Ultrasound tissue scatterer distribution imaging: An adjunctive diagnostic tool for shear wave elastography in characterizing focal liver lesions

Chien-Ming Chen; Ya-Chun Tang; Shin-Han Huang; Kuang-Tse Pan; Kar-Wai Lui; Yan-Heng Lai; Po-Hsiang Tsui

doi:10.1016/j.ultsonch.2023.106716

Ultrasound tissue scatterer distribution imaging: An adjunctive diagnostic tool for shear wave elastography in characterizing focal liver lesions

Ultrason Sonochem. 2023 Dec:101:106716. doi: 10.1016/j.ultsonch.2023.106716. Epub 2023 Dec 7.

Authors

Chien-Ming Chen¹, Ya-Chun Tang², Shin-Han Huang³, Kuang-Tse Pan¹, Kar-Wai Lui¹, Yan-Heng Lai³, Po-Hsiang Tsui⁴

Affiliations

¹ Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
² Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: tyj@cgmh.org.tw.
³ Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁴ Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Research Center for Radiation Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: tsuiph@mail.cgu.edu.tw.

Abstract

Objectives: Focal liver lesion (FLL) is a prevalent finding in cross-sectional imaging, and distinguishing between benign and malignant FLLs is crucial for liver health management. While shear wave elastography (SWE) serves as a conventional quantitative ultrasound tool for evaluating FLLs, ultrasound tissue scatterer distribution imaging (TSI) emerges as a novel technique, employing the Nakagami statistical distribution parameter to estimate backscattered statistics for tissue characterization. In this prospective study, we explored the potential of TSI in characterizing FLLs and evaluated its diagnostic efficacy with that of SWE.

Methods: A total of 235 participants (265 FLLs; the study group) were enrolled to undergo abdominal examinations, which included data acquisition from B-mode, SWE, and raw radiofrequency data for TSI construction. The area under the receiver operating characteristic curve (AUROC) was used to evaluate performance. A dataset of 20 patients (20 FLLs; the validation group) was additionally acquired to further evaluate the efficacy of the TSI cutoff value in FLL characterization.

Results: In the study group, our findings revealed that while SWE achieved a success rate of 49.43 % in FLL measurements, TSI boasted a success rate of 100 %. In cases where SWE was effectively implemented, the AUROCs for characterizing FLLs using SWE and TSI stood at 0.84 and 0.83, respectively. For instances where SWE imaging failed, TSI achieved an AUROC of 0.78. Considering all cases, TSI presented an overall AUROC of 0.81. There was no statistically significant difference in AUROC values between TSI and SWE (p > 0.05). In the validation group, using a TSI cutoff value of 0.67, the AUROC for characterizing FLLs was 0.80.

Conclusions: In conclusion, ultrasound TSI holds promise as a supplementary diagnostic tool to SWE for characterizing FLLs.

Keywords: Envelope statistics; Focal liver lesion; Nakagami distribution; Ultrasound.

MeSH terms

Diagnosis, Differential
Elasticity Imaging Techniques* / methods
Humans
Liver Neoplasms* / diagnostic imaging
Liver Neoplasms* / pathology
Prospective Studies
Ultrasonography