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Zhang X, Chen Z, You J, Lu Q, Liu L, Cai D. Clinical practice of the transrectal shear-wave elastography in benign prostatic hyperplasia. Aging Male 2024; 27:2363267. [PMID: 38867423 DOI: 10.1080/13685538.2024.2363267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/29/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVE To investigate the practical value of the transrectal two-dimensional shear-wave elastography (SWE) in benign prostatic hyperplasia (BPH). METHODS Consecutive male participants with and without BPH constituted the BPH and control group respectively were enrolled prospectively between March and December 2022. Transrectal conventional ultrasound and SWE examinations for the prostate were performed on these participants. Data of quantitative stiffness of the transitional zone (TZ) and peripheral zone (PZ) of prostate, volume of prostate (VP) and volume of TZ (VTZ) and prostate specific androgen (PSA), etc., were collected. Linear regression analyses were used to investigate the associations between quantitative stiffness data and other clinical parameters. RESULTS There were 200 participants evaluated, including 100 healthy participants and 100 BPH patients. For every one-year increment in age, it was correlated with 0.50 kPa increasement of TZ stiffness. VP and VTZ were correlated with TZ stiffness. Higher TZ stiffness was associated with higher free prostate specific antigen (PSA) and total PSA. CONCLUSIONS The prostate is stiffer and larger in BPH group compared to control group. Quantitative stiffness of the TZ was related with age, VP, VTZ and PSA.
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Affiliation(s)
- Xuhui Zhang
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Zeyu Chen
- Department of Urology Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jia You
- Department of Urology Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Lu
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Liangren Liu
- Department of Urology Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Diming Cai
- Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu, China
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Eliahoo P, Setayesh H, Hoffman T, Wu Y, Li S, Treweek JB. Viscoelasticity in 3D Cell Culture and Regenerative Medicine: Measurement Techniques and Biological Relevance. ACS MATERIALS AU 2024; 4:354-384. [PMID: 39006396 PMCID: PMC11240420 DOI: 10.1021/acsmaterialsau.3c00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 07/16/2024]
Abstract
The field of mechanobiology is gaining prominence due to recent findings that show cells sense and respond to the mechanical properties of their environment through a process called mechanotransduction. The mechanical properties of cells, cell organelles, and the extracellular matrix are understood to be viscoelastic. Various technologies have been researched and developed for measuring the viscoelasticity of biological materials, which may provide insight into both the cellular mechanisms and the biological functions of mechanotransduction. Here, we explain the concept of viscoelasticity and introduce the major techniques that have been used to measure the viscoelasticity of various soft materials in different length- and timescale frames. The topology of the material undergoing testing, the geometry of the probe, the magnitude of the exerted stress, and the resulting deformation should be carefully considered to choose a proper technique for each application. Lastly, we discuss several applications of viscoelasticity in 3D cell culture and tissue models for regenerative medicine, including organoids, organ-on-a-chip systems, engineered tissue constructs, and tunable viscoelastic hydrogels for 3D bioprinting and cell-based therapies.
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Affiliation(s)
- Payam Eliahoo
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California 90089 United States
| | - Hesam Setayesh
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California 90089 United States
| | - Tyler Hoffman
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California 90095 United States
| | - Yifan Wu
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California 90095 United States
| | - Song Li
- Department of Bioengineering, University of California Los Angeles, Los Angeles, California 90095 United States
| | - Jennifer B Treweek
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California 90089 United States
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Santos R, Loft MK, Pedersen MRV. Elastography of the Male Pelvic Region-Perspectives on Malignant Lesions. Diagnostics (Basel) 2024; 14:1218. [PMID: 38928634 PMCID: PMC11202996 DOI: 10.3390/diagnostics14121218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 06/28/2024] Open
Abstract
Ultrasound elastography is widely used to assess tissue stiffness for lesion characterization, including differentiation between benign and malignant lesions. This study focuses on the use of elastography in the male pelvis, including the prostate, testicles, and rectum, by comparing elastography types (shear wave and strain). This article provides a summary of the existing literature on the use of elastography in the male pelvic region and outlines the clinical perspective. Ultrasound elastography is a good technique for evaluating and monitoring lesions in the male pelvic region.
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Affiliation(s)
- Rute Santos
- Medical Imaging and Radiotherapy Department, Coimbra Health School, Polytechnic University of Coimbra, 3045-093 Coimbra, Portugal
- H&TRC—Health & Technology Research Center, Coimbra Health School, Polytechnic University of Coimbra, 3045-093 Coimbra, Portugal
- CIPER-UC, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Martina Kastrup Loft
- Department of Radiology, University Hospital of Southern Denmark, Vejle Hospital, Beriderbakken 4, 7100 Vejle, Denmark; (M.K.L.); (M.R.V.P.)
- Department of Radiology, University Hospital of Southern Denmark, Kolding Hospital, Sygehusvej 24, 6000 Kolding, Denmark
| | - Malene Roland Vils Pedersen
- Department of Radiology, University Hospital of Southern Denmark, Vejle Hospital, Beriderbakken 4, 7100 Vejle, Denmark; (M.K.L.); (M.R.V.P.)
- Department of Radiology, University Hospital of Southern Denmark, Kolding Hospital, Sygehusvej 24, 6000 Kolding, Denmark
- Department of Regional Health, Faculty of Health, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
- Discipline of Medical Imaging & Radiation Therapy, School of Medicine, University College Cork, T12 AK54 Cork, Ireland
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Marukatat N, Parklug P, Issaragrisil S, Sumanasrethakul C. Shear wave elastography for solid breast masses evaluation: Quantitative measurement of mean elasticity value and elasticity ratio. Eur J Radiol Open 2024; 12:100573. [PMID: 38855720 PMCID: PMC11157203 DOI: 10.1016/j.ejro.2024.100573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/15/2024] [Accepted: 05/23/2024] [Indexed: 06/11/2024] Open
Abstract
Purpose Shear wave elastography (SWE), an ultrasonographic technique to measure the elasticity of mass lesions to evaluate breast mass. This study aimed to find out the cutoff values identifying breast malignancy using the mean elasticity (E-mean) and elasticity ratio (E-ratio) of breast masses. Methods This retrospective study included women underwent SWE and US-guided biopsy of breast masses. During conventional US, the SWE mode was also performed, determining elasticity measurements, E-mean and E-ratio. Histopathological reports were obtained to identify mass status. The optimal and alternative cutoff values for E-mean and E-ratio to determine malignancy were assessed by receiver operating characteristic (ROC) curve analysis and Youden's index score. Results Among 147 benign and 93 malignant masses, the median of E-means were 26.20 (IQR 15.70-56.60) and 141.60 (IQR 119.80-154.60) kPa and the median E-ratios were 3.11 (IQR 1.83-5.23) and 9.24 (IQR 6.76-12.44), respectively. Using Youden's index, the optimal cutoff values for E-mean and E-ratio were 90.35 and 5.89, with sensitivity of 87.1 % and 82.8 %, specificity of 89.1 % and 83.7 %, positive predictive value (PPV) of 83.5 % and 76.2 %, negative predictive value (NPV) of 91.6 % and 88.5 %, positive likelihood ratio (LR+) of 8.00 and 5.07, and negative likelihood ratio (LR-) of 0.14 and 0.21, respectively. Conclusion This study revealed that SWE is useful in predicting malignancy. With the optimal cutoff values of E-mean and E-ratio at 90.35 kPa and 5.89, the sensitivity was nearly 90 % with E-mean and slightly over 80 % with E-ratio, respectively. These findings could be used in conjunction with conventional US.
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Affiliation(s)
- N. Marukatat
- Department of Radiology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd., Dusit, Bangkok 10300, Thailand
| | - P. Parklug
- Department of Radiology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd., Dusit, Bangkok 10300, Thailand
| | - S. Issaragrisil
- Department of Radiology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd., Dusit, Bangkok 10300, Thailand
| | - C. Sumanasrethakul
- Department of Urban Medicine, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd., Bangkok 10300, Thailand
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Saloux E, Garrec ML, Menet N, Dillon L, Simard C, Fraschini C, Manrique A. Cardiac 2-D Shear Wave Imaging Using a New Dedicated Clinical Ultrasound System: A Phantom Study. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:843-851. [PMID: 38471998 DOI: 10.1016/j.ultrasmedbio.2024.02.006] [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: 06/22/2023] [Revised: 01/18/2024] [Accepted: 02/09/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE The purpose of this study was to assess cardiac shear wave imaging implemented in a new MACH 30 ultrasound machine (SuperSonic Imaging, Aix-en-Provence, France) and interfaced with a linear probe and a phased array probe, in comparison with a previously validated Aixplorer system connected to a linear probe (SuperSonic Imaging) using Elasticity QA phantoms (Models 039 and 049, CIRS Inc., Norfolk, VA, USA). METHODS Quantile-quantile plots were used for distribution agreement. The accuracy of stiffness measurement was assessed by the percentage error and the mean percentage error (MPE), and its homogeneity, by the standard deviation of the MPE. A p value <0.01 was considered to indicate statistical significance. RESULTS The accuracy of dedicated cardiac sequences for linear probes was similar for the two systems with an MPE of 8 ± 14% versus 20 ± 21% (p = not significant) with the SuperSonic MACH 30 and Aixplorer, respectively, and was influenced by target stiffness and location of the measurement in the field of view, but without drift over time. The optimal transthoracic cardiac probe workspace was located between 4 and 10 cm, with an MPE of 29.5 ± 25% compared with 93.3 ± 130% outside this area (p < 0.0001). In this area, stiffness below 20 kPa was significantly different from the reference (p < 0.0001). The sectorial probe revealed no MPE difference in any of the measurement areas, with no significant lateral or axial gradient. CONCLUSION The new Supersonic MACH 30 system upgraded with a sectorial probe and specific cardiac settings provided homogenous stiffness measurements, especially when operating at depths between 4 and 10 cm. These phantom results may be useful in designing future in vivo studies.
