The application of conventional us and transthoracic ultrasound elastography in evaluating peripheral pulmonary lesions

The aim of the present study was to evaluate the diagnostic value of ultrasound (US) elastography in differentiating between benign and malignant peripheral lung lesions (PLLs). This retrospective study included 91 consecutive patients with 91 PLLs. Conventional US, strain elastography (SE), acoustic radiation force impulse imaging (ARFIimaging) and point share wave elastography (p-SWE) were performed. All of the pathological results were confirmed by US-guided biopsies or surgeries. There were 36 benign PLLs and 55 malignant PLLs on pathology. For conventional US, a lesion diameter ≥5 cm, irregular contour, presence of air bronchogram and non-abundant vascularity were predictive factors of malignancy (P<0.05). SE scores were observed to be invalid in differentiating between malignant and benign PLLs (P=0.542). For ARFIimaging scores, an elasticity score of 3 or greater was predictive of malignancy, with a sensitivity of 83.6% (46/55) and a specificity of 52.8% (19/36). For p-SWE, the share wave velocity of malignant PLLs was higher than benign ones (2.47±0.92 vs. 1.85±0.92 m/sec; P=0.0022). When 1.951 m/sec was selected as the cut-off value, a sensitivity of 70.9% (39/55) and a specificity of 69.4% (25/36) were obtained. Thus, US, particularly US elastography, is helpful in distinguishing malignant PLLs from benign PLLs.