Shear wave elastography-based ultrasomics: differentiating malignant from benign focal liver lesions

Purpose: Ultrasomics is a radiomics technique that extracts high-throughput quantitative data from ultrasound imaging. The aim of this study was to differentiate malignant from benign focal liver lesions (FLLs) using two-dimensional shear wave elastography (2D-SWE)-based ultrasomics.

Methods: A total of 175 FLLs in 169 patients were prospectively analyzed. The study population was divided into a training cohort (n = 122) and a validation cohort (n = 53). The maxima, minima, mean, and standard deviation of 2D-SWE measurements were expressed in kilopascals (E_max, E_min, E_mean, and E_SD). The ultrasonics technique was used to extract the features from the 2D-SWE images. Support vector machine was used to establish two prediction models: the ultrasomics score (ultrasomics features only) and the combined score (SWE measurements and ultrasomics features). The diagnostic performance of the models in differentiating FLLs was analyzed.

Results: A total of 1044 features were extracted and 15 features were selected. The AUC for the combined score, ultrasomics score, E_max, E_mean, E_min and E_SD were 0.94, 0.91, 0.92, 0.89, 0.67, and 0.89, respectively. The combined score had the best diagnostic performance. The sensitivity, specificity, PPV, NPV, +LR, LR of the combined score were 92.59%, 87.50%, 94.59%, 82.50%, 7.35%, and 0.09%, respectively. The decision curve analysis results showed that when the threshold probability was > 29%, the combined score showed improved benefits for patients compared to using the ultrasomics score and 2D-SWE measurements.

Conclusion: The results of this study demonstrated that the combined score had good diagnostic accuracy in differentiating malignant from benign FLLs.