{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:33:31Z","timestamp":1760150011596,"version":"build-2065373602"},"reference-count":39,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T00:00:00Z","timestamp":1697068800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Purpose: Nontraumatic focal splenic lesions (FSL) are rare, and the need for tissue diagnosis must be weighed against the very high risk of bleeding after a splenic biopsy. The aim of this study was to explore the feasibility and diagnostic potential of acoustic radiation force impulse (ARFI) elastography as a noninvasive method for different benign and malignant FSLs. No human studies on the elastographic characteristics of FSL exist. Methods: This was a retrospective analysis of 34 patients with FSLs, who underwent abdominal B-mode ultrasound (B-US), contrast-enhanced ultrasound (CEUS), and standardized ARFI examinations between October 2021 and December 2022 at our university hospital. The inclusion criteria were: (i) FSL size \u2265 1 cm; (ii) 10 valid ARFI measurements of the FSL, as well as of the normal splenic parenchyma (NSP) as an in vivo reference; and (iii) diagnostic confirmation of FSL etiology based on histological examination (8\/34; 23.5%) or clinical evaluation, which included a clinical and sonographic follow-up (FU), CEUS morphology, and\/or morphology on cross-sectional imaging (26\/34; 76.5%). CEUS was performed on all patients and the FSLs were classified according to the current guidelines; cross-sectional imaging was available for 29\/34 (85.3%). The mean FU duration was 25.8 \u00b1 30.5 months. The mean ARFI velocity (MAV) of the FSL (MAVL), the NSP (MAVP), and the ratio of the MAVL to the MAVP (MAVL\/P) were calculated and compared. Results: Of the 34 FSLs, 13 (38.2%) were malignant (mFSL) and 21 (61.8%) were benign (bFSL). The MAVL of all 34 FSLs (2.74 \u00b1 0.71 m\/s) was lower than the MAVP (3.20 \u00b1 0.59 m\/s), p = 0.009, with a mean MAVL\/P ratio of 0.90 \u00b1 0.34. No significant differences in the MAVL were observed between the mFSL (2.66 \u00b1 0.67 m\/s) and bFSL (2.79 \u00b1 0.75 m\/s). There were also no significant differences between the MAVP in patients with mFSL (3.24 \u00b1 0.68 m\/s) as compared to that in the patients with bFSL (3.18 \u00b1 0.55 m\/s). Likewise, the MAV L\/P ratio did not differ between the mFSL (0.90 \u00b1 0.41 m\/s) and bFSL (0.90 \u00b1 0.30 m\/s) groups. Conclusion: ARFI elastography is feasible in evaluating the stiffness of FSLs. The lesions\u2019 stiffness was lower than that of the NSP, regardless of the FSL etiology. However, differentiation between benign and malignant FSL with the help of this elastographic method does not appear possible. Larger prospective studies are needed to validate these findings.<\/jats:p>","DOI":"10.3390\/cancers15204964","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T12:46:13Z","timestamp":1697114773000},"page":"4964","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acoustic Radiation Force Impulse (ARFI) Elastography of Focal Splenic Lesions: Feasibility and Diagnostic Potential"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1308-988X","authenticated-orcid":false,"given":"Amjad","family":"Alhyari","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Endocrinology, Metabolism and Infectious Diseases, University Hospital Giessen and Marburg, Philipp University of Marburg, 35033 Marburg, Germany"},{"name":"Interdisciplinary Centre of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipp University of Marburg, 35033 Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1900-5149","authenticated-orcid":false,"given":"Christian","family":"G\u00f6rg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Endocrinology, Metabolism and Infectious Diseases, University Hospital Giessen and Marburg, Philipp University of Marburg, 35033 Marburg, Germany"},{"name":"Interdisciplinary Centre of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipp University of Marburg, 35033 Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suhaib","family":"Tahat","sequence":"additional","affiliation":[{"name":"Interdisciplinary Centre of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipp University of Marburg, 35033 Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4573-7802","authenticated-orcid":false,"given":"Corinna","family":"Trenker","sequence":"additional","affiliation":[{"name":"Interdisciplinary Centre of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipp University of Marburg, 35033 Marburg, Germany"},{"name":"Department of Haematology, Oncology and Immunology, University Hospital Giessen and Marburg, Philipps University of Marburg, 35033 Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6015-6347","authenticated-orcid":false,"given":"Christoph Frank","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Bern, Beau Site, Salem und Permanence, 3013 Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6812-3563","authenticated-orcid":false,"given":"Christina C.","family":"Westhoff","sequence":"additional","affiliation":[{"name":"Institute of Pathology, University Hospital Giessen and Marburg, Philipps University of Marburg, 35033 Marburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9775-3989","authenticated-orcid":false,"given":"Ehsan","family":"Safai Zadeh","sequence":"additional","affiliation":[{"name":"Interdisciplinary Centre of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipp University of Marburg, 35033 Marburg, Germany"},{"name":"Department of Biomedical Imaging and Imaging-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0180-5452","authenticated-orcid":false,"given":"Hajo","family":"Findeisen","sequence":"additional","affiliation":[{"name":"Interdisciplinary Centre of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipp University of Marburg, 35033 Marburg, Germany"},{"name":"Department of Internal Medicine, Red Cross Hospital Bremen, 28199 Bremen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s40477-013-0014-0","article-title":"Focal splenic lesions: US findings","volume":"16","author":"Caremani","year":"2013","journal-title":"J. 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