance in the differential diagnosis between benign and malignant soft tissue lesions
In the ES3 pattern,
the role of elastography is very limited as our data demonstrated,
while in the other patterns there was complete clinical/histological concordance.Indeed in the 15 cases with ES3 pattern,
only 8/10 were confirmed as true negative in histology,
while the remaining 7/15 were found as false negative in histology.
However,
further studies will berequired in order to improve understanding and interpreting elastography...
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Elastography:...