Role of Strain Elastography in Differentiating Malignant Hypoechoic Splenic Lesions in Dogs: Preliminary Results

This study aims to assess the repeatability and reproducibility of strain elastography in the evaluation of splenic nodules and to verify if it can differentiate benign from malignant splenic lesions in dogs. Twenty-four dogs with a single splenic hypoechoic lesion, underwent strain elastosonography. The strain ratio (SR) and hardness value (HV) were calculated. Repeatability and reproducibility were assessed by the coefficient of variability (CV) and the K of Cohen respectively. ANOVA and Fisher exact test verified the differences between the SR values and HV of benign versus malignant lesions. The odds ratio was also calculated. The SR and HV of benign lesions were different from those of malignant lesions (P<0.05). Malignant lesions tended to have a SR≥1.5 (P=0.0003) and an HV ≥ 70% (P=0.001). The correlation between SR≥1.5 and malignancy was significant (OR, 80.6; P=0.0067) as the one between HV ≥ 70% and malignancy (OR, 47.22; P=0.013). This technique was repeatable and reproducible (CV 0.08±0.03 and K=1 for the SR; CV 0.08±0.05 and K=0.66 for the HV). Elastosonography can differentiate malignant from benign canine hypoechoic splenic lesions.