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Affiliation(s)
- Eric Saloux
- Centre Hospitalier, Universitaire de Caen Normandie, Caen, France; UR 4650 PSIR, Université de Caen Normandie, Caen, France.
| | | | - Nina Menet
- UR 4650 PSIR, Université de Caen Normandie, Caen, France
| | - Ludovic Dillon
- Centre Hospitalier, Universitaire de Caen Normandie, Caen, France
| | | | | | - Alain Manrique
- Centre Hospitalier, Universitaire de Caen Normandie, Caen, France; UR 4650 PSIR, Université de Caen Normandie, Caen, France
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Ayyalasomayajula V, Ervik Ø, Sorger H, Skallerud B. Macro-indentation testing of soft biological materials and assessment of hyper-elastic material models from inverse finite element analysis. J Mech Behav Biomed Mater 2024; 151:106389. [PMID: 38211503 DOI: 10.1016/j.jmbbm.2024.106389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/29/2023] [Accepted: 01/07/2024] [Indexed: 01/13/2024]
Abstract
Mechanical characterization of hydrogels and ultra-soft tissues is a challenging task both from an experimental and material parameter estimation perspective because they are much softer than many biological materials, ceramics, or polymers. The elastic modulus of such materials is within the 1 - 100 kPa range, behaving as a hyperelastic solid with strain hardening capability at large strains. In the current study, indentation experiments have been performed on agarose hydrogels, bovine liver, and bovine lymph node specimens. This work reports on the reliable determination of the elastic modulus by indentation experiments carried out at the macro-scale (mm) using a spherical indenter. However, parameter identification of the hyperelastic material properties usually requires an inverse finite element analysis due to the lack of an analytical contact model of the indentation test. Hence a comprehensive study on the spherical indentation of hyperelastic soft materials is carried out through robust computational analysis. Neo-Hookean and first-order Ogden hyperelastic material models were found to be most suitable. A case study on known anisotropic hyperelastic material showed the inability of the inverse finite element method to uniquely identify the whole material parameter set.
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Affiliation(s)
- Venkat Ayyalasomayajula
- Department of Structural Engineering, Norwegian University of Science and Technology, Trondheim, 7052, Norway.
| | - Øyvind Ervik
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, 7052, Norway; Clinic of medicine, Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, 7600, Norway
| | - Hanne Sorger
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, 7052, Norway; Clinic of medicine, Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, 7600, Norway
| | - Bjørn Skallerud
- Department of Structural Engineering, Norwegian University of Science and Technology, Trondheim, 7052, Norway
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Tavakkoli M, Bahrpeyma F. Elastic Modulus of Suboccipital Muscles, Cervical Range of Motion, and Forward Head Posture in Cervicogenic Headache. J Biomed Phys Eng 2023; 13:463-470. [PMID: 37868938 PMCID: PMC10589696 DOI: 10.31661/jbpe.v0i0.2104-1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 09/10/2021] [Indexed: 10/24/2023]
Abstract
Background Although stiffness of neck muscles, the limitation of cervical range of motion (ROM), and forward head posture (FHP) are proposed as clinical characteristics of cervicogenic headache (CGH), adequate consistent data failed to support these characteristics. Objective This study aims to compare the elastic modulus of suboccipital muscles, cervical ROM, and FHP between individuals suffering from CGH and healthy controls. Material and Methods In this cross-sectional study, 20 individuals with a history of CGH and 20 normal individuals participated. Sonography images and a universal goniometer (UG) were used to assess elastic modulus and cervical ROM, respectively. In addition, FHP was assessed based on measuring craniovertebral angle (CVA) using a digital imaging technique and also the distance of anterior tragus of the ear with the vertical line passed from anterior of lateral malleolus according to the Kendall and McCreary method. Results Elastic modulus of suboccipital muscles in the CGH group was significantly higher than that of the normal group (P=0.008). The two groups were not significantly different in terms of FHP. Moreover, ROM of cervical extension (P=0.035), right rotation (P=0.046), and left rotation (P=0.018) showed a significant reduction in the CGH group compared to the control group. Conclusion Suboccipital muscles are stiffer and ROM of cervical rotation and extension is smaller in CGH patients than the healthy controls, but FHP is not different between the groups, leading to diagnosing CGH and treatment.
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Affiliation(s)
- Mahdi Tavakkoli
- Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farid Bahrpeyma
- Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Van V, Rademacher N, Liu CC, Keeton S, Johnston AN. Shear wave velocity values measured by 2D-shear wave elastography are not different between awake and anesthetized cats without clinically significant hepatic fibrosis. Vet Radiol Ultrasound 2023; 64:913-919. [PMID: 37439064 PMCID: PMC10949614 DOI: 10.1111/vru.13267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/19/2023] [Accepted: 05/29/2023] [Indexed: 07/14/2023] Open
Abstract
Two-dimensional shear wave elastography (2D-SWE) is widely used as a noninvasive method to quantify liver stiffness. In humans, liver stiffness approximates histologic hepatic fibrosis. While histology is the gold standard for diagnosing liver disease, 2D-SWE may be a minimally invasive alternative to biopsy in feline patients. The objectives of this prospective, observational, crossover study were trifold: (1) to assess the feasibility of performing 2D-SWE in awake cats, (2) to determine whether anesthesia altered shear wave velocity (SWV) measurements, and (3) to correlate hepatic stiffness with histologically quantified hepatic fibrosis. Eleven healthy, purpose-bred cats underwent 2D-SWE in awake and anesthetized states. SWV measurements were compared with histologic fibrosis measurements obtained from liver biopsies during the anesthetic period. The mean velocities were not significantly different between awake (1.47 ± 0.18 m/s) and anesthetized (1.47 ± 0.24 m/s) cats. Premedication and anesthetic drugs did not impact mean SWV. There was a higher variability in the SWV values in the awake group. The data points were reliably replicated, with an interquartile range of 0.24 and 0.32 in anesthetized and awake groups, respectively. There was moderate agreement between observers (intraclass correlation coefficient = 0.66). All cats had clinically insignificant fibrosis. There was no correlation between the SWV measurements and the histological fibrosis values. This study demonstrates that 2D-SWE is feasible in awake cats and that the anesthetic protocol employed did not significantly alter mean SWV. This work is the first to histologically validate normal SWV values in cats and show that 2D-SWE cannot differentiate minimal differences in feline hepatic fibrosis.
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Affiliation(s)
- Victoria Van
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Nathalie Rademacher
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Chin-Chi Liu
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Sarah Keeton
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Andrea N Johnston
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
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Jiang L, Yu Q, Zhang X, Wang D, Chen H, Jiang W. Regional assessments of supraspinatus muscle stiffness in normal adults using shear wave elastography. Heliyon 2023; 9:e17696. [PMID: 37539314 PMCID: PMC10395121 DOI: 10.1016/j.heliyon.2023.e17696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 08/05/2023] Open
Abstract
Objectives To provide normal references for regional shear wave elastography assessments of supraspinatus muscle in a population. Methods Shear wave elastography images of supraspinatus muscles were evaluated on 100 shoulders of 50 normal adults in a fixed position with 30° shoulder abduction both at rest and contraction. Shear wave velocity values and activity values of intramuscular tendon, anterior superficial, anterior deep, posterior superficial, posterior deep, and central subregions were measured. The possible differences in hand dominance, sexes, stratified age groups, and internal muscular-component subregions were discussed. Results The results showed that shear wave velocity values at rest and activity values differed significantly among supraspinatus muscular-component subregions. Shear wave velocity values at rest were normally highest in posterior deep and lowest in central subregions, whereas activity values were highest in central subregions. The results also showed evaluation of the intramuscular tendon using shear wave elastography to be practicable. The differences in shear wave velocity values at rest between the dominant and nondominant sides were not significant in each subregion, while the values at rest of the majority of subregions were significantly greater in males than in females. Stratified by age groups of 10 years, the shear wave velocity values at rest of some subregions tended to increase with age, with uncorrelations possibly related to insufficient sample sizes and different intensities of limb activities. Conclusions This study suggested that regional assessments of supraspinatus stiffness using shear wave elastography are feasible, with further research supporting that it can provide information on the surgery, training, and rehabilitation of rotator cuff tears.
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Affiliation(s)
- Lan Jiang
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Yu
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xihong Zhang
- School of Public Health, North China University of Science and Technology, China
| | - Dong Wang
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hong Chen
- Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Jiang
- Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Assessment of Neck Muscle Shear Modulus Normalization in Women with and without Chronic Neck Pain. Diagnostics (Basel) 2022; 12:diagnostics12081791. [PMID: 35892502 PMCID: PMC9331943 DOI: 10.3390/diagnostics12081791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Identifying the objective stiffness of the neck muscles facilitates the early and specific diagnosis of neck pain and targeted therapy. However, individual variation in the muscle shear modulus obscures differences between healthy and diseased individuals. Normalization may improve the comparability between individuals. The shear modulus at different functional tasks served as a reference for normalizing the neck muscles’ shear modulus of 38 women, 20 with chronic neck pain and 18 asymptomatic. Reference tasks were maximal voluntary contraction, relaxed sitting, prone head lift, balancing 1 kg on the head, and neck extension at 48 N. The effects of normalization on within-group variation and between-group differences were compared. Normalization with maximal voluntary contraction was discarded due to imaging problems. Normalization with relaxed sitting, prone head lift, balancing 1 kg, and neck extension at 48 N reduced within-group variation, by 23.2%, 26.8%, 11.6%, and 33.6%, respectively. All four normalization approaches reduced the p-values when testing for between-group differences. For the pain group, normalization with relaxed sitting and head lift indicated less normalized muscle stiffness, while normalization with balancing 1 kg and extension at 48 N indicated higher stiffness. The contradictory results are explainable by non-significant group differences in the reference tasks. Normalization of the muscle shear modulus is effective to reduce within-group variation, but a trustworthy normalization approach for group comparisons has yet to be identified.
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Abstract
Over the past decade, ultrasound elastography has emerged as a new technique for measuring soft tissue properties. Real-time, noninvasive, and quantitative evaluations of tissue stiffness have improved and aid in the assessment of normal and pathological conditions. Specifically, its use has substantially increased in the evaluation of muscle, tendon, and ligament properties. In this review, the authors describe the principles of elastography and present different techniques including strain elastography and shear-wave elastography; discuss their applications for assessing soft tissues in the hand before, during, and postsurgeries; present the strengths and limitations of their measurement capabilities; and describe directions for future research.
