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Khair RM, Sukanen M, Finni T. Achilles Tendon Stiffness: Influence of Measurement Methodology. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1522-1529. [PMID: 39079832 DOI: 10.1016/j.ultrasmedbio.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/15/2024] [Accepted: 06/16/2024] [Indexed: 09/06/2024]
Abstract
OBJECTIVE Mechanical stiffness derived from force-elongation curves is fundamentally different from shear wave (SW) elastography-based tissue properties. We compared these techniques, with a total of five methods of assessing Achilles tendon (AT) stiffness. METHODS Seventeen participants (12 male and 5 female) with unilateral AT rupture performed submaximal contractions at 30% and 10% maximal isometric contraction torque of the un-injured limb. SW velocity was acquired at rest. Force-elongation curves were assessed from the free AT and the medial gastrocnemius (MG) tendon. Mechanical stiffness was determined near the end of the linear region of the force-elongation curve and from the toe region. Bivariate correlations between mechanical stiffness and SW velocity, as well as pairwise t-tests between limbs, were computed. RESULTS In the injured limb, SW velocity correlated with MG tendon and free AT toe-region stiffness during 10% (r = 0.59, p = 0.020 and r = 0.60, p = 0.011, respectively) and 30% of submaximal contractions (r = 0.56, p = 0.018 and r = 0.67, p = 0.004, respectively). The un-injured limb showed no associations. In both limbs pooled together, SW velocity correlated with MG tendon toe-region stiffness in 30% of submaximal contractions (r = 0.43, p = 0.012). Free tendon mechanical stiffness was lower in the injured limb, with a mean difference of 148.5 Nmm⁻¹ (95% CI: 35.6-261.3, p = 0.013), while SW velocity was higher in the injured limb (1.67 m × s⁻¹, 95% CI; -2.4 to -0.9, p < 0.001). CONCLUSION SW elastography may reflect AT viscoelastic properties at the initial slope of the force-length curve with strains <1% but cannot offer insight into AT mechanics at higher loads. Extended toe regions in the injured limb could have caused the association between mechanical stiffness and SW-based stiffness.
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Affiliation(s)
- Ra'ad M Khair
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland.
| | - Maria Sukanen
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Taija Finni
- Faculty of Sport and Health Sciences, Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland
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Gurun E, Ozturk M, Bozduman O. How should meniscus tissue stiffness be measured, what are the correct parameters? Acad Radiol 2024:S1076-6332(24)00564-6. [PMID: 39153962 DOI: 10.1016/j.acra.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 08/19/2024]
Affiliation(s)
- Enes Gurun
- Department of Radiology, Samsun University Faculty of Medicine, SAMSUN.
| | - Mesut Ozturk
- Department of Radiology, Samsun University Faculty of Medicine, SAMSUN.
| | - Omer Bozduman
- Department of Orthopedics and Traumatology, Memorial Antalya Hospital, ANTALYA.
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Gallet J, Sassaroli E, Yuan Q, Aljabal A, Park MA. Quality Assurance of Point and 2D Shear Wave Elastography through the Establishment of Baseline Data Using Phantoms. SENSORS (BASEL, SWITZERLAND) 2024; 24:4961. [PMID: 39124008 PMCID: PMC11314857 DOI: 10.3390/s24154961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 07/09/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024]
Abstract
Ultrasound elastography has been available on most modern systems; however, the implementation of quality processes tends to be ad hoc. It is essential for a medical physicist to benchmark elastography measurements on each system and track them over time, especially after major software upgrades or repairs. This study aims to establish baseline data using phantoms and monitor them for quality assurance in elastography. In this paper, we utilized two phantoms: a set of cylinders, each with a composite material with varying Young's moduli, and an anthropomorphic abdominal phantom containing a liver modeled to represent early-stage fibrosis. These phantoms were imaged using three ultrasound manufacturers' elastography functions with either point or 2D elastography. The abdominal phantom was also imaged using magnetic resonance elastography (MRE) as it is recognized as the non-invasive gold standard for staging liver fibrosis. The scaling factor was determined based on the data acquired using MR and US elastography from the same vendor. The ultrasound elastography measurements showed inconsistency between different manufacturers, but within the same manufacturer, the measurements showed high repeatability. In conclusion, we have established baseline data for quality assurance procedures and specified the criteria for the acceptable range in liver fibrosis phantoms during routine testing.
