Application of acoustic radiation force impulse imaging for the evaluation of focal liver lesion elasticity

BackgroundAcoustic radiation force impulse (ARFI) imaging is a new elastography method for the evaluation of tissue stiffness. This study aims to evaluate the performance of ARFI in noninvasive assessment of the tissue stiffness of focal liver lesion (FLL) and to explore its potential value in the differential diagnosis of FLL.MethodsARFI was performed in 140 patients with 154 FLLs, which included 28 hemangiomas (ANGIs), 14 focal nodular hyperplasias (FNHs), 61 hepatocellular carcinomas (HCCs), 39 metastases and 12 cholangiocellular carcinomas (CCCs). Virtual touch tissue quantification (VTTQ) values were obtained, analyzed and compared. The area under the receiver operating characteristic curve (AUROC) and optimal cut-off values were obtained using a receiver operating characteristic (ROC) curve analysis to assess diagnostic performance. All cases were definitively diagnosed using histopathology, CT, MRI or contrast-enhanced ultrasound.ResultsThe VTTQ median values of ANGI, FNH, HCC, metastasis and CCC were 1.30, 1.80, 2.52, 3.08 and 3.89 m/s, respectively. A significant increase in the VTTQ values of different lesions was observed: ANGI