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Affiliation(s)
- Hugo Giambini
- Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, College of Engineering and Integrated Design, One UTSA Circle, San Antonio, TX 78249, USA.
| | - Kai-Nan An
- Mayo Clinic College of Medicine, 200 First Street, S.W, Rochester, MN 55905, USA
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Sung JH, Kwon YJ, Baek SH, Son MH, Lee JH, Kim BJ. Utility of shear wave elastography and high-definition color for diagnosing carpal tunnel syndrome. Clin Neurophysiol 2021; 135:179-187. [PMID: 34963555 DOI: 10.1016/j.clinph.2021.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The diagnostic values of measuring median nerve (MN) stiffness and vascularity with shear wave elastography (SWE) and high-definition (HD) color were investigated in carpal tunnel syndrome (CTS). METHODS Seventy patients (123 wrists) with CTS and thirty-five healthy volunteers (70 wrists) were enrolled. Based on nerve conduction studies (NCS), the patients were subdivided into NCS-negative, mild-to-moderate, and severe CTS groups. MN and abductor pollicis brevis (APB) SWE and MN HD color were performed on a longitudinal plane. RESULTS The mild-to-moderate and severe CTS groups showed increased MN stiffness at the wrist and MN stiffness ratio (wrist-to forearm) compared with the control (p < 0.001). The NCS-negative CTS group showed increased MN stiffness at the wrist (p = 0.022) and MN stiffness ratio (p = 0.032) compared with the control. The severe CTS group showed increased MN stiffness at the wrist compared with the mild-to-moderate CTS group (p = 0.034). The cutoff-values in diagnosing NCS-confirmed CTS were 50.12 kPa for MN stiffness at the wrist, 1.91 for MN stiffness ratio, and grade 1 for HD color. CONCLUSIONS SWE and HD color are good supportive tools in diagnosing and assessing severity in CTS. SIGNIFICANCE SWE and HD color demonstrated that MN in CTS was associated with increased stiffness and hypervascularity.
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Affiliation(s)
- Joo Hye Sung
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Ye Ji Kwon
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Seol-Hee Baek
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Myeong Hun Son
- Neurophysiology Laboratory, Korea University Anam Hospital, Seoul, Republic of Korea.
| | - Jung Hun Lee
- Neurophysiology Laboratory, Korea University Anam Hospital, Seoul, Republic of Korea.
| | - Byung-Jo Kim
- Department of Neurology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea; BK21 FOUR Program in Learning Health Systems, Korea University, Seoul, Korea.
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Technical feasibility and correlations between shear-wave elastography and histology in kidney fibrosis in children. Pediatr Radiol 2021; 51:1879-1888. [PMID: 33893848 DOI: 10.1007/s00247-021-05068-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/18/2020] [Accepted: 03/21/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Ultrasound elastography has been suggested for assessing organ fibrosis. OBJECTIVE To study the feasibility of shear-wave elastography in children with kidney disease and the correlation between elasticity and kidney fibrosis in order to reduce the indications for kidney biopsy and its complications. MATERIALS AND METHODS Four operators measured kidney elasticity in children with kidney diseases or transplants, all of whom also had a renal biopsy. We assessed the feasibility and the intraobserver variability of the elasticity measurements for each probe used and each kidney explored. Then we tested the correlation between elasticity measurements and the presence of fibrosis. RESULTS Overall, we analyzed 95 children and adolescents, 31 of whom had renal transplant. Measurements with the convex probe were possible in 100% of cases. Linear probe analysis was only possible for 20% of native kidneys and 50% of transplants. Intraobserver variabilities ranged from moderate to high, depending on the probe and kidney studied. Elasticity was higher with the linear probe than with the convex probe (P<0.001 for left kidney and P=0.03 for right kidney). Measurements did not differ from one kidney to another in the same child. Elasticity and fibrosis were both higher in transplant patients (P=0.02 with convex probe; P=0.01 with linear probe; P=0.04 overall). There was no correlation between elasticity and fibrosis. CONCLUSION Of the devices used in this work, kidney elastography was more accurately analyzed with a convex probe. Our study did not identify any correlation between elasticity and kidney fibrosis.
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Quarato CMI, Venuti M, Dimitri L, Lacedonia D, Simeone A, Mirijello A, Cosmo SD, Maiello E, Taurchini M, Scioscia G, Barbaro MPF, Copetti M, Sperandeo M. Transthoracic ultrasound shear wave elastography for the study of subpleural lung lesions. Ultrasonography 2021; 41:93-105. [PMID: 34218607 PMCID: PMC8696150 DOI: 10.14366/usg.21021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/15/2021] [Indexed: 11/03/2022] Open
Abstract
PURPOSE The aim of this study was to assess whether new-generation shear wave elastography (SWE) is suitable for the characterization of lung subpleural lesions. METHODS In total, 190 consecutive patients with subpleural lung lesions received ultrasonography and SWE. Patients with suspected malignancy underwent ultrasound-guided transthoracic needle biopsy. Final diagnoses were made on the basis of patients' clinical course, microbiological studies, and histological results. SWE was also performed in 25 healthy volunteers. RESULTS We found no statistically significant differences in stiffness between lung carcinomas, lung metastases, and pneumonia (P=0.296) or between different histological types of lung cancer (P=0.393). Necrosis was associated with reduced stiffness in pneumonia. Excluding necrotic lesions, pneumonia showed higher stiffness than lung carcinomas (2.95±0.68 m/s vs. 2.60±0.54 m/s, P=0.006). Chronic pneumonia showed increased stiffness (3.03±0.63 m/s), probably due to the presence of fibrotic tissue on histology. Pleural effusion was associated with a statistically significant reduction in stiffness, both in lung carcinomas (P=0.004) and lung metastases (P=0.002). The presence of air in healthy lung tissue may lead to incorrect speed estimates due to shear wave reflection (very high values, 14.64±2.19 m/s). CONCLUSION Transthoracic SWE could not distinguish lung malignancy from pneumonia, or between different histological types of lung carcinomas. In particular, SWE seems unable to resolve the clinical dilemma of chronic subpleural consolidations.
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Affiliation(s)
- Carla Maria Irene Quarato
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy
| | - Mariapia Venuti
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy
| | - Lucia Dimitri
- Unit of Pathology, Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Donato Lacedonia
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy
| | - Anna Simeone
- Department of Radiology, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Antonio Mirijello
- Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Salvatore De Cosmo
- Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Evaristo Maiello
- Unit of Oncology, Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Marco Taurchini
- Unit of Thoracic Surgery, Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Giulia Scioscia
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy
| | - Maria Pia Foschino Barbaro
- Department of Medical and Surgical Sciences, Institute of Respiratory Diseases, Policlinico Riuniti di Foggia, University of Foggia, Foggia, Italy
| | - Massimiliano Copetti
- Unit of Biostatistics, Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Marco Sperandeo
- Unit of Interventional and Diagnostic Ultrasound, Department of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
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Garcés Iñigo E, Llorens Salvador R, Escrig R, Hervás D, Vento M, Martí-Bonmatí L. Quantitative Evaluation of Neonatal Brain Elasticity Using Shear Wave Elastography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:795-804. [PMID: 32876366 DOI: 10.1002/jum.15464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/09/2020] [Accepted: 07/12/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To demonstrate the feasibility of 2-dimensional brain ultrasound shear wave elastography (SWE) and to define the average elasticity values of the gray and white matter in term neonates. METHODS This work was a prospective observational single-center study including 55 healthy term neonates consecutively recruited in the maternity ward between the second and third postnatal days. All were successfully evaluated with a cerebral SWE examination performed with a multifrequency 4-9-MHz transducer. Bilateral sagittal planes of the thalamus and corona radiata were used to measure stiffness using a quantitative SWE method. Several elastograms with 5 to 15 nonoverlapping areas were obtained from the 2 different anatomic locations. The 5 most central measurements were averaged as representative values. RESULTS The 55 neonates ranged from 37 to 40 weeks' gestation. The estimated mean velocity values of the thalamus (1.17 m/s; 95% confidence interval, 1.13, 1.22 m/s) and corona radiata (1.60 m/s; 95% confidence interval, 1.57, 1.64 m/s) were statistically different (P < .001). There was no significant influence of laterality, gestational age, cephalic perimeter, sex, length, or type of delivery on the stiffness measurements. CONCLUSIONS Brain ultrasound SWE is feasible and allows measurements of neonatal brain elasticity. The elasticity of the thalamus and corona radiata at the frontal white matter in healthy term neonates is different. The knowledge of normal SWE ranges in term neonates allows comparative studies under pathologic conditions.
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Affiliation(s)
| | | | - Raquel Escrig
- Department of Pediatrics, Neonatal Research Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - David Hervás
- Data Science, Biostatistics, and Bioinformatics Platform, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Máximo Vento
- Department of Pediatrics, Neonatal Research Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Luis Martí-Bonmatí
- Department of Radiology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Research Group on Biomedical Imaging, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
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Braz GA, Baggio AL, Agnollitto PM, Grillo FW, Pavan TZ, Paula FJA, Nogueira-Barbosa MH, Cardoso GC, Carneiro AAO. Tissue Characterization by Low-Frequency Acoustic Waves Generated by a Single High-Frequency Focused Ultrasound Beam. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:334-344. [PMID: 33131928 DOI: 10.1016/j.ultrasmedbio.2020.09.024] [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: 03/27/2020] [Revised: 09/07/2020] [Accepted: 09/29/2020] [Indexed: 06/11/2023]
Abstract
The mechanical properties of biological tissues are fingerprints of certain pathologic processes. Ultrasound systems have been used as a non-invasive technique to both induce kilohertz-frequency mechanical vibrations and detect waves resulting from interactions with biological structures. However, existing methodologies to produce kilohertz-frequency mechanical vibrations using ultrasound require the use of variable-frequency, dual-frequency and high-power systems. Here, we propose and demonstrate the use of bursts of megahertz- frequency acoustic radiation to observe kilohertz-frequency mechanical responses in biological tissues. Femoral bones were obtained from 10 healthy mice and 10 mice in which osteoporosis had been induced. The bones' porosity, trabecular number, trabecular spacing, connectivity and connectivity density were determined using micro-computed tomography (μCT). The samples were irradiated with short, focused acoustic radiation pulses (f = 3.1 MHz, t = 15 μs), and the low-frequency acoustic response (1-100 kHz) was acquired using a dedicated hydrophone. A strong correlation between the spectral maps of the acquired signals and the μCT data was found. In a subsequent evaluation, soft tissue stiffness measurements were performed with a gel wax-based tissue-mimicking phantom containing three spherical inclusions of the same type of gel but different densities and Young's moduli, yet with approximately the same echogenicity. Conventional B-mode ultrasound was unable to image the inclusions, while the novel technique proposed here showed good image contrast.
