**2.3 Limitations of elastography for FLL evaluation**

Elastographic evaluation of FLLs has several limitations:


The location of the lesion can limit SWE evaluation; the maximum depth of SWE examination is limited to 8 cm from the skin [56]. The size of the lesion can lead to higher variability of elastographic values [43]. Patient-related limitations are connected to poor image acquisition due to poor intercostal window, obesity, and the patient's inability to hold respiration. Another confounding factor that must be mentioned is that the SWE values overlap between malignant and benign lesions, leading to diagnostic confusion. There is no consensus regarding the necessary number of elastographic measurements in FLLs [8, 18].

Nevertheless, elastography remains a powerful and essential diagnostic tool for FLL evaluation that can be added complementary to routine US examinations.
