Characterization of soft tissue tumours with ultrasound, shear wave elastography and MRI

Objective To predict accurately whether a soft tissue mass was benign or malignant and to characterize its type using ultrasound, shear wave elastography and MRI. We hypothesized that with the addition of shear wave elastography, it would be possible to determine a threshold velocity value to classi...

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Bibliographic Details
Published in:Skeletal radiology 2020-06, Vol.49 (6), p.869-881
Main Authors: Winn, N., Baldwin, J., Cassar-Pullicino, V., Cool, P., Ockendon, M., Tins, B., Jaremko, J. L.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Benign
Biopsy
Classification
Diagnosis
Doppler effect
Elasticity Imaging Techniques - methods
Female
Humans
Imaging
Lesions
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Malignancy
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Middle Aged
Nuclear Medicine
Oncology
Orthopedics
Pathology
Prospective Studies
Radiology
Regression models
Scientific Article
Soft Tissue Neoplasms - diagnostic imaging
Soft Tissue Neoplasms - pathology
Soft tissues
Transverse shear
Tumors
Ultrasonic imaging
Ultrasonography - methods
Ultrasound
Velocity
Wave propagation
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Summary:Objective To predict accurately whether a soft tissue mass was benign or malignant and to characterize its type using ultrasound, shear wave elastography and MRI. We hypothesized that with the addition of shear wave elastography, it would be possible to determine a threshold velocity value to classify a lesion as benign or malignant. Materials and methods A total of 151 consecutive, consenting adult patients were prospectively recruited to this study in a tertiary referral musculoskeletal oncology centre. All lesions were assessed with ultrasound, including B mode, Doppler and shear wave elastography measurements. One hundred thirty-eight patients also underwent MRI of the lesion. A histological diagnosis was obtained for all lesions. Results Malignant lesions were larger than benign lesions and had a greater Doppler activity. There was no useful threshold shear wave velocity to differentiate between benign and malignant lesions. Longitudinal and transverse shear wave velocities were strongly positively correlated with each other. An inverse correlation was shown with lesion size and depth, regardless of whether it was benign or malignant. A logistic regression model combining the ultrasound and MRI characteristics did not confidently classify a lesion as benign or malignant and was inferior to expert opinion. Conclusion The strongest predictors of malignancy are large lesion size and high vascularity. The combination of all ultrasound characteristics (including shear wave elastography) and MRI features does not confidently classify a lesion as benign or malignant, and histological diagnosis remains the gold standard.
ISSN:0364-2348
1432-2161
DOI:10.1007/s00256-019-03363-1