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Affiliation(s)
- Guilherme A Braz
- Department of Physics, Faculty of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Andre L Baggio
- Physics Institute, Federal University of Alagoas, Maceio, Brazil
| | - Paulo M Agnollitto
- Department of Medical Imaging, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Felipe W Grillo
- Department of Physics, Faculty of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Theo Z Pavan
- Department of Physics, Faculty of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Francisco J A Paula
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Marcello H Nogueira-Barbosa
- Department of Medical Imaging, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - George C Cardoso
- Department of Physics, Faculty of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Antonio A O Carneiro
- Department of Physics, Faculty of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Dickson DM, Smith SL, Hendry GJ. Can patient characteristics explain variance in ultrasound strain elastography measures of the quadratus femoris and patellar tendons? Knee 2021; 28:282-293. [PMID: 33460994 DOI: 10.1016/j.knee.2020.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/18/2020] [Accepted: 12/21/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To explore the associations between participant characteristics and magnitudes of difference in paired elastography measures of knee tendon from different ultrasound systems, and to compare strain elastography pattern description. MATERIALS AND METHODS Quadriceps and patellar tendons of 20 healthy volunteers (40 tendons) were examined by an experienced operator employing two ultrasound systems (GE S8 and Esaote MyLab 70XVG). Pearson/Spearman correlations explored the influence of participant characteristics (BMI, body fat %, leg circumference, activity level) on the magnitude of differences between measures. Paired-sample t test or Wilcoxon signed rank test were performed to compare repeated measures of individual ultrasound systems. RESULTS The quadriceps tendon was characteristically stiffer than the patellar tendon. Participant characteristics were associated with within machine differences of the distal quadriceps tendon (BMI; r = 0.49, p = 0.028-0.03 and body fat %; r = 0.43, p = 0.05-0.056) ER measures. CONCLUSIONS Anthropometric and body composition parameters were associated with within machine differences for elasticity measures, where high BMI and body fat % contribute to paired measurement variance at the distal quadriceps tendon. Strain elastography protocols should be standardised, repeated ER measures performed using the same US system and patient characteristics considered for future clinical applications.
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Affiliation(s)
- Diane M Dickson
- Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK.
| | - Stephanie L Smith
- Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK; University of Nottingham, University Park, Nottingham, UK
| | - Gordon J Hendry
- Glasgow Caledonian University, School of Health and Life Sciences, Glasgow, UK
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18
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Bastijns S, De Cock AM, Vandewoude M, Perkisas S. Usability and Pitfalls of Shear-Wave Elastography for Evaluation of Muscle Quality and Its Potential in Assessing Sarcopenia: A Review. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2891-2907. [PMID: 32843232 DOI: 10.1016/j.ultrasmedbio.2020.06.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 06/18/2020] [Accepted: 06/30/2020] [Indexed: 05/08/2023]
Abstract
Sarcopenia is age-related progressive and generalized loss of skeletal muscle mass and strength. Its prevalence is rising, which poses a burden for society because it increases disability and dependency and therefore raises health care costs. Muscle mass quality, however-an essential part of sarcopenia-is not easily diagnosable yet. Recent interest has risen for ultrasonographic evaluation of muscle. This review introduces muscle elastography as a possible, easy and cheap tool to evaluate qualitative muscle parameters. Basic principles of muscle elastography are described, as well as different elastography techniques and some technical considerations. Furthermore, a proposal for practical guidelines is offered and factors influencing muscle stiffness are highlighted.
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Affiliation(s)
- Sophie Bastijns
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium.
| | - Anne-Marie De Cock
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium
| | - Maurits Vandewoude
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium; Belgian Ageing Muscle Society, Liege, Belgium
| | - Stany Perkisas
- Department of Medicine, University of Antwerp, Antwerp, Belgium; Ziekenhuisnetwerk Antwerpen, Antwerp, Belgium; Belgian Ageing Muscle Society, Liege, Belgium
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Thanaboonnipat C, Sutayatram S, Buranakarl C, Choisunirachon N. Renal ultrasonographic shear-wave elastography and urinary procollagen type III amino-terminal propeptide in chronic kidney disease dogs. Vet World 2020; 13:1955-1965. [PMID: 33132611 PMCID: PMC7566241 DOI: 10.14202/vetworld.2020.1955-1965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/04/2020] [Indexed: 12/20/2022] Open
Abstract
Background and Aim: Renal fibrosis is a well-established pathological alteration associated with chronic kidney disease (CKD) in several species and progresses as CKD advances. Although a renal biopsy is the gold standard for determining renal fibrosis, it is an invasive, impractical method for clinical practice. In humans, ultrasonographic shear-wave elastography (SWE), a novel advanced diagnostic imaging tool, can evaluate renal parenchyma stiffness, and urinary procollagen type III amino-terminal propeptide (uPIIINP), a promising renal fibrosis biomarker in humans, has increasingly been use applied to reduce the biopsies. This study compares renal tissue elasticity observed through SWE Young’s modulus (E) values between healthy dogs (HD) and those with CKD. Materials and Methods: The E value acquired by SWE, uPIIINP levels, and renal function were evaluated in 15 CKD dogs and 15 HD. Results: The renal cortical E values were significantly higher than the renal medullary E values in both groups (p<0.001). Renal cortical and medullary E values in CKD dogs were significantly higher than in HD (p<0.01). Cortical E values had greater significant correlations with renal functional parameters than the medullary E values and had a significant positive correlation with concentrations of plasma creatinine (Cr) (p<0.001); blood urea nitrogen (p<0.01); urine protein Cr ratio (p<0.01); and fractional excretions of sodium (p<0.05), potassium (p<0.05), chloride (p<0.05), and magnesium (p<0.001) while they had a negative correlation with urine specific gravity (p<0.05) and urine osmolality to plasma osmolality ratio (p<0.05). The uPIIINP to Cr (uPIIINP/Cr) ratios of CKD dogs were higher than those of HD (p<0.001). Moreover, the uPIIINP/Cr levels presented significant correlations with the renal cortical E values (p<0.01) and also the renal functional parameters. Conclusion: SWE offers a complementary, non-invasive diagnostic imaging tool for evaluating renal tissue stiffness in CKD dogs with renal function deterioration. In addition, uPIIINP levels are associated with renal function and structural changes in dogs. Therefore, the uPIIINP level might be a non-invasive, complementary, and promising biomarker for evaluating renal fibrosis in canine CKD.
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Affiliation(s)
- Chutimon Thanaboonnipat
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Saikaew Sutayatram
- Department of Veterinary Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chollada Buranakarl
- Department of Veterinary Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Nan Choisunirachon
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, 10330, Thailand
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Recent Advances in Ultrasound Diagnosis of Carpal Tunnel Syndrome. Diagnostics (Basel) 2020; 10:596. [PMID: 32824261 PMCID: PMC7460039 DOI: 10.3390/diagnostics10080596+10.1055/s-0032-1325397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
With the widespread use of high-resolution ultrasonography, ultrasonic examination has been shown to be useful as a diagnostic method for carpal tunnel syndrome. The main advantages of ultrasonography are that it is simple, quick, non-invasive, and economical. Another advantage is that tissue dynamics can be observed with real-time imaging. In recent reports, it has been shown that ultrasonic examination can provide similar diagnostic accuracy as nerve conduction study in the diagnosis of carpal tunnel syndrome. It has been expected that ultrasound demand in daily medical care will continue to increase. Ultrasonography in carpal tunnel syndrome shows an enlarged median nerve in proximal carpal tunnel, thickening of the flexor retinaculum, and edema around flexor tendons in cross-sectional images. In addition, with the introduction of new technologies such as ultrasonic elastography and speckle tracking, it has become possible to quantify dynamics and material property changes of nerves, tendons, and their surrounding structures. In this review, we describe recent advancements of carpal tunnel syndrome diagnosis based on ultrasound dynamic images, and discuss its pathology.
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21
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Abstract
With the widespread use of high-resolution ultrasonography, ultrasonic examination has been shown to be useful as a diagnostic method for carpal tunnel syndrome. The main advantages of ultrasonography are that it is simple, quick, non-invasive, and economical. Another advantage is that tissue dynamics can be observed with real-time imaging. In recent reports, it has been shown that ultrasonic examination can provide similar diagnostic accuracy as nerve conduction study in the diagnosis of carpal tunnel syndrome. It has been expected that ultrasound demand in daily medical care will continue to increase. Ultrasonography in carpal tunnel syndrome shows an enlarged median nerve in proximal carpal tunnel, thickening of the flexor retinaculum, and edema around flexor tendons in cross-sectional images. In addition, with the introduction of new technologies such as ultrasonic elastography and speckle tracking, it has become possible to quantify dynamics and material property changes of nerves, tendons, and their surrounding structures. In this review, we describe recent advancements of carpal tunnel syndrome diagnosis based on ultrasound dynamic images, and discuss its pathology.
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22
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Recent Advances in Ultrasound Diagnosis of Carpal Tunnel Syndrome. Diagnostics (Basel) 2020; 10:diagnostics10080596. [PMID: 32824261 PMCID: PMC7460039 DOI: 10.3390/diagnostics10080596] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 12/21/2022] Open
Abstract
With the widespread use of high-resolution ultrasonography, ultrasonic examination has been shown to be useful as a diagnostic method for carpal tunnel syndrome. The main advantages of ultrasonography are that it is simple, quick, non-invasive, and economical. Another advantage is that tissue dynamics can be observed with real-time imaging. In recent reports, it has been shown that ultrasonic examination can provide similar diagnostic accuracy as nerve conduction study in the diagnosis of carpal tunnel syndrome. It has been expected that ultrasound demand in daily medical care will continue to increase. Ultrasonography in carpal tunnel syndrome shows an enlarged median nerve in proximal carpal tunnel, thickening of the flexor retinaculum, and edema around flexor tendons in cross-sectional images. In addition, with the introduction of new technologies such as ultrasonic elastography and speckle tracking, it has become possible to quantify dynamics and material property changes of nerves, tendons, and their surrounding structures. In this review, we describe recent advancements of carpal tunnel syndrome diagnosis based on ultrasound dynamic images, and discuss its pathology.
