Sonoelastography for qualitative and quantitative evaluation of superficial soft tissue lesions: a feasibility study

To evaluate the feasibility of qualitative and quantitative analysis using sonoelastography (SE) for differentiating between benign and malignant superficial soft-tissue lesions.

For this prospective study, 32 patients with superficial soft-tissue lesions detected with grey-scale ultrasound and colour and/or power Doppler ultrasound were evaluated between October 2011 and December 2012. Qualitative analysis: visual grading system was adopted according to colour variation (red-soft, green-medium, blue-hard). Quantitative analysis: median and fraction area of each colour were computed within a region of interest. Differences between fraction areas and median values in compression and decompression phases were calculated. Reference standard: histological findings.

Twelve out of 32 lesions (37.5%) were malignant. Intraclass correlation coefficient (ICC) was 0.989 (95% confidence interval [CI] 0.980-0.994, P < 0.01) with optimal reliability. Area under the curve was 0.823 (95% CI 0.677-0.969) and 0.958 (95% CI 0.989-1.019) for blue and blue area differences, and 0.777 (95% CI 0.615-0.939) and 0.629 (95% CI 0.426-0.833) for red and red area differences, respectively. Blue variations predicted malignancy more accurately (variation ≥0.431: 100% sensitivity, 80% specificity); the blue area difference was highly accurate.

Preliminary results showed good correlations between SE and reference standards. SE could be useful in the evaluation of superficial soft tissue lesions.

• Sonoelastography helps clarify ambiguous soft-tissue lesions identified using conventional ultrasound techniques. • Addition of this tool increases the diagnostic accuracy of ultrasound. • Sonoelastography provides both qualitative and quantitative analysis. • Sonoelastography may help clinicians improve patient care.