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Background <p>Ultrasound elastography has various applications in different fields of medicine with encouraging outcomes. Theoretically, transthoracic pleural two-dimensional shear-wave elastography (2D-SWE) could aid in differentiating benign peripheral lung lesions from malignant lesions through adding accurate information about tissue stiffness to B-mode gray scale ultrasound obtained images. A cross-sectional study was conducted to evaluate the predictive value of 2D-SWE for diagnosing peripheral lung lesions. Forty-seven patients with a peripheral pulmonary lesion illustrated by radiography were enrolled. 2D-SWE was conducted to assess the lesions of interest. The elasticity of subpleural lung lesions was measured and expressed as shear-wave velocity (m/s) and shear-wave elasticity (kPa). Final diagnoses were made on the basis of pathology report for either sonographic or computed tomography (CT)-guided&#xa0;or bronchoscopic biopsy if indicated and/or microbiological studies.</p> Results <p>Majority (83%) of included patients were males. Mean age for study participants was 55.34 ± 14.47 years. Demographic and baseline data for patients exhibiting malignant lesions versus those with non-malignant lesions showed no significant differences. Mean value for shear-wave elasticity&#xa0;(SWE) and shear-wave velocity&#xa0;(SWV) were significantly higher among patients with malignant lesions versus patients with non-malignant lesions (46.7 ± 29.9 kPa vs. 16.4 ± 10.6 kPa for SWE; 3.7 ± 1.2 m/s vs. 2.24 ± 0.68 m/s for SWV). ROC&#xa0;curve analysis was used to identify the cut-off value regarding shear-wave elasticity and velocity for predicting malignant peripheral lung lesions. SWE at the cut-off value of 20.33 kPa showed 81.8% sensitivity, 76% specificity, and 0.86 area under the curve (AUC). While, SWV at cut-off value of 2.6 m/s, the sensitivity was 81.8% and the specificity was 76% with 0.855 AUC.</p> Conclusions <p>Transthoracic shear-wave ultrasound elastography can be applied as a promising tool for assessing unidentified and difficult-to-diagnose peripheral lung lesions. A cutoff point of 20.33 kPa for shear-wave elasticity and 2.6 m/s for shear-wave velocity is suggested for predicting lung malignancy in peripheral lung lesions. </p> Trial registration <p>NCT05759390. Registered February 26, 2023.</p>

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Transthoracic ultrasound shear-wave elastography: can it play a role in assessing peripheral lung lesions?

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月23日

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  • Manal A. Mahmoud,
  • Samiaa Hamdy Sadek,
  • Ramy Mohammed Ahmed,
  • Asmaa Abdeltawab,
  • Waleed Gamal Elddin Khaleel

摘要

Background

Ultrasound elastography has various applications in different fields of medicine with encouraging outcomes. Theoretically, transthoracic pleural two-dimensional shear-wave elastography (2D-SWE) could aid in differentiating benign peripheral lung lesions from malignant lesions through adding accurate information about tissue stiffness to B-mode gray scale ultrasound obtained images. A cross-sectional study was conducted to evaluate the predictive value of 2D-SWE for diagnosing peripheral lung lesions. Forty-seven patients with a peripheral pulmonary lesion illustrated by radiography were enrolled. 2D-SWE was conducted to assess the lesions of interest. The elasticity of subpleural lung lesions was measured and expressed as shear-wave velocity (m/s) and shear-wave elasticity (kPa). Final diagnoses were made on the basis of pathology report for either sonographic or computed tomography (CT)-guided or bronchoscopic biopsy if indicated and/or microbiological studies.

Results

Majority (83%) of included patients were males. Mean age for study participants was 55.34 ± 14.47 years. Demographic and baseline data for patients exhibiting malignant lesions versus those with non-malignant lesions showed no significant differences. Mean value for shear-wave elasticity (SWE) and shear-wave velocity (SWV) were significantly higher among patients with malignant lesions versus patients with non-malignant lesions (46.7 ± 29.9 kPa vs. 16.4 ± 10.6 kPa for SWE; 3.7 ± 1.2 m/s vs. 2.24 ± 0.68 m/s for SWV). ROC curve analysis was used to identify the cut-off value regarding shear-wave elasticity and velocity for predicting malignant peripheral lung lesions. SWE at the cut-off value of 20.33 kPa showed 81.8% sensitivity, 76% specificity, and 0.86 area under the curve (AUC). While, SWV at cut-off value of 2.6 m/s, the sensitivity was 81.8% and the specificity was 76% with 0.855 AUC.

Conclusions

Transthoracic shear-wave ultrasound elastography can be applied as a promising tool for assessing unidentified and difficult-to-diagnose peripheral lung lesions. A cutoff point of 20.33 kPa for shear-wave elasticity and 2.6 m/s for shear-wave velocity is suggested for predicting lung malignancy in peripheral lung lesions.

Trial registration

NCT05759390. Registered February 26, 2023.