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23
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Thanaboonnipat C, Sutayatram S, Buranakarl C, Choisunirachon N. Renal ultrasonographic strain elastography and symmetric dimethylarginine (SDMA) in canine and feline chronic kidney disease. J Vet Med Sci 2020; 82:1104-1112. [PMID: 32554935 PMCID: PMC7468054 DOI: 10.1292/jvms.19-0496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Chronic kidney disease (CKD) is a common renal disease in dogs and cats. Renal fibrosis
is a main pathologic process leading of CKD progression. Renal biopsy is the gold standard
for renal fibrosis assessment. However, it is not routinely performed in clinic due to its
invasiveness. Therefore, the aim of this study was to evaluate the use of ultrasonographic
strain elastography (SE), which is a non-invasive method for renal tissue stiffness
determination and its association with renal function. Renal strain ratios and renal
function were evaluated in 13 CKD dogs (CKDD), 38 healthy dogs (HD), 17 CKD cats (CKDC)
and 26 healthy cats (HC). There were significantly lower renal cortical strain ratios than
medullary strain ratios in all groups (HD; P<0.01, HC;
P<0.01, CKDD and CKDC; P<0.05) and significantly
lower cortical and medullary strain ratios in both CKDD and CKDC than in healthy control
animals of both species (P<0.0001). In dogs, the renal cortical and
medullary strain ratios significantly negatively correlated with plasma creatinine
(P<0.05), blood urea nitrogen (BUN; P<0.05;
P<0.01, respectively), and symmetric dimethylarginine (SDMA;
P<0.01). In cats, similar correlations were found for plasma
creatinine (P<0.001), BUN (P<0.05;
P<0.001, respectively) and SDMA (P<0.05). SE
might be a promising imaging diagnostic tool for renal-elasticity evaluation, also
correlating with renal functional impairment in canine and feline CKD.
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Affiliation(s)
- Chutimon Thanaboonnipat
- Department of Veterinary Physiology, Faculty of Veterinary Science, Chulalongkorn University, 39 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, Thailand.,Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, 39 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, Thailand
| | - Saikaew Sutayatram
- Department of Veterinary Physiology, Faculty of Veterinary Science, Chulalongkorn University, 39 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, Thailand
| | - Chollada Buranakarl
- Department of Veterinary Physiology, Faculty of Veterinary Science, Chulalongkorn University, 39 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, Thailand
| | - Nan Choisunirachon
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, 39 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, Thailand
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Naganuma H, Ishida H, Uno A, Nagai H, Kuroda H, Ogawa M. Diagnostic problems in two-dimensional shear wave elastography of the liver. World J Radiol 2020; 12:76-86. [PMID: 32549956 PMCID: PMC7288776 DOI: 10.4329/wjr.v12.i5.76] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 05/06/2020] [Accepted: 05/13/2020] [Indexed: 02/06/2023] Open
Abstract
Two-dimensional shear wave elastography (2D-SWE) is used in the clinical setting for observation of the liver. Unfortunately, a wide spectrum of artifactual images are frequently encountered in 2D-SWE, the precise mechanisms of which remain incompletely understood. This review was designed to present many of the artifactual images seen in 2D-SWE of the liver and to analyze them by computer simulation models that support clinical observations. Our computer simulations yielded the following suggestions: (1) When performing 2D-SWE in patients with chronic hepatic disease, especially liver cirrhosis, it is recommended to measure shear wave values through the least irregular hepatic surface; (2) The most useful 2D-SWE in patients with focal lesion will detect lesions that are poorly visible on B-mode ultrasound and will differentiate true tumors from pseudo-tumors (e.g., irregular fatty change); and (3) Measurement of shear wave values in the area posterior to a focal lesion must be avoided.
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Affiliation(s)
- Hiroko Naganuma
- Department of Gastroenterology, Yokote Municipal Hospital, Yokote 0138602, Akita, Japan
| | - Hideaki Ishida
- Department of Gastroenterology, Akita Red Cross Hospital, Kamikitatesaruta 0101495, Akita, Japan
| | - Atsushi Uno
- Department of Gastroenterology, Oomori Municipal Hospital, Yokote 0130525, Akita, Japan
| | - Hiroshi Nagai
- New Generation Imaging Laboratory, Tokyo 1680065, Japan
| | - Hidekatsu Kuroda
- Division of Gastroenterology and Hepatology, Iwate Medical University, Morioka 0200023, Iwate, Japan
| | - Masahiro Ogawa
- Department of Gastroenterology and Hepatology, Nihon University Hospital, Chiyoda 1018309, Tokyo, Japan
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Cortela GA, Negreira CA, Pereira WCA. Durability study of a gellan gum-based tissue-mimicking phantom for ultrasonic thermal therapy. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2020; 147:1531. [PMID: 32237853 DOI: 10.1121/10.0000813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/12/2020] [Indexed: 06/11/2023]
Abstract
Stability and duration of ultrasonic phantoms are still subjects of research. This work presents a tissue-mimicking material (TMM) to evaluate high-intensity therapeutic ultrasound (HITU) devices, composed of gellan gum (matrix), microparticles (scatterers), and chemicals. The ultrasonic velocity and attenuation coefficient were characterized as a function of temperature (range 20 °C-85 °C). The nonlinear parameter B/A was determined by the finite amplitude insertion substitution (FAIS) method, and the shear modulus was determined by a transient elastography technique. The thermal conductivity and specific heat were determined by the line source method. The attenuation was stable for 60 days, and in an almost linear frequency dependence (0.51f0.96 dB cm-1), at 20 °C (1-10 MHz). All other evaluated physical parameters are also close to typical soft tissue values. Longitudinal ultrasonic velocities were between 1.49 and 1.75 mm μs-1, the B/A parameter was 7.8 at 30 °C, and Young's modulus was 23.4 kPa. The thermal conductivity and specific heat values were 0.7 W(m K)-1 and 4.7 kJ(kg K)-1, respectively. Consistent temperature increases and thermal doses occurred under identical HITU exposures. Low cost, longevity, thermal stability, and thermal repeatability make TMM an excellent material for ultrasonic thermal applications. The TMM developed has the potential to assess the efficacy of hyperthermia devices and could be used to adjust the ultrasonic emission of HITU devices.
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Affiliation(s)
- Guillermo A Cortela
- Institute of Physics, Faculty of Sciences, Universidad de la Republica Montevideo, Iguá 4225, 11400, Montevideo, Uruguay
| | - Carlos A Negreira
- Institute of Physics, Faculty of Sciences, Universidad de la Republica Montevideo, Iguá 4225, 11400, Montevideo, Uruguay
| | - Wagner C A Pereira
- Biomedical Engineering Program-COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Hariri A, Chen F, Moore C, Jokerst JV. Noninvasive staging of pressure ulcers using photoacoustic imaging. Wound Repair Regen 2019; 27:488-496. [PMID: 31301258 PMCID: PMC8043767 DOI: 10.1111/wrr.12751] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 06/30/2019] [Indexed: 01/07/2023]
Abstract
Ulcers including pressure ulcers and diabetic foot ulcers damage the skin and underlying tissue in people with compromised blood circulation. They are classified into four stages of severity and span from mild reddening of the skin to tissue damage and muscle/bone infections. Here, we used photoacoustic imaging as a noninvasive method for detecting early tissue damage that cannot be visually observed while also staging the disease using quantitative image analysis. We used a mouse model of pressure ulcers by implanting subdermal magnets in the dorsal flank and periodically applying an external magnet to the healed implant site. The magnet-induced pressure was applied in cycles, and the extent of ulceration was dictated by the number of cycles. We used both laser- and light-emitting diode (LED)-based photoacoustic imaging tools with 690 nm excitation to evaluate the change in photoacoustic signal and depth of injury. Using laser-based photoacoustic imaging system, we found a 4.4-fold increase in the photoacoustic intensity in stage I vs. baseline (no pressure). We also evaluated the depth of injury using photoacoustics. We measured a photoacoustic ulcer depth of 0.38 ± 0.09 mm, 0.74 ± 0.11 mm, 1.63 ± 0.4 mm, and 2.7 ± 0.31 mm (n = 4) for stages I-IV, respectively. The photoacoustic depth differences between each stage were significant (p < 0.05). We also used an LED-based photoacoustic imaging system to detect early stage (stage I) pressure ulcers and observed a 2.5-fold increase in photoacoustic signal. Importantly, we confirmed the capacity of this technique to detect dysregulated skin even before stage I ulcers have erupted. We also observed significant changes in photoacoustic intensity during healing suggesting that this approach can monitor therapy. These findings were confirmed with histology. These results suggest that this photoacoustic-based approach might have clinical value for monitoring skin diseases including pressure ulcers.
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Affiliation(s)
- Ali Hariri
- Department of NanoEngineering, University of California San Diego, La Jolla, California, 92093
| | - Fang Chen
- Department of NanoEngineering, University of California San Diego, La Jolla, California, 92093
- Material Science and Engineering Program, University of California San Diego, La Jolla, California, 92093
| | - Colman Moore
- Department of NanoEngineering, University of California San Diego, La Jolla, California, 92093
| | - Jesse V. Jokerst
- Department of NanoEngineering, University of California San Diego, La Jolla, California, 92093
- Material Science and Engineering Program, University of California San Diego, La Jolla, California, 92093
- Department of Radiology, University of California San Diego, La Jolla, California, 92093
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Feasibility of two-dimensional ultrasound shear wave elastography of human fetal lungs and liver: A pilot study. Diagn Interv Imaging 2019; 101:69-78. [PMID: 31447393 DOI: 10.1016/j.diii.2019.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/02/2019] [Accepted: 08/05/2019] [Indexed: 01/18/2023]
Abstract
PURPOSE The first aim was to evaluate feasibility and reproducibility of 2-dimensional ultrasound (2D) shear wave elastography (SWE) of human fetal lungs and liver between 24 and 34weeks of gestation. The second aim was to model fetal lung-to-liver elastography ratio (LLE ratio) and to assess its variations according to gestational age and maternal administration of corticosteroids. MATERIAL AND METHODS 2D-SWE examinations were prospectively performed in fetuses of women with an uncomplicated pregnancy (group 1) and fetuses of women with a threatened preterm labor requiring administration of corticosteroids (group 2). Two 2D-SWE examinations were performed at "day 0" and "day 2" in group 1; before and 24hours after a course of corticosteroid in group 2. Three operators performed 2 cycles of 3 measurements on the lung (regions A1, A2, A3) and the liver (regions IV, V, VI). Repeatability and reproducibility of measurements were calculated. The fetal LLE ratio was modeled from the most reproducible regions. RESULTS Fifty-five women were enrolled in group 1 and 48 in group 2. For the lung, 8.6% of measurements were considered invalid and 6.9% for the liver. The most reproducible region for the lung was A3 [ICC between 0.70 (95% CI: 0.42-0.85) and 0.78 (95% CI: 0.48-0.90)] and region VI for the liver [ICC between 0.70 (95% CI: 0.40-0.85) and 0.84 (95% CI: 0.60-0.94)]. According to gestational age, a moderate positive linear correlation was found for stiffness values of A3 (R=0.56), V (R=0.46) and VI (R=0.44). LLE ratio values at "day 0" were not different between the two groups but decreased at "day 2" in group 2 (0.2; 95% CI: 0.07-0.34; P<0.001). CONCLUSION Quantitative fetal lung and liver stiffness measurements are possible with 2D-SWE with acceptable reproducibility.
