Comparison of Point Shear Wave Elastography and 2-Dimensional Shear Wave Elastography Values of Liver Metastases from Colorectal Cancer

Nowadays ultrasound-based non-invasive techniques for the evaluation of tissue elasticity are becoming increasingly popular. A key determinant for the adequate treatment of focal liver lesions is on establishment of accurate diagnosis. Contemporary imaging modalities, particularly ultrasonographic, are widely accepted for assessing the elasticity of focal liver lesions but the investigation of their accuracy and differentiation potential is still ongoing. Aim: To compare the values of point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) for liver metastases from colorectal cancer. Materials and Methods: A total of 31 adult patients with liver metastases from colorectal cancer (CRC) were included from the Department of Gastroenterology of University Hospital Kaspela, Plovdiv, Bulgaria, in the period June 2022 to November 2022. The men/women ratio of the participants was respectively 11 women and 20 men. For all of them point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) were performed to evaluate the stiffness of liver metastases, by measuring the shear wave velocity (SWV) in a region of interest (ROI). Prior histological confirmation of colorectal cancer through diagnostic lower endoscopy was a prerequisite for inclusion in the study. Contrast-enhanced computer tomography (CECT) was used as a reference imaging modality to confirm the presence of lesions in the liver. All the images were evaluated by a radiologist with long-standing experience in liver imaging. Results: For point shear wave elastography (pSWE), the lower limit was found to be 1.80 m/s (90% CI: 1.39 to 2.32) and the upper limit was 4.21 m/s (90% CI: 3.69 to 4.60). For two-dimensional shear wave elastography (2D-SWE), the lower limit was determined to be 1.87 m/s (90% CI: 1.54 to 2.25) and the upper limit was 3.65 m/s (90% CI: 3.26 to 3.97). Conclusions: Point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) could bring additional information about the stiffness of liver metastases from colorectal cancer but they are not to be considered a method to substitute biopsy of colorectal cancer during lower endoscopy

Point Shear Wave Elastography and 2-Dimensional Shear Wave Elastography as a Non-Invasive Method in Differentiating Benign from Malignant Liver Lesions

Non-invasive, ultrasound-based methods for visualizing and measuring tissue elasticity are becoming more and more common in routine daily practice. An accurate diagnosis of malignant and benign tumors is essential for determining the appropriate treatment. Despite the wide use of imaging techniques, the investigation for assessing the elasticity of focal liver lesions and their differentiating is still continuing. Aim: To investigate the value of point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) for the differential diagnosis of benign and malignant focal liver lesions. Materials and Methods: A total of 125 adult patients were included from the Clinic of Gastroenterology of University Hospital Kaspela, Plovdiv city, Bulgaria, in the period from January 2021 to July 2022. Participants were divided into two groups—with benign (hemangiomas) and malignant focal liver lesions (hepatocellular carcinoma). The group with benign lesions included 63 patients and the group with malignant focal liver lesions (FLLs)—62 patients. Point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) integrated in the same ultrasound machine (Esaote MyLab™ 9Exp) were performed for each lesion. Results: Malignant FLLs have significantly higher stiffness in both pSWE (2.52–4.32 m/s, 90% CI: 2.37 to 2.68, 90% CI: 4.19 to 4.55) and 2d-SWE (2.52–4.43 m/s, 90% CI: 2.31 to 2.65, 90% CI: 4.27 to 4.61). Conclusion: 2D-SWE and pSWE could provide complementary data about FLLs. They enable us to conveniently and easily obtain accurate stiffness information of FLLs