Is ultrasound elastography adding value in diagnosis of focal hepatic lesions? Our experience in a single-center study

Background The aim of this study was to assess the use of ultrasound elastography in differentiating hepatic lesions in order to increase the sensitivity and specificity of grey-scale ultrasound. Methods This study included 104 patients who were referred to the radiology department at Alexandria Main University Hospital for focal hepatic lesions detected by grey-scale ultrasound and were recommended to undergo further evaluation by ultrasound elastography. All studied patients were subjected to the following: (1) grey-scale ultrasound and ultrasound elastography using semiquantitative technique and (2) triphasic MDCT of the liver. MRI was done in 11 patients with malignant lesions; further confirmation with histopathological assessment was conducted. Results Benign lesions showed a low strain ratio, while malignant lesions showed a high strain ratio. The mean ratio in the benign lesions was 1.08 +/- 0.40, while the mean ratio in the malignant lesions was 4.14 +/- 1.25. The cut-off value used to diagnose the malignant lesions and differentiate these lesions from the benign lesions was 1.7, which had a sensitivity of 100%, specificity of 93.10%, PPV of 97.40% and NPV of 100%. Conclusion Ultrasound elastography is a promising non-invasive, non-contrast technique that can be added to routine grey-scale sonographic examinations of the liver to characterize hepatic lesions.