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Dubinsky TJ, Shah HU, Erpelding TN, Sannananja B, Sonneborn R, Zhang M. Propagation Imaging in the Demonstration of Common Shear Wave Artifacts. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1611-1616. [PMID: 30380161 DOI: 10.1002/jum.14840] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 09/13/2018] [Indexed: 06/08/2023]
Abstract
In this article, we describe our experience with shear wave propagation imaging (SWPI) as an adjunct to 2-dimensional (2D) shear wave elastography (SWE) in a cohort of patients being evaluated for diffuse liver disease. Two-dimensional SWE has been extensively studied in previous publications; however, 2D SWE using propagation images has not been widely described in the literature to date. We observed that when certain artifacts occurred on the color elastograms, highly characteristic changes to shear wave propagation contours were seen, which can help clarify the cause of the artifacts. To our knowledge, the use of SWPI to explain the etiology of artifacts has never been published before. The artifacts described in this article include the capsule reverberation artifact, penetration limitation or dropout artifact, artifact due to blood vessels, shadowing artifact, tissue motion artifact, and near-field distortion/precompression artifact. Hence, the purpose of this article is to show examples of common artifacts seen on 2D SWE as depicted on corresponding SWPI to demonstrate that both types of image displays are complementary to each other.
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Affiliation(s)
- Theodore J Dubinsky
- Department of Radiology, University of Washington Medical Center, Seattle, Washington, USA
| | - Hardik U Shah
- Department of Radiology, University of Washington Medical Center, Seattle, Washington, USA
| | | | - Bhagya Sannananja
- Department of Radiology, University of Washington Medical Center, Seattle, Washington, USA
| | - Rachelle Sonneborn
- Department of Radiology, University of Washington Medical Center, Seattle, Washington, USA
| | - Man Zhang
- Department of Radiology, University of Washington Medical Center, Seattle, Washington, USA
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Maßlo K, Möllers M, de Murcia KO, Klockenbusch W, Schmitz R. New Method for Assessment of Levator Avulsion Injury: A Comparative Elastography Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1301-1307. [PMID: 30208248 DOI: 10.1002/jum.14810] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aim of this study was to introduce elastography as a new method for sonographic assessment of postpartum pelvic floor trauma. METHODS We examined 86 postpartum primiparous women, of whom 43 had undergone primary caesarean section (group_CS) and 43 vaginal delivery (group_VD). In a puborectal-symphysis plane, B-mode and elastographic ultrasonography were used to evaluate pelvic floor trauma. The strain value of left and right puborectal muscle was assessed close to the symphysis (Trauma_Elastography). The strain ratio maximum of this measurement was stored (Trauma_Index). RESULTS The elastographic evaluation revealed more trauma-suspicious lesions than the B-mode investigation (60.5% versus 39.5%; P < .001). The median Trauma_Index was higher in group_VD compared to group_CS (1.63 versus 1.18; P < .001). CONCLUSION Sonographic elastography assessment in a new examination plane shows postpartum trauma of the pelvic floor in women after vaginal delivery. This new method may help to identify women with a higher risk of postpartum pelvic floor disorders.
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Affiliation(s)
- Katharina Maßlo
- Department of Obstetrics and Gynaecology, Asklepios Klinik Altona, Hamburg, Germany
| | - Mareike Möllers
- Department of Obstetrics and Gynaecology, University Hospital Münster, Münster, Germany
| | | | - Walter Klockenbusch
- Department of Obstetrics and Gynaecology, University Hospital Münster, Münster, Germany
| | - Ralf Schmitz
- Department of Obstetrics and Gynaecology, University Hospital Münster, Münster, Germany
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Thanaboonnipat C, Sutayatram S, Buranakarl C, Choisunirachon N. Renal shear wave elastography and urinary procollagen type III amino-terminal propeptide (uPIIINP) in feline chronic kidney disease. BMC Vet Res 2019; 15:54. [PMID: 30744640 PMCID: PMC6371591 DOI: 10.1186/s12917-019-1801-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 01/29/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is one of the most common diseases occurring in cats. It is characterized by renal fibrosis, which is strongly correlated with impairment of renal function. Since renal biopsy is not performed routinely in clinical practice, the non-invasive method of ultrasonographic shear-wave elastography (SWE) was used to determine renal parenchymal stiffness. Currently, urinary procollagen type III amino-terminal propeptide (uPIIINP) is a renal fibrosis biomarker in humans. Moreover, PIIINP is increasingly applied for identification of fibrosis in various organs in animals. RESULTS The Young's modulus (E) value on SWE, uPIIINP, and renal function were evaluated in 23 CKD cats and 25 healthy cats (HC). The renal cortical E values were significantly higher than those of the renal medulla in both groups (P < 0.001). The E values of the renal cortex and medulla were significantly higher in CKD cats than in HC (P < 0.001 and P < 0.01, respectively). The E values, especially of the cortex, showed a significant positive correlation with concentrations of plasma creatinine (P < 0.001), blood urea nitrogen (P < 0.05), while they had a negative correlation with urine specific gravity (P < 0.001) and urine osmolality per plasma osmolality ratio (P < 0.01). The uPIIINP to creatinine ratios (uPIIINP/Cr) were significantly higher in CKD cats than in HC (P < 0.01) and were highly correlated with renal cortical E values (P < 0.001). CONCLUSIONS SWE might be an additively useful and non-invasive diagnostic imaging tool to evaluate renal parenchymal stiffness, which correlates with renal functional impairment in CKD cats. Moreover, the uPIIINP/Cr might be a promissing biomarker for adjunctive assessing the renal fibrosis in feline CKD.
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Affiliation(s)
- Chutimon Thanaboonnipat
- Department of Veterinary Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand.,Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, 39 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, 10330, Thailand
| | - Saikaew Sutayatram
- Department of Veterinary Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Chollada Buranakarl
- Department of Veterinary Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Nan Choisunirachon
- Department of Veterinary Surgery, Faculty of Veterinary Science, Chulalongkorn University, 39 Henri-Dunant Road, Wangmai, Pathumwan, Bangkok, 10330, Thailand.
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Raayai-Ardakani S, Chen Z, Earl DR, Cohen T. Volume-controlled cavity expansion for probing of local elastic properties in soft materials. SOFT MATTER 2019; 15:381-392. [PMID: 30534776 DOI: 10.1039/c8sm02142b] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Cavity expansion can be used to measure the local nonlinear elastic properties in soft materials, regardless of the specific damage or instability mechanism that it may ultimately induce. To that end, we introduce a volume-controlled cavity expansion procedure and an accompanying method that builds on the Cavitation Rheology technique [J. A. Zimberlin et al., Soft Matter, 2007, 3, 763-767], but without relying on the maximum recorded pressure. This is achieved by determining an effective radius of the cavity that is based on the volume measurements, and is further supported by numerical simulations. Applying this method to PDMS samples, we show that it consistently collapses the experimental curves to the theoretical prediction of cavity expansion prior to the occurrence of fracture or cavitation, thus resulting in high precision measurement with less than 5% of scatter and good agreement with results obtained via conventional techniques. Moreover, since it does not require visual tracking of the cavity, this technique can be applied to measure the nonlinear elastic response in opaque samples.
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Affiliation(s)
- Shabnam Raayai-Ardakani
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, USA.
| | - Zhantao Chen
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, USA
| | - Darla Rachelle Earl
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, USA.
| | - Tal Cohen
- Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, USA. and Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA, USA
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Na XMD, Bei XMD, Wei SMD, Ningning TMD, ZhiXia WMD, Binxuan HMD, Hongwei TMD. Dual Modal Ultrasound Elastography of the Sternocleidomastoid Muscle in Healthy Infants: A Prospective Study. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2019. [DOI: 10.37015/audt.2019.191219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Zhang L, Ding Z, Dong F, Wu H, Liang W, Tian H, Ye X, Luo H, Xu J. Diagnostic Performance of Multiple Sound Touch Elastography for Differentiating Benign and Malignant Thyroid Nodules. Front Pharmacol 2018; 9:1359. [PMID: 30534072 PMCID: PMC6275196 DOI: 10.3389/fphar.2018.01359] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/05/2018] [Indexed: 12/21/2022] Open
Abstract
This study evaluated the ability of Sound Touch Elastography (STE) to distinguish malignant from benign thyroid nodules by quantifying tumor stiffness using the elastic ratio (EI) and shear modulus (G). Eighty-six patients with 86 nodules were enrolled in this study. There were 24/86 (27.90%) thyroid papillary carcinomas (TPC) and 62/86 (72.10%) benign nodules. The mean EI was significantly lower in TPCs than in benign nodules. The EI area under the receiver operating characteristic curve (ROC) was 80%. The EI cutoff value for TPCs was 0.215%. The sensitivity (Sen), specificity (Spe), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were 71%, 73%, 2.58, and 0.40, respectively. Gmax, Gmean, and Gsd were significantly higher in TPCs than in benign nodules. There were no significant differences in Gmin. Compared with other G parameters, Gmax with an optimal cutoff value of 15.82 kPa had the highest AUROC value (84%). The Sen, Spe, LR+, and LR- were 79.17%, 79.03%, 3.776, and 0.261, respectively. We pooled the EI, Gmax, Gmean, and Gsd and the pooled-Sen, Spe, LR+, LR-, diagnostic odds ratio and odds ratio, and area under the summary ROC were 79%, 71%, 2.73, 0.29, 2.23, 9.29, and 82%, respectively. STE could be a new ultrasound diagnostic method for evaluating benign and malignant thyroid nodules.
