Background: Hepatocellular carcinoma (HCC) has an increasing incidence worldwide, and is considered the second
cause of cancer-related death.
Aim: The aim of the study is to assess the usefulness of real-time shear-wave elastography in differentiating HCC from other
hepatic focal lesions.
Patients and methods: The current study was conducted on 110 patients in addition to 10 healthy subjects, divided into
four groups as follows: liver cirrhosis, HCC, hepatic focal lesions other than HCC, and control. Demographic, laboratory
and imaging data were collected and then elastographic assessment of the hepatic focal lesions and the surrounding liver
parenchyma using elastograph point quantification (ElastPQ) (iU22x MATRIX, Philips) was done.
Results: ElastPQ (iU22x MATRIX, Philips) has shown its ability to differentiate between HCC and cystic focal lesions, HCC
and cholangiocarcinoma, and HCC and focal nodular hyperplasia (FNH). Cystic lesions demonstrated lower stiffness in
comparison to HCC; however, cholangiocarcinoma and FNH demonstrated higher stiffness in comparison to HCC. ElastPQ
was unable to differentiate between stiffness in both ‘HCC and hemangioma’ and ‘HCC and metastatic focal lesions’. ElastPQ
showed that HCC, cystic focal lesions, and cholangiocarcinoma had lower stiffness in comparison to their surrounding
liver parenchyma, whereas FNH had higher stiffness in comparison to the surrounding liver parenchyma. ElastPQ showed
that the surrounding liver parenchyma of the HCC group has the highest stiffness amongst all studied hepatic focal lesions
surrounding liver parenchyma.
Conclusion: ‘Point’ shear-waves elastography (ElastPQ; Philips iU22x MATRIX, Philips) is a noninvasive, quantitative and
nonradiating method for evaluation of tissue elasticity, and is helpful in differentiating HCC from other hepatic focal lesions.