AbstractBackground: Ultrasound elastography is a non-invasive diagnostic modality that quantifies tissue stiffness, aiding in the characterization of focal liver lesions (FLLs). This study evaluates its efficacy by correlating Elastography parameters with histopathologic findings.
Materials and Methods: This prospective study was conducted at Tagore Medical College, Chennai, over one year. A total of 100 patients aged 20–80 years with FLLs identified by imaging underwent ultrasound elastography using strain elastography and shear wave elastography. Elastographic parameters—stiffness value, stiffness ratio, shear wave velocity (SWV), and strain ratio—were recorded and compared against histopathologic results.
Results: Malignant lesions were predominant in older males (mean age: 62 years), while benign lesions were common in younger patients (mean age: 38 years). Strain ratio emerged as the most reliable diagnostic parameter, achieving 100% sensitivity and specificity at a cutoff of 2.34. Other parameters, including stiffness value (cutoff: 16.51 kPa, sensitivity: 79.54%, specificity: 81.82%) and SWV (cutoff: 1.96 m/s, sensitivity: 82.10%, specificity: 81.81%), also demonstrated strong diagnostic accuracy. Lesion-specific analysis revealed significantly higher stiffness and SWV for metastatic lesions compared to hemangiomas (P < 0.05).
Conclusion: Ultrasound elastography is a valuable non-invasive tool for differentiating benign and malignant liver lesions, with strain ratio being the most discriminatory parameter. These findings support elastography’s integration into routine diagnostic protocols to enhance clinical decision-making.
