The Added Diagnostic Value of Shear Wave Elastography to Differentiate between Benign and Malignant Musculoskeletal Soft Tissue Tumors

Abstract

Background: It is highly challenging for radiologists to differentiate benign from malignant soft tissue tumors using imaging features alone. The present work aimed for evaluation the diagnostic value of ultrasound (US) as well as the shear wave elastography to differentiate benign from malignant soft tissue tumors. Methods: We conducted this prospective cross-sectional study on 30 cases who were clinically suspected to have superficial soft tissue masses in Radio-diagnosis Department, Faculty of Medicine, Zagazig University. All cases were subjected to entire history taking with clinical assessment. In addition to radiological assessment including US, Doppler US, and SWE and compared with histopathological findings. Results: On conducting Receiver operation Curve (ROC) analysis to determine the optimal cutoff value to discriminate benign from malignant lesions value at cut-off value (4.5), the analysis showed that average velocity of shear wave elastography had the highest sensitivity (80.95%) and specificity (88.89%) with an area under the curve was (0.751). There was significant difference between histopathological finding and age and sex (p=0.03 and 0.008 respectively) There was significant difference between histopathological and ultrasonographic findings as regard size, cystic component, invasion, definition of margin, echogenicity and vascularity types (p= 0.02, 0.03, 0.02, 0.001, 0.03 and 0.001 respectively) with a sensitivity of (88.9%), specificity of (90.5%) and accuracy of (90%). Conclusion: Despite the fact that ultrasound characteristics can differentiate benign from malignant tumors of soft tissues, but the combined use of Shear Wave Elastography and ultrasound together can increase the diagnostic validity and considered a first-line diagnostic tool