ACOUSTIC RADIATION FORCE IMPULSE ELASTOGRAPHY FOR THE DIFFERENTIAL DIAGNOSIS OF LIVER TUMORS IN PATIENTS WITH LIVER DYSFUNCTION

Objective : Acoustic radiation force impulse (ARFI) technology can measure the elasticity of tissue and tumor. The aim of this study was to evaluate whether the ARFI technology can differentiate cavernous hemangioma, hepatocellular carcinoma (HCC) and metastatic liver tumors in patients with liver dysfunction. Materials and Methods : Forty patients with liver dysfunction and liver tumors were enrolled in the study. The shear wave velocities (SWVs) in the tumors and background liver were examined by ARFI elastography under ultrasonography (US). Results : The SWVs in livers bearing HCCs were significantly higher than those of livers bearing cavernous hemangiomas. The SWVs in HCCs and metastatic liver tumors were significantly higher than those in cavernous hemangiomas. The SWVs in metastatic liver tumors were significantly higher than those in HCCs. The SWV ratio of metastatic liver tumor/parenchyma was significantly higher than that of cavernous hemangioma/parenchyma and HCC/parenchyma. There was a significant correlation between the tumor sizes and the SWVs in metastatic liver tumors. Conclusions : We herein demonstrated that ARFI elastography could noninvasively provide helpful information, without the need for biopsy, that could be used for the differential diagnosis among cavernous hemangiomas, HCCs and metastatic liver tumors in patients with liver dysfunction.