Wei Zheng1, Zhong-Guo Zhou2, Chong-Hei Wong2,3, Xiao-Qing Pei4, Shu-Lian Zhuang5, Qing Li1, Min-Shan Chen2, An-Hua Li1, Fu-Jun Zhang6. 1. Department of Ultrasound, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China. 2. Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China. 3. Department of Oncology, Centro Hospitalar Conde de S. Januario (CHCSJ), Macao, People's Republic of China. 4. Department of Ultrasound, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China. peixq@sysucc.org.cn. 5. Department of Ultrasonography, the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, 510120, People's Republic of China. 6. Minimally Invasive Interventional Centre, Sun Yat-sen University Cancer Centre, State Key Laboratory of Oncology in South China; Collaborative Innovation Centre for Cancer Medicine, Guangzhou, Guangdong, 510060, People's Republic of China. windyangle@163.com.
Abstract
OBJECTIVES: To determine the methodology of non-invasive test for evaluation of liver stiffness (LS) with tumours using two-dimensional (2D) shear wave elastography (SWE). METHODS: One hundred and twenty-seven patients with liver tumours underwent 2D-SWE before surgery to measure liver and spleen stiffness (SS). Two-dimensional SWE values were obtained in the liver at 0-1 cm, 1-2 cm and >2 cm from the tumour edge (PLS-1, PLS-2 and RLS, respectively). The influence of tumour-associated factors was evaluated. The area under the receiver operating characteristic curve (AUC) for each value was analysed to diagnose cirrhosis. RESULTS: PLS-1 was higher than PLS-2, which was even higher than RLS (p < 0.001). The AUCs of PLS-1, PLS-2, RLS and SS for diagnosing cirrhosis were 0.760, 0.833, 0.940 and 0.676, with the specificity of 75.7%, 67.6%, 90.3% and 77.4%, respectively. Tumour sizes, locations or types showed no apparent influence on 2D-SWE values except for RLS, which was higher in patients with primary hepatic carcinomas (p < 0.05). CONCLUSIONS: LS with tumours is best measured at >2 cm away from the tumour edge. SS measurement could be used as an alternative to LS measurement in the event of no available liver for detection. KEY POINTS: • Tumour-associated factors impact background liver stiffness assessment. • Background liver stiffness is best measured at >2 cm from tumour edge. • Spleen stiffness can be an alternative to assess background liver stiffness.
OBJECTIVES: To determine the methodology of non-invasive test for evaluation of liver stiffness (LS) with tumours using two-dimensional (2D) shear wave elastography (SWE). METHODS: One hundred and twenty-seven patients with liver tumours underwent 2D-SWE before surgery to measure liver and spleen stiffness (SS). Two-dimensional SWE values were obtained in the liver at 0-1 cm, 1-2 cm and >2 cm from the tumour edge (PLS-1, PLS-2 and RLS, respectively). The influence of tumour-associated factors was evaluated. The area under the receiver operating characteristic curve (AUC) for each value was analysed to diagnose cirrhosis. RESULTS:PLS-1 was higher than PLS-2, which was even higher than RLS (p < 0.001). The AUCs of PLS-1, PLS-2, RLS and SS for diagnosing cirrhosis were 0.760, 0.833, 0.940 and 0.676, with the specificity of 75.7%, 67.6%, 90.3% and 77.4%, respectively. Tumour sizes, locations or types showed no apparent influence on 2D-SWE values except for RLS, which was higher in patients with primary hepatic carcinomas (p < 0.05). CONCLUSIONS: LS with tumours is best measured at >2 cm away from the tumour edge. SS measurement could be used as an alternative to LS measurement in the event of no available liver for detection. KEY POINTS: • Tumour-associated factors impact background liver stiffness assessment. • Background liver stiffness is best measured at >2 cm from tumour edge. • Spleen stiffness can be an alternative to assess background liver stiffness.
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