The role of acoustic radiation force impulse elastography to differentiate benign and malignant focal liver masses

Aim: The aim of this study was to compare benign and malign focal liver lesions and background liver tissue elasticity with acoustic radiation force impulse technology . Material and Methods: This prospective study included 70 liver lesions, which were detected on conventional ultrasonography in our department between January 2016 and October 2016. It was performed 5 measurements per each lesion and 2 measurements in the surrounding liver. Acoustic radiation force impulse (ARFI) measurement for each tumor type were expressed as mean ± standart deviation for liver tumor and background liver ARFI values were also compared with tumor type and surrounding liver tissue. Results: For liver tumors, the mean stiffness values were 2,15± 0,73 m/s for hemangioma (n= 34), 3,22 ± 0,18 m/s for focal nodular hyperplasia (n=4), 2,75 ± 0,53 m/s for hepatocellular carcinoma (n=10), 3,59±0,51 m/s for metastasis (n=22). Altough there wasn't significant difference between hemangioma and HCC lesions (p>0,05), there was significant difference between hemangioma and FNH, metastasis (p<0,05). There were significant differences in ARFI values between malignant and benign masses ( mean 3,31 m/s vs 2,26 m/s ). The areas under the receiver operating characteristics curves (AUROC) for discrimination the malignant masses from benign liver masses were 0,826 (p<0,001). An ARFI value of 2,32 m/s was selected as cut-off value to differentiate malignant from benign liver masses (sensitivity:0,93- specifity:0,60). Conclusion: Although, acoustic radiation force impulse (ARFI) is not enough method in the primary diagnosis of focal solid liver lesions at this stage, it provides non-invasively additional important infor