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Abstract - Real time strain elastography for differentiation of solid renal masses
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Fatih Mehmet Tezcan


Objective: The aim of this study was to investigate the diagnostic performance of real time strain elastography for evaluation of solid renal masses.

Material and methods: Forty two patients who were incidentally detected solid renal masses underwent Real Time Strain Elastography. Strain index value was detected for each lesion by dividing ROI of lesion to ROI of adjacent renal cortex. Strain index values and color encoding patterns of lesions and renal parenchyma were obtained. Mean strain index values and color encoding patterns for benign and malignant lesions were compared. Also by using ROC curve, cut-off value was obtained and diagnostic performance of method was evaluated.

Results: Any statistically significant difference of mean ages of patients was not found. Mean strain index value of malignant lesions were significantly higher than benign lesions. When cut-off value for strain index ratio was taken 0.3, high diagnostic performance was obtained for differentiation of solid renal masses as benign or malignant.

Conclusion: Real time strain elastography can be useful for differentiation of solid renal masses as malignant or benign.

Key words: elastography, solid renal mass, kidney, strain

Corresponding author: Fatih Mehmet Tezcan. fatihtezcan427@gmail.com



1. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics 2007. CA Cancer J Clin. 2007; 57:43-66. https://doi.org/10.3322/canjclin.57.1.43


2. Luciani LG, Cestar R, Tallarigo C. Incidental renal cell carcinoma-age and stage characterizatıon and clinical implications: study of 1092 patients. Urology. 2000; 56:58-62. https://doi.org/10.1016/S0090-4295(00)00534-3


3. Stakhovskyi O, Yap SA, Leveridge M, Lawrentschuk N, Jewett MA. Small renal mass: what the urologist needs to know for treatment planning andassessment of treatment results. AJR Am J Roentgenol. 2011; 196:1267-1273. https://doi.org/10.2214/AJR.10.6336


4. Kutikov A, Fossett LK, Ramchandani P, et al. Incidence of benign pathologic findings at partial nephrectomy for solitary renal mass presumed to be renal cell carcinoma on preoperative imaging. Urology. 2006; 68:737-740. https://doi.org/10.1016/j.urology.2006.04.011


5. Chang JY, Moon JH, Koh SH, Park SY, Lee KS. Clinical Application of ShearWave Elastography in Breast Masses. Iran J Radio. 2017; 14(1):e39585. https://doi.org/10.5812/iranjradiol.39585


6. Altunkeser A, Alkan E, Günenç O, Tolu I, Körez MK. Evaluation of a Healthy Pregnant Placenta with Shear Wave Elastography. Iran J Radio. 2018; 16(1):e68280. https://doi.org/10.5812/iranjradiol.68280


7. Dumitriu D, Dudea S, Botar-Jid C, Baciut M, Baciut G. Real-time sonoelastography of major salivary gland tumors. AJR Am J Roentgenol. 2011; 197:924-930. https://doi.org/10.2214/AJR.11.6529


8. Onur MR, Poyraz AK, Bozgeyik Z, et al. Utility of semiquantitative strain elastography for differentiation between benign and malignant solid renal masses. J Ultrasound Med. 2015; 34(4):639-647. https://doi.org/10.7863/ultra.34.4.639


9. Aydin S, Yildiz S, Turkmen I, Sharifov R, Uysal O, Gucin Z, ArmaganA, Kocakoc E. Value of shear wave elastography for differentiatingbenign and malignant renal lesions. Med Ultrason. 2018; 1:21-26. https://doi.org/10.11152/mu-1161


10. Pallwein-Prettner L, Flöry D, Rotter CR, et al. Assessment and characterisation of common renal masses with CT and MRI. Insights Imaging. 2011; 2:543-556. https://doi.org/10.1007/s13244-011-0116-1


11. Lyshchik A, Higashi T, Asato R, et al. Thyroid Gland Tumor Diagnosis at US Elastography. Radiology. 2005; 237:202-211. https://doi.org/10.1148/radiol.2363041248


12. Lyshchik A, Higashi T, Asato R, et al. Cervical Lymph Node Metastases: Diagnosis at Sonoelastography-Initial Experience. Radiology. 2007; 243 :258-267. https://doi.org/10.1148/radiol.2431052032


13. Kumar V, Cotran RS, Robbins Sl. Basic Pathology 6th ed. Ankara: Çevikbaş U. 2000; 475-476.


14. Lee JW, Lorenzo EI, Ahn B, et al. Palpation device for the identification of kidney and bladder cancer: a pilot study. Yonsei Med J. 2011; 52:768-772. https://doi.org/10.3349/ymj.2011.52.5.768


15. Derieppe M, Delmas Y, Gennisson JL, et al. Detection of intrarenal microstructural changes with supersonic shear wave elastography in rats. Eur Radiol. 2012; 22:243-250. https://doi.org/10.1007/s00330-011-2229-9


16. Emelianov SY, Lubinski MA, Weitzel WF, Wiggins RC, Skovoroda AR, O'Donnell M. Elasticity imaging for early detection of renal pathology. Ultrasound Med Biol. 1995; 21:871-883.


17. Gallotti A, D'Onofrio M, Pozzi Mucelli R. Acoustic Radiation Force Impulse (ARFI) technique in ultrasound with Virtual Touch tissue quantification of the upper abdomen. Radiol Med. 2010; 115:889-897. https://doi.org/10.1007/s11547-010-0504-5


18. Arda K, Ciledag N, Aktas E, Aribas BK, Köse K. Quantitative assessment of normal soft-tissue elasticity using shear-wave ultrasound elastography. AJR Am J Roentgenol. 2011; 197:532-536.


19. Clevert DA, Stock K, Klein B, et al. Evaluation of Acoustic Radiation Force Impulse (ARFI) imaging and contrast-enhanced ultrasound in renal tumors of unknown etiology in comparison to histological findings. Clin Hemorheol Microcirc. 2009; 43:95-107. https://doi.org/10.3233/CH-2009-1224


20. Onur MR, Poyraz AK, Bozgeyik Z, et al. (2015) Utility of semiquantitative strain elastography for differentiation between benign and malignant solid renal masses. J Ultrasound Med. 34(4):639-647. https://doi.org/10.7863/ultra.34.4.639


21. Aydin S, Yildiz S, Turkmen I, Sharifov R , Uysal O, Gucin Z, Armagan A, Kocakoc E. Value of Shear Wave Elastography for Differentiating Benign and Malignant Renal Lesions. Med Ultrason. 2018;1(1):21-26. doi: 10.11152/mu-1161. https://doi.org/10.11152/mu-1161



Volume 5, Number 59 (2020)