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Affiliation(s)
- Lei Zhang
- Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China.,Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Zhimin Ding
- Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China.,Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Fajin Dong
- Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China.,Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China.,The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese Ministry of Health, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Huaiyu Wu
- Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China.,Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Weiyu Liang
- Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China.,Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Hongtian Tian
- Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China.,Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Xiuqin Ye
- Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China.,Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Hui Luo
- Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China.,Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Jinfeng Xu
- Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China.,Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
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Grand-Perret V, Jacquet JR, Leguerney I, Benatsou B, Grégoire JM, Willoquet G, Bouakaz A, Lassau N, Pitre-Champagnat S. A Novel Microflow Phantom Dedicated to Ultrasound Microvascular Measurements. ULTRASONIC IMAGING 2018; 40:325-338. [PMID: 29923458 DOI: 10.1177/0161734618783975] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Tumor microvascularization is a biomarker of response to antiangiogenic treatments and is accurately assessed by ultrasound imaging. Imaging modes used to visualize slow flows include Power Doppler imaging, dynamic contrast-enhanced ultrasonography, and more recently, microvascular Doppler. Flow phantoms are used to evaluate the performance of Doppler imaging techniques, but they do not have a steady flow and sufficiently small channels. We report a novel device for robust and stable microflow measurements and the study of the microvascularization. Based on microfluidics technology, the prototype features wall-less cylindrical channels of diameters ranging from as small as 147 up to 436 µm, cast in a soft silicone polymer and perfused via a microfluidic flow pressure controller. The device was assessed using flow rates from 49 to 146 µL/min, with less than 1% coefficient of variation over three minutes, corresponding to velocities of 6 to 142 mm/s. This enabled us to evaluate and confirm the reliability of the Superb Microvascular Imaging Doppler mode compared with the Power Doppler mode at these flow rates in the presence of vibrations mimicking physiological motion.
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Affiliation(s)
- Virginie Grand-Perret
- 1 Imagerie par Resonance Magnetique Medicale et Multi-Modalites, Université Paris-Saclay, Orsay, France
| | - Jean-René Jacquet
- 2 Imagerie et cerveau, Inserm, Univ. François Rabelais, Tours, France
| | - Ingrid Leguerney
- 1 Imagerie par Resonance Magnetique Medicale et Multi-Modalites, Université Paris-Saclay, Orsay, France
- 3 Research Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Baya Benatsou
- 1 Imagerie par Resonance Magnetique Medicale et Multi-Modalites, Université Paris-Saclay, Orsay, France
- 3 Research Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | | | - Georges Willoquet
- 1 Imagerie par Resonance Magnetique Medicale et Multi-Modalites, Université Paris-Saclay, Orsay, France
| | - Ayache Bouakaz
- 2 Imagerie et cerveau, Inserm, Univ. François Rabelais, Tours, France
| | - Nathalie Lassau
- 1 Imagerie par Resonance Magnetique Medicale et Multi-Modalites, Université Paris-Saclay, Orsay, France
- 3 Research Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
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Prado-Costa R, Rebelo J, Monteiro-Barroso J, Preto AS. Ultrasound elastography: compression elastography and shear-wave elastography in the assessment of tendon injury. Insights Imaging 2018; 9:791-814. [PMID: 30120723 PMCID: PMC6206379 DOI: 10.1007/s13244-018-0642-1] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/22/2018] [Accepted: 06/21/2018] [Indexed: 12/27/2022] Open
Abstract
Ultrasound elastography (USE) is a recent technology that has experienced major developments in the past two decades. The assessment of the main mechanical properties of tissues can be made with this technology by characterisation of their response to stress. This article reviews the two major techniques used in musculoskeletal elastography, compression elastography (CE) and shear-wave elastography (SWE), and evaluates the studies published on major electronic databases that use both techniques in the context of tendon pathology. CE accounts for more studies than SWE. The mechanical properties of tendons, particularly their stiffness, may be altered in the presence of tendon injury. CE and SWE have already been used for the assessment of Achilles tendons, patellar tendon, quadriceps tendon, epicondylar tendons and rotator cuff tendons and muscles. Achilles tendinopathy is the most studied tendon injury with USE, including the postoperative period after surgical repair of Achilles rupture tendon. In relation to conventional ultrasound (US), USE potentially increases the sensitivity and diagnostic accuracy in tendinopathy, and can detect pathological changes before they are visible in conventional US imaging. Several technical limitations are recognised, and standardisation is necessary to ensure repeatability and comparability of the results when using these techniques. Still, USE is a promising technique under development and may be used not only to promote an early diagnosis, but also to identify the risk of injury and to support the evaluation of rehabilitation interventions. KEY POINTS: • USE is used for the assessment of the mechanical properties of tissues, including the tendons. • USE increases diagnostic performance when coupled to conventional US imaging modalities. • USE will be useful in early diagnosis, tracking outcomes and monitoring treatments of tendon injury. • Technical issues and lack of standardisation limits USE use in the assessment of tendon injury.
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Affiliation(s)
- Rui Prado-Costa
- Department of Physical and Rehabilitation Medicine, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - João Rebelo
- Department of Radiology, Centro Hospitalar São João, Porto, Portugal.
| | - João Monteiro-Barroso
- Department of Physical and Rehabilitation Medicine, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Ana Sofia Preto
- Department of Radiology, Centro Hospitalar São João, Porto, Portugal
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Yang Y, Wang L, Yan F, Xiang X, Tang Y, Zhang L, Liu J, Qiu L. Determination of Normal Skin Elasticity by Using Real-time Shear Wave Elastography. JOURNAL OF ULTRASOUND IN MEDICINE 2018; 37:2507-2516. [PMID: 29575120 DOI: 10.1002/jum.14608] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/05/2018] [Accepted: 01/25/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To define the reference ranges of normal skin elasticity measurements associated with shear wave elastography (SWE) in healthy volunteers and analyze the factors that may affect SWE. METHODS Mean skin thickness and elastic modulus values from 90 healthy volunteers were evaluated with B-mode ultrasonography and SWE in the right fingers and forearms, anterior chest, and abdominal walls. Reference ranges of normal skin elasticity were calculated by using lower and upper limits at the 2.5th and 97.5th percentiles. To investigate the effects of potential factors (site, sex, age, body mass index, and skin thickness) on skin elasticity measurements, a 1-way analysis of variance, the Student t test, and the Pearson correlation test were performed. RESULTS Skin elasticity was significantly different at different sites (P < .05). Mean elastic modulus values were 30.3 kPa for the finger, 14.8 kPa for the forearm, 17.8 kPa for the chest wall, and 9.5 kPa for the abdominal wall, and reference ranges of normal skin elasticity were 12.1 to 48.4kPa for the finger, 3.5 to 26.0 kPa for the forearm, 6.6 to 28.9 kPa for the chest wall, and 3.5 to 15.5 kPa for the abdominal wall. Our study revealed that men had higher skin elasticity measurements than women (P < .05), and they were more elevated in participants aged 20 to 50 years than in the other groups at the finger (P < .05). The body mass index and skin thickness had a negligible impact on skin elasticity measurements (P > .05). CONCLUSIONS This study revealed that the site, sex, and age should be taken into account when determining the reference ranges of normal skin elasticity by skin elasticity measurements.
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Affiliation(s)
- Yujia Yang
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Liyun Wang
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Feng Yan
- Department of Clinical Ultrasound Imaging Drug Research Laboratory, West China Hospital of Sichuan University, Chengdu, China
| | - Xi Xiang
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Yuanjiao Tang
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Lingyan Zhang
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Jibin Liu
- Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Li Qiu
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, China
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Ultrasound elastography in tendon pathology: state of the art. Skeletal Radiol 2017; 46:1643-1655. [PMID: 28765991 DOI: 10.1007/s00256-017-2726-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 06/30/2017] [Accepted: 07/10/2017] [Indexed: 02/02/2023]
Abstract
Elastography assesses the biomechanical and structural properties of tissues by measuring their stiffness. Despite promising results, elastography has not yet earned its place in the daily practice of musculoskeletal radiologists. The purpose of this article is to present and examine the data available to date on ultrasound elastography of the tendons through a review of the literature to provide musculoskeletal radiologists with an overview that may help them better understand and use elastography routinely. The most common techniques in ultrasound elastography are described. Then, the aspects of the physiologic and pathologic tendon are presented and discussed. One must make this technique one's own to better apprehend its contribution to the musculoskeletal imaging field, while bearing in mind that further research will be required before admitting elastography as a reliable and validated tool able to optimize our daily clinical practice.
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Aubé C, Bazeries P, Lebigot J, Cartier V, Boursier J. Liver fibrosis, cirrhosis, and cirrhosis-related nodules: Imaging diagnosis and surveillance. Diagn Interv Imaging 2017; 98:455-468. [DOI: 10.1016/j.diii.2017.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/09/2017] [Accepted: 03/09/2017] [Indexed: 02/06/2023]
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Accuracy of shear wave elastography for the diagnosis of prostate cancer: A meta-analysis. Sci Rep 2017; 7:1949. [PMID: 28512326 PMCID: PMC5434001 DOI: 10.1038/s41598-017-02187-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 04/20/2017] [Indexed: 02/07/2023] Open
Abstract
Many studies have established the high diagnostic accuracy of shear wave elastography (SWE) for the detection of prostate cancer (PCa); however, its utility remains a subject of debate. This meta-analysis sought to appraise the overall accuracy of SWE for the detection of PCa. A literature search of the PubMed, Embase, Cochrane Library, Web of Science and CNKI (China National Knowledge Infrastructure) databases was conducted. In all of the included studies, the diagnostic accuracy of SWE was compared with that of histopathology, which was used as a standard. Data were pooled, and the sensitivity, specificity, area under the curve (AUC), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated to estimate the accuracy of SWE. The pooled sensitivity and specificity for the diagnosis of PCa by SWE were 0.844 (95% confidence interval: 0.696–0.927) and 0.860 (0.792–0.908), respectively. The AUC was 0.91 (0.89–0.94), the PLR was 6.017 (3.674–9.853), and the NLR was 0.182 (0.085–0.389). The DOR was 33.069 (10.222–106.982). Thus, SWE exhibited high accuracy for the detection of PCa using histopathology as a diagnostic standard. Moreover, SWE may reduce the number of core biopsies needed.
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Rouvière O, Melodelima C, Hoang Dinh A, Bratan F, Pagnoux G, Sanzalone T, Crouzet S, Colombel M, Mège-Lechevallier F, Souchon R. Stiffness of benign and malignant prostate tissue measured by shear-wave elastography: a preliminary study. Eur Radiol 2017; 27:1858-1866. [PMID: 27553936 DOI: 10.1007/s00330-016-4534-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/13/2016] [Accepted: 07/25/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To measure benign and malignant prostate tissue stiffness using shear-wave elastography (SWE). METHODS Thirty consecutive patients underwent transrectal SWE in the axial and sagittal planes before prostatectomy. After reviewing prostatectomy specimens, two radiologists measured stiffness in regions corresponding to cancers, lateral and median benign peripheral zone (PZ) and benign transition zone (TZ). RESULTS Cancers were stiffer than benign PZ and TZ. All tissue classes were stiffer on sagittal than on axial imaging, in TZ than in PZ, and in median PZ than in lateral PZ. At multivariate analysis, the nature of tissue (benign or malignant; P < 0.00001), the imaging plane (axial or sagittal; P < 0.00001) and the location within the prostate (TZ, median PZ or lateral PZ; P = 0.0065) significantly and independently influenced tissue stiffness. On axial images, the thresholds maximising the Youden index in TZ, lateral PZ and median PZ were respectively 62 kPa, 33 kPa and 49 kPa. On sagittal images, the thresholds were 76 kPa, 50 kPa and 72 kPa, respectively. CONCLUSIONS SWE can distinguish prostate malignant and benign tissues. Tissue stiffness is influenced by the imaging plane and the location within the gland. KEY POINTS • Prostate cancers were stiffer than the benign peripheral zone • All tissue classes were stiffer on sagittal than on axial imaging • All tissue classes were stiffer in the transition zone than in the peripheral zone • All tissue classes were stiffer in the median than in the lateral peripheral zone • Taking into account imaging plane and zonal anatomy can improve cancer detection.