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Affiliation(s)
- Jacqueline Gallet
- Department of Radiology, Division of Medical Physics, UT Southwestern Medical Center, Dallas, TX 75390, USA; (Q.Y.); (A.A.)
| | | | - Qing Yuan
- Department of Radiology, Division of Medical Physics, UT Southwestern Medical Center, Dallas, TX 75390, USA; (Q.Y.); (A.A.)
| | - Areej Aljabal
- Department of Radiology, Division of Medical Physics, UT Southwestern Medical Center, Dallas, TX 75390, USA; (Q.Y.); (A.A.)
| | - Mi-Ae Park
- Department of Radiology, Division of Medical Physics, UT Southwestern Medical Center, Dallas, TX 75390, USA; (Q.Y.); (A.A.)
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Lim WTH, Ooi EH, Foo JJ, Ng KH, Wong JHD, Leong SS. In silico analysis reveals the prospects of renal anisotropy in improving chronic kidney disease detection using ultrasound shear wave elastography. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2024:e3857. [PMID: 39075679 DOI: 10.1002/cnm.3857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 07/07/2024] [Accepted: 07/20/2024] [Indexed: 07/31/2024]
Abstract
Renal anisotropy is a complex property of the kidney and often poses a challenge in obtaining consistent measurements when using shear wave elastography to detect chronic kidney disease. To circumvent the challenge posed by renal anisotropy in clinical settings, a dimensionless biomarker termed the 'anisotropic ratio' was introduced to establish a correlation between changes in degree of renal anisotropy and progression of chronic kidney disease through an in silico perspective. To achieve this, an efficient model reduction approach was developed to model the anisotropic property of kidneys. Good agreement between the numerical and experimental data were obtained, as percentage errors of less than 5.5% were reported when compared against experimental phantom measurement from the literature. To demonstrate the applicability of the model to clinical measurements, the anisotropic ratio of sheep kidneys was quantified, with both numerical and derived experimental results reporting a value of .667. Analysis of the anisotropic ratio with progression of chronic kidney disease demonstrated that patients with normal kidneys would have a lower anisotropic ratio of .872 as opposed to patients suffering from renal impairment, in which the anisotropic ratio may increase to .904, as determined from this study. The findings demonstrate the potential of the anisotropic ratio in improving the detection of chronic kidney disease using shear wave elastography.
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Affiliation(s)
- William T H Lim
- Department of Mechanical Engineering, School of Engineering, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Ean H Ooi
- Department of Mechanical Engineering, School of Engineering, Monash University Malaysia, Bandar Sunway, Malaysia
- Medical Engineering and Technology Hub, School of Engineering, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Ji J Foo
- Department of Mechanical Engineering, School of Engineering, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Kwan H Ng
- Faculty of Medicine, Department of Biomedical Imaging, Universiti Malaya, Kuala Lumpur, Malaysia
- Faculty of Medicine and Health Sciences, UCSI University, Springhill, Malaysia
| | - Jeannie H D Wong
- Faculty of Medicine, Department of Biomedical Imaging, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sook S Leong
- Centre of Medical Imaging, Faculty of Health Sciences, Universiti Teknologi MARA Selangor, Bandar Puncak Alam, Malaysia
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Kimondo JJ, Said RR, Wu J, Tian C, Wu Z. Mechanical rheological model on the assessment of elasticity and viscosity in tissue inflammation: A systematic review. PLoS One 2024; 19:e0307113. [PMID: 39008477 PMCID: PMC11249233 DOI: 10.1371/journal.pone.0307113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 06/30/2024] [Indexed: 07/17/2024] Open
Abstract
Understanding the extent of inflammation is crucial for early disease detection, monitoring disease progression, and evaluating treatment responses. Over the past decade, researchers have demonstrated the need to understand the extent of inflammation through qualitative or quantitative characterization of tissue viscoelasticity using different techniques. In this scientific review, an examination of research on the association between elasticity and Viscosity in diseases, particularly as tissue inflammation progresses, is conducted. A review of utilizing mechanical rheological models to characterize quantitative viscoelastic parameters of normal and inflamed tissues is also undertaken. Based on inclusion and exclusion criteria, we identified 14 full-text studies suitable for review out of 290 articles published from January 2000 to January 2024. We used PRISMA guidelines for the systematic review. In the review, three studies demonstrated the criterion used by the researchers in identifying the best rheological model. Eleven studies showed the clinical application of the rheological model in quantifying the viscoelastic properties of normal and pathological tissue. The review quantified viscoelastic parameters for normal and pathological tissue across various soft tissues. It evaluated the effectiveness of each viscoelastic property in distinguishing between normal and pathological tissue stiffness. Furthermore, the review outlined additional viscoelastic-related parameters for researchers to consider in future stiffness classification studies.
