The diagnostic value of ultrasound and shear wave elastography in the differentiation of benign and malignant soft tissu
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SCIENTIFIC ARTICLE
The diagnostic value of ultrasound and shear wave elastography in the differentiation of benign and malignant soft tissue tumors Mesut Ozturk 1 & Mustafa Bekir Selcuk 1 & Ahmet Veysel Polat 1 & Aysu Basak Ozbalci 1 & Yakup Sancar Baris 2 Received: 8 April 2020 / Revised: 25 May 2020 / Accepted: 25 May 2020 # ISS 2020
Abstract Aim To evaluate the diagnostic value of ultrasound (US) and shear wave elastography (SWE) in the differentiation of benign and malignant soft tissue tumors. Materials and methods A hundred and nine patients (mean age 43.3 ± 20.5, range 0–85; 64 men and 45 women) diagnosed with soft tissue tumors between August 2016 and January 2020 were evaluated with US and SWE. The stiffness of the lesions was measured as mean and maximum shear wave velocity (SWVmean and SWVmax) in meters/second (m/s). Two radiologists evaluated the US images independently and then reached a final consensus. Final diagnosis was obtained either by histopathological examination (core needle biopsy or surgery) or by follow-up. The diagnostic value of US and SWE in the differentiation of malignant and benign lesions was assessed. Results Pathology results revealed 37 malignant and 43 benign lesions. Twenty-nine lesions were benign based on follow-up criteria. Consensus US reading revealed 91.9% sensitivity and 72.2% specificity with almost perfect inter-observer agreement (κ = 0.802). Larger lesion size, male gender, advanced patient age, deep location, hypoechoic and hypervascular appearance, illdefined margins, and presence of cystic area were associated with malignant diagnosis (p < 0.001, p = 0.010, p = 0.001, p = 0.001, p = 0.003, p < 0.001, p = 0.001, and p = 0.011, respectively). Median SWVmean and median SWVmax of malignant lesions (2.87 and 2.68) were not significantly different than those of the benign lesions (3.30 and 3.05; p = 0.271 and p = 0.402, respectively). Conclusion US features can differentiate malignant and benign soft tissue tumors, whereas SWE did not contribute to the differentiation of soft tissue tumors. Keywords Soft tissue neoplasms . Sarcoma . Sonoelastography . Ultrasonography
Introduction Soft tissue tumors are a group of neoplasms which consist of benign, intermediate, and malignant histologic subgroups. Radiologists frequently encounter soft tissue tumors, but it is very challenging to differentiate them as benign or malignant based on imaging features. The incidence of soft tissue tumors is reported as 0.3%, and more than 90% of them are benign [1–4]. Therefore, many patients with benign soft tissue tumors * Mesut Ozturk [email protected] 1
Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
2
Department of Pathology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
may undergo unnecessary examinations, and the accurate diagnosis of patients with malignant tumors may be delayed. In addition, a variety of non-neoplastic lesions like fluid collections, epidermal inclusion cysts, fat necrosis, and foreign bodies may mim
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