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Subject Area

Endemic and Tropical Medicine

Article Type

Original Study

Abstract

Objectives This work aimed to evaluate the diagnostic role of point shear wave elastography (PSWE) for the differentiation of benign and malignant hepatic focal lesions (HFLs). Background Elastography is a medical imaging modality that maps the elastic properties and stiffness of soft tissue. The main applications of PSWE in the liver are assessment of fibrosis and characterization of HFLs. Patients and methods The current study included 135 patients in addition to 20 healthy volunteers. These participants were divided into four groups: group I (50 patients with nonmalignant HFLs), group II (70 patients with malignant HFLs), group III (15 patients with liver cirrhosis) and group IV (20 healthy volunteers as a control group). Demographic, laboratory, and imaging data were collected, and then elastographic assessment of the HFLs and the surrounding liver parenchyma using point quantification elastography (ElastPQ) (iU22x MATRIX, Philips) was done. Results ElastPQ (iU22x MATRIX, Philips) has shown respectable ability to differentiate between hepatocellular carcinoma and other malignant HFLs by calculation of SWE of HFL to SWE of surrounding liver parenchyma ratio (P < 0.001). ElastPQ has shown its ability to differentiate between regenerative liver nodule and different benign HFLs (P value <0.001). ElastPQ had the ability to differentiate between hemangioma and focal nodular hyperplasia (P < 0.001) and also hemangioma and hepatic abscess (P = 0.005). Cystic lesions demonstrated lower stiffness in comparison with hepatocellular carcinoma. Conclusion Although PSWE is a noninvasive quantitative and nonradiating safe imaging machine, it lacks sensitivity, specificity, and accuracy in differentiation between malignant and nonmalignant focal liver lesions.

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