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Affiliation(s)
- Jotham Josephat Kimondo
- School of life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ramadhan Rashid Said
- School of life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jun Wu
- School of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Chao Tian
- Department of Women’s Health, Sichuan Cancer Hospital, Chengdu, China
| | - Zhe Wu
- School of life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
- Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, China
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Bisht SR, Paul A, Patel P, Thareja P, Mercado-Shekhar KP. Systematic quantification of differences in shear wave elastography estimates between linear-elastic and viscoelastic material assumptionsa). THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2024; 155:2025-2036. [PMID: 38470185 DOI: 10.1121/10.0025291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/27/2024] [Indexed: 03/13/2024]
Abstract
Quantitative, accurate, and standardized metrics are important for reliable shear wave elastography (SWE)-based biomarkers. For over two decades, the linear-elastic material assumption has been employed in SWE modes. In recent years, viscoelasticity estimation methods have been adopted in a few clinical systems. The current study aims to systematically quantify differences in SWE estimates obtained using linear-elastic and viscoelastic material assumptions. An acousto-mechanical simulation framework of acoustic radiation force impulse-based SWE was created to elucidate the effect of material viscosity and shear modulus on SWE estimates. Shear modulus estimates exhibited errors up to 72% when a numerical viscoelastic phantom was assessed as linearly elastic. Shear modulus estimates of polyvinyl alcohol phantoms between rheometry and SWE following the Kelvin-Voigt viscoelastic model assumptions were not significantly different. However, the percentage difference in shear modulus estimates between rheometry and SWE using the linear-elastic assumption was 50.1%-62.1%. In ex vivo liver, the percentage difference in shear modulus estimates between linear-elastic and viscoelastic methods was 76.1%. These findings provide a direct and systematic quantification of the potential error introduced when viscoelastic tissues are imaged with SWE following the linear-elastic assumption. This work emphasizes the need to utilize viscoelasticity estimation methods for developing robust quantitative imaging biomarkers.
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Affiliation(s)
- Sapna R Bisht
- Department of Biological Sciences and Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, Gujarat 382355, India
| | - Abhijit Paul
- Department of Biological Sciences and Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, Gujarat 382355, India
| | - Panchami Patel
- Department of Chemical Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, Gujarat 382355, India
| | - Prachi Thareja
- Department of Chemical Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, Gujarat 382355, India
| | - Karla P Mercado-Shekhar
- Department of Biological Sciences and Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, Gujarat 382355, India
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Zimmer M, Bunz EK, Ehring T, Kaiser B, Kienzlen A, Schlüter H, Zürn M. In Vivo Assessment of Shear Wave Propagation in Pennate Muscles Using an Automatic Ultrasound Probe Alignment System. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2023; 4:259-267. [PMID: 38196975 PMCID: PMC10776096 DOI: 10.1109/ojemb.2023.3338090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/28/2023] [Accepted: 11/28/2023] [Indexed: 01/11/2024] Open
Abstract
Goal: Skeletal muscle mechanics can be assessed in vivo using shear wave elastography. However, the impact of pennation angle on shear wave velocity (SWV) remains unclear. This study aims to quantify the effect by automatically aligning the ultrasound probe with muscle fiber orientation. Methods: We propose an automatic ultrasound probe alignment system and compare it to manual and no alignment. SWV of the gastrocnemius medialis muscle of ten volunteers was measured during rest and isometric contractions. Results: The SWV was different between the conditions (p = 0.008). The highest SWV was obtained during the automatic alignment and differences between the conditions were most pronounced during high-level contractions. The automatic system yielded more accurate alignment compared to a manual operator (p = 0.05). Conclusions: The present study indicates that pennation angle affects SWV, hence muscle fiber orientation must be considered to reliably interpret SWV. Using automatic alignment systems allows for more accurate alignment, improving the methodology of ultrasound elastography in skeletal muscles.
