• Gökçe Annaç, Murat Canyiğit, Sinan Tan, Ersin Akşam, Nuran Süngü Adıyaman, and Halil Arslan.
• Department of Radiology, Bartın State Hospital, Bartın, Turkey.
• Turk J Med Sci. 2021 Dec 13; 51 (6): 295929672959-2967.

Background/AimTo evaluate benign and malignant cutaneous-subcutaneous lesions using real-time strain elastography (RTSE) and to compare the findings with histopathologic results.Materials And MethodsOver a period of 10 months, 72 patients (38 with benign and 34 with malignant cutaneous and subcutaneous lesions) were prospectively included in this study. Elasticity patterns and strain ratios were examined for each lesion. Lesions were evaluated in 4 groups as yellow-red (soft; pattern-1), green-yellow (moderate; pattern-2), blue-green (hard; pattern-3) and blue (hardest; pattern-4). The stiffness of the lesions was displayed with strain ratios by comparing of a nearby reference tissue. The recorded images were compared with histopathologic findings.ResultsOn sonoelastograms, considering patterns 1-2 as benign and patterns 3-4 as malignant, the sensitivity, specificity, and positive and negative predictive values for the differentiation of malignant from benign lesions were 100%, 68.5%, 74%, and 100%, respectively. Considering a cut-off value of the strain ratio as > 3.05, the sensitivity, specificity, and positive and negative predictive values were 91%, 89%, 88%, and 92%, respectively. The area under the curve (AUC: 0.972) showed the excellent ability of strain elastography to differentiate benign and malignant lesions.ConclusionRTSE is an important imaging tool to differentiate benign and malignant superficial soft tissue lesions. Our results suggest that RTSE can be used to predict malignancy since malignant lesions are more confidentially diagnosed than benign superficial soft tissue lesions on elastograms.This work is licensed under a Creative Commons Attribution 4.0 International License.

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