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Affiliation(s)
- Manuela Zimmer
- Institute of Structural Mechanics and Dynamics in Aerospace EngineeringUniversity of Stuttgart70569StuttgartGermany
| | - Elsa K. Bunz
- Institute for Modelling and Simulation of Biomechanical SystemsUniversity of Stuttgart70569StuttgartGermany
| | - Tobias Ehring
- Institute of Applied Analysis and Numerical SimulationUniversity of Stuttgart70569StuttgartGermany
| | - Benedikt Kaiser
- Institute of Electrical Energy ConversionUniversity of Stuttgart70569StuttgartGermany
| | - Annika Kienzlen
- Institute for Control Engineering of Machine Tools and Manufacturing UnitsUniversity of Stuttgart70174StuttgartGermany
| | - Henning Schlüter
- Institute for Systems Theory and Automatic ControlUniversity of Stuttgart70569StuttgartGermany
| | - Manuel Zürn
- Institute for Control Engineering of Machine Tools and Manufacturing UnitsUniversity of Stuttgart70174StuttgartGermany
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8
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Latus S, Grube S, Eixmann T, Neidhardt M, Gerlach S, Mieling R, Huttmann G, Lutz M, Schlaefer A. A Miniature Dual-Fiber Probe for Quantitative Optical Coherence Elastography. IEEE Trans Biomed Eng 2023; 70:3064-3072. [PMID: 37167045 DOI: 10.1109/tbme.2023.3275539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Optical coherence elastography (OCE) allows for high resolution analysis of elastic tissue properties. However, due to the limited penetration of light into tissue, miniature probes are required to reach structures inside the body, e.g., vessel walls. Shear wave elastography relates shear wave velocities to quantitative estimates of elasticity. Generally, this is achieved by measuring the runtime of waves between two or multiple points. For miniature probes, optical fibers have been integrated and the runtime between the point of excitation and a single measurement point has been considered. This approach requires precise temporal synchronization and spatial calibration between excitation and imaging. METHODS We present a miniaturized dual-fiber OCE probe of 1 mm diameter allowing for robust shear wave elastography. Shear wave velocity is estimated between two optics and hence independent of wave propagation between excitation and imaging. We quantify the wave propagation by evaluating either a single or two measurement points. Particularly, we compare both approaches to ultrasound elastography. RESULTS Our experimental results demonstrate that quantification of local tissue elasticities is feasible. For homogeneous soft tissue phantoms, we obtain mean deviations of 0.15 ms-1 and 0.02 ms-1 for single-fiber and dual-fiber OCE, respectively. In inhomogeneous phantoms, we measure mean deviations of up to 0.54 ms-1 and 0.03 ms-1 for single-fiber and dual-fiber OCE, respectively. CONCLUSION We present a dual-fiber OCE approach that is much more robust in inhomogeneous tissues. Moreover, we demonstrate the feasibility of elasticity quantification in ex-vivo coronary arteries. SIGNIFICANCE This study introduces an approach for robust elasticity quantification from within the tissue.
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9
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Rao WT, Jiang S, Shen YH, Wang YH, Liu SN, Tang JD, Xing JF. Myofibroblasts: A New Factor Affecting the Hyperlipidemia-Induced Elastic Abnormality of Corpus Cavernosum in Rabbits Detected by 2-D Shear Wave Elastography. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:2336-2345. [PMID: 37544829 DOI: 10.1016/j.ultrasmedbio.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/22/2023] [Accepted: 07/11/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE Two-dimensional shear wave elastography (2-D SWE) has been proven to detect hyperlipidemia-induced elastic abnormality in the corpus cavernosum. This study investigated cytological factors affecting the elasticity of the corpus cavernosum in rabbits with hyperlipidemia using single-cell RNA sequencing (scRNA-seq). METHODS Male New Zealand white rabbits were randomly divided into a hyperlipidemia group (high-cholesterol diet) and a control group (standard diet). Penile 2-D SWE was performed to detect the elastic abnormality in the corpus cavernosum. ScRNA-seq was performed to observe cellular changes in the corpus cavernosum of rabbits with hyperlipidemia. Immunohistochemistry, immunofluorescence and histological examinations were conducted to verify the results of scRNA-seq. RESULTS Two-dimensional SWE revealed that the Young's modulus of the corpus cavernosum was significantly greater in the hyperlipidemia group than that in the control group (p < 0.001). Histological findings revealed extracellular matrix accumulation within the corpus cavernosum, with stronger staining of collagen types I and Ⅲ. ScRNA-seq revealed that fibroblasts, smooth muscle cells, and endothelial cells were the major cell types in the corpus cavernosum. A novel subtype of fibroblasts (myofibroblast) was discovered in the hyperlipidemia group, which was verified by immunofluorescence staining and gene ontology analysis. Fibroblasts, smooth muscle cells and endothelial cells were three cellular sources for myofibroblasts. CONCLUSION Myofibroblasts are activated and proliferate and secrete large amounts of collagen fibers in the corpus cavernosum during hyperlipidemia, leading to abnormal Young's modulus detected by 2-D SWE and their recognition as a new factor affecting the hyperlipidemia-induced elastic abnormality of the corpus cavernosum.
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Affiliation(s)
- Wan-Ting Rao
- Department of Medical Ultrasound, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Shuai Jiang
- Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Yi-Hao Shen
- Department of Medical Ultrasound, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Yan-He Wang
- Department of Medical Ultrasound, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Sen-Ning Liu
- Department of Medical Ultrasound, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Jing-Dong Tang
- Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Jin-Fang Xing
- Department of Medical Ultrasound, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China; Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China.
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Naganuma H, Ishida H. Factors other than fibrosis that increase measured shear wave velocity. World J Gastroenterol 2022; 28:6512-6521. [PMID: 36569278 PMCID: PMC9782834 DOI: 10.3748/wjg.v28.i46.6512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/27/2022] [Accepted: 11/21/2022] [Indexed: 12/08/2022] Open
Abstract
Shear wave elastography (SWE) is now becoming an indispensable diagnostic tool in the routine examination of liver diseases. In particular, accuracy is required for shear wave propagation velocity measurement, which is directly related to diagnostic accuracy. It is generally accepted that the liver shear wave propagation velocity reflects the degree of fibrosis, but there are still few reports on other factors that increase the shear wave propagation velocity. In this study, we reviewed such factors in the literature and examined their mechanisms. Current SWE measures propagation velocity based on the assumption that the medium has a homogeneous structure, uniform density, and is purely elastic. Otherwise, the measurement is subject to error. The other (confounding) factors that we routinely experience are primarily: (1) Conditions that appear to increase the viscous component; and (2) Conditions that appear to increase tissue density. Clinically, the former includes acute hepatitis, congested liver, biliary obstruction, etc, and the latter includes diffuse infiltration of malignant cells, various storage diseases, tissue necrosis, etc. In any case, it is important to evaluate SWE in the context of the entire clinical picture.
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Affiliation(s)
- Hiroko Naganuma
- Department of Gastroenterology, Yokote Municipal Hospital, Yokote 013-8602, Japan
| | - Hideaki Ishida
- Department of Gastroenterology, Akita Red Cross Hospital, Akita 010-1495, Japan
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Quantitative Assessment of Breast-Tumor Stiffness Using Shear-Wave Elastography Histograms. Diagnostics (Basel) 2022; 12:diagnostics12123140. [PMID: 36553148 PMCID: PMC9777730 DOI: 10.3390/diagnostics12123140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/08/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose: Shear-wave elastography (SWE) measures tissue elasticity using ultrasound waves. This study proposes a histogram-based SWE analysis to improve breast malignancy detection. Methods: N = 22/32 (patients/tumors) benign and n = 51/64 malignant breast tumors with histological ground truth. Colored SWE heatmaps were adjusted to a 0−180 kPa scale. Normalized, 250-binned RGB histograms were used as image descriptors based on skewness and area under curve (AUC). The histogram method was compared to conventional SWE metrics, such as (1) the qualitative 5-point scale classification and (2) average stiffness (SWEavg)/maximal tumor stiffness (SWEmax) within the tumor B-mode boundaries. Results: The SWEavg and SWEmax did not discriminate malignant lesions in this database, p > 0.05, rank sum test. RGB histograms, however, differed between malignant and benign tumors, p < 0.001, Kolmogorov−Smirnoff test. The AUC analysis of histograms revealed the reduction of soft-tissue components as a significant SWE biomarker (p = 0.03, rank sum). The diagnostic accuracy of the suggested method is still low (Se = 0.30 for Se = 0.90) and a subject for improvement in future studies. Conclusions: Histogram-based SWE quantitation improved the diagnostic accuracy for malignancy compared to conventional average SWE metrics. The sensitivity is a subject for improvement in future studies.
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12
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Huang K, Liu J, Chen Q, Feng D, Wu H, Aldanakh A, Jian Y, Xu Z, Wang S, Yang D. The effect of mechanical force in genitourinary malignancies. Expert Rev Anticancer Ther 2021; 22:53-64. [PMID: 34726963 DOI: 10.1080/14737140.2022.2000864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Mechanical force is attributed to the formation of tumor blood vessels, influences cancer cell invasion and metastasis, and promotes reprogramming of the energy metabolism. Currently, therapy strategies for the tumor microenvironment are being developed progressively. The purpose of this article is to discuss the molecular mechanism, diagnosis, and treatment of mechanical force in urinary tract cancers and outline the medications used in the mechanical microenvironment. AREAS COVERED This review covers the complex mechanical elements in the microenvironment of urinary system malignancies, focusing on mechanical molecular mechanisms for diagnosis and treatment. EXPERT OPINION The classification of various mechanical forces, such as matrix stiffness, shear force, and other forces, is relatively straightforward. However, little is known about the molecular process of mechanical forces in urinary tract malignancies. Because mechanical therapy is still controversial, it is critical to understand the molecular basis of mechanical force before adding mechanical therapy solutions.
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Affiliation(s)
- Kai Huang
- Department of Urology, First Affifiliated Hospital of Dalian Medical University, Dalian, China
| | - Junqiang Liu
- Department of Urology, First Affifiliated Hospital of Dalian Medical University, Dalian, China
| | - Qiwei Chen
- Department of Urology, First Affifiliated Hospital of Dalian Medical University, Dalian, China.,School of Information Science and Technology, Dalian Maritime University, Dalian City, China
| | - Dan Feng
- Department of Urology, First Affifiliated Hospital of Dalian Medical University, Dalian, China
| | - Haotian Wu
- Department of Urology, First Affifiliated Hospital of Dalian Medical University, Dalian, China
| | - Abdullah Aldanakh
- Department of Urology, First Affifiliated Hospital of Dalian Medical University, Dalian, China
| | - Yuli Jian
- Department of Biochemistry, Institute of Glycobiology, Dalian Medical University, Dalian, China
| | - Zhongyang Xu
- Department of Biochemistry, Institute of Glycobiology, Dalian Medical University, Dalian, China
| | - Shujing Wang
- Department of Biochemistry, Institute of Glycobiology, Dalian Medical University, Dalian, China
| | - Deyong Yang
- Department of Urology, First Affifiliated Hospital of Dalian Medical University, Dalian, China
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