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Affiliation(s)
- Olivier Rouvière
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, 69437, France.
- Université de Lyon, Lyon, 69003, France.
- Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, 69003, France.
- Inserm, U1032, LabTau, Lyon, 69003, France.
| | - Christelle Melodelima
- Université Joseph Fourier, Laboratoire d'Ecologie Alpine, BP 53, Grenoble, 38041, France
- CNRS, UMR 5553, BP 53, Grenoble, 38041, France
| | | | - Flavie Bratan
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, 69437, France
- Université de Lyon, Lyon, 69003, France
- Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, 69003, France
- Inserm, U1032, LabTau, Lyon, 69003, France
| | - Gaele Pagnoux
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, 69437, France
| | - Thomas Sanzalone
- Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, 69437, France
- Université de Lyon, Lyon, 69003, France
- Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, 69003, France
| | - Sébastien Crouzet
- Université de Lyon, Lyon, 69003, France
- Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, 69003, France
- Inserm, U1032, LabTau, Lyon, 69003, France
- Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon, 69437, France
| | - Marc Colombel
- Université de Lyon, Lyon, 69003, France
- Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, 69003, France
- Hospices Civils de Lyon, Department of Urology, Hôpital Edouard Herriot, Lyon, 69437, France
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Borysewicz-Sanczyk H, Dzieciol J, Sawicka B, Bossowski A. Practical Application of Elastography in the Diagnosis of Thyroid Nodules in Children and Adolescents. Horm Res Paediatr 2017; 86:39-44. [PMID: 27372081 DOI: 10.1159/000447490] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 06/07/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Ultrasound elastography is a noninvasive method of imaging based on the estimation of the mechanical properties of tissue. Data in adults indicate that decreased flexibility in comparison to the surrounding healthy tissue is characteristic of malignancy (in most thyroid carcinomas, except for follicular thyroid carcinoma). The purpose of our study was to assess the deformation of thyroid nodules and to evaluate the usefulness of elastography in predicting malignant thyroid nodules in adolescent patients. METHODS We examined 47 children with 62 thyroid nodules. All patients underwent elastography and fine needle aspiration cytology (FNAC). RESULTS Thirty-seven girls (79%) and 10 boys (21%) were included in the study. A strain ratio <2 was observed in 17 nodules (27% of the study group), a strain ratio between 2 and 4.9 in 34 nodules (55%) and a strain ratio >5 in 11 nodules (18%). According to cytological examination, 3 nodules (4.8% of the study group) were malignant. Two of them were hard (strain ratio ≥5), and 1 nodule had a strain ratio of 2. CONCLUSIONS Our results suggest that elastography can be complementary to conventional ultrasonography and useful while making a decision about FNAC. At the same time, it should not replace the cytological assessment of thyroid nodules in children and adolescents.
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Affiliation(s)
- Hanna Borysewicz-Sanczyk
- Department of Pediatrics, Endocrinology and Diabetes with a Cardiology Division, Medical University of Biax0142;ystok, Biax0142;ystok, Poland
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Ryu J, Jeong WK. Current status of musculoskeletal application of shear wave elastography. Ultrasonography 2017; 36:185-197. [PMID: 28292005 PMCID: PMC5494870 DOI: 10.14366/usg.16053] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 02/03/2017] [Accepted: 02/04/2017] [Indexed: 12/31/2022] Open
Abstract
Ultrasonography (US) is a very powerful diagnostic modality for the musculoskeletal system due to the ability to perform real-time dynamic high-resolution examinations with the Doppler technique. In addition to acquiring morphologic data, we can now obtain biomechanical information by quantifying the elasticity of the musculoskeletal structures with US elastography. The earlier diagnosis of degeneration and the ability to perform follow-up evaluations of healing and the effects of treatment are possible. US elastography enables a transition from US-based inspection to US-based palpation in order to diagnose the characteristics of tissue. Shear wave elastography is considered the most suitable type of US elastography for the musculoskeletal system. It is widely used for tendons, ligaments, and muscles. It is important to understand practice guidelines in order to enhance reproducibility. Incorporating viscoelasticity and overcoming inconsistencies among manufacturers are future tasks for improving the capabilities of US elastography.
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Affiliation(s)
- JeongAh Ryu
- Department of Radiology, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri, Korea
| | - Woo Kyoung Jeong
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Haen TX, Roux A, Soubeyrand M, Laporte S. Shear waves elastography for assessment of human Achilles tendon's biomechanical properties: an experimental study. J Mech Behav Biomed Mater 2017; 69:178-184. [PMID: 28086149 DOI: 10.1016/j.jmbbm.2017.01.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 12/30/2016] [Accepted: 01/04/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Achilles tendon is the most frequently ruptured tendon, but its optimal treatment is increasingly controversial. The mechanical properties of the healing tendon should be studied further. Shear waves elastography (SWE) measures the shear modulus, which is proven to be correlated to elastic modulus in animal tendons. The aim of our study was to study whether the shear moduli of human cadaveric Achilles tendon, given by SWE, were correlated with the apparent elastic moduli of those tendons given by tensile tests. MATERIALS AND METHODS Fourteen cadaveric lower-limbs were studied. An elastographic study of the Achilles tendon (AT) was first done in clinical-like conditions. SWE was performed at three successive levels (0, 3 and 6cm from tendon insertion) with elastographic probe oriented parallel to tendon fibers, blindly, for three standardized ankle positions (25° plantar flexion, neutral position, and maximal dorsal flexion). The mean shear moduli were collected through blind offline data-analysis. Then, AT with triceps were harvested. They were subjected to tensile tests. A continuous SWE of the Achilles tendon was performed simultaneously. The apparent elastic modulus was obtained from the experimental stress-strain curve, and correlation with shear modulus (given by SWE) was studied. RESULTS Average shear moduli of harvested AT, given by SWE made an instant before the tensile tests, were significantly correlated with shear moduli of the same AT made at the same level, previously in clinical-like condition (p<0.05), only in neutral position. There was a statistical correlation (p<0.005) and a correlation coefficient R² equal to 0.95±0.05, between shear moduli (SWE) and apparent elastic moduli (tensile tests), for 11 tendons (3 tendons were inoperable due to technical error), before a constant disruption in the correlation curves. DISCUSSION We demonstrated a significant correlation between SWE of Achilles tendon performed in clinical-like conditions (in neutral position) and SWE performed in harvested tendon. We also found a correlation between SWE performed on harvested tendon and apparent elastic moduli obtained with tensile tests (for 11 specimens). As a consequence, we can suppose that SWE of AT in clinical-like conditions is related to tensile tests. To our knowledge, the ability of SWE to reliably assess biomechanical properties of a tendon or muscle was, so far, only demonstrated in animal models. CONCLUSION SWE can provide biomechanical information of the human AT non-invasively.
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Affiliation(s)
- T X Haen
- Arts et Metiers ParisTech, Institut de Biomécanique Humaine Georges Charpak, 151 bd de l'Hôpital, 75013 Paris, France; Service de Chirurgie Orthopédique, Hôpital Raymond Poincaré (A.P.-H.P), 104 bd Raymond Poincaré, 92380 Garches (Paris area), France.
| | - A Roux
- Arts et Metiers ParisTech, Institut de Biomécanique Humaine Georges Charpak, 151 bd de l'Hôpital, 75013 Paris, France
| | - M Soubeyrand
- Service de Chirurgie Orthopédique, Hôpital de Bicêtre (A.P.-H.P.), 78 rue du Général Leclerc, 94270 Le Kremlin-Bicêtre (Paris area), France
| | - S Laporte
- Arts et Metiers ParisTech, Institut de Biomécanique Humaine Georges Charpak, 151 bd de l'Hôpital, 75013 Paris, France
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Mulabecirovic A, Vesterhus M, Gilja OH, Havre RF. In Vitro Comparison of Five Different Elastography Systems for Clinical Applications, Using Strain and Shear Wave Technology. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:2572-2588. [PMID: 27570209 DOI: 10.1016/j.ultrasmedbio.2016.07.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 06/30/2016] [Accepted: 07/02/2016] [Indexed: 06/06/2023]
Abstract
Several different platforms providing ultrasound elastography have emerged in recent years. In this in vitro study on a single tissue-mimicking phantom (CIRS Model 49), we aimed to compare the performance of quantitative elastography measurements from platforms running strain elastography and others running shear wave elastography. We evaluated five different elastography platforms using both linear and curvilinear probes. All measurements were performed in parallel by two independent investigators who recorded the elasticity quantitatively. We investigated intra- and inter-observer agreement by intra-class correlation analysis and coefficient of variation, by correlation and limits of agreement. The reproducibility of elasticity measurements was good to excellent for shear wave and strain elastography. All five elastography platforms had high intra-observer (intra-class correlation coefficient: 0.932-1.0) and inter-observer correlation (intra-class correlation coefficient: 0.845-0.996). All inclusions could be differentiated by quantitative elastography by all systems (p < 0.001). The use of a linear probe yielded more reproducible measurements compared with use of a convex probe in 3/4 platforms.
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Affiliation(s)
- Anesa Mulabecirovic
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, N-5021 Bergen, Norway; Institute of Clinical Medicine, University of Bergen, N-5020, Bergen, Norway
| | - Mette Vesterhus
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, N-5021 Bergen, Norway; Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Cancer Medicine, Surgery and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Odd Helge Gilja
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, N-5021 Bergen, Norway; Institute of Clinical Medicine, University of Bergen, N-5020, Bergen, Norway
| | - Roald Flesland Havre
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, N-5021 Bergen, Norway.
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Correas JM, Anglicheau D, Joly D, Gennisson JL, Tanter M, Hélénon O. Ultrasound-based imaging methods of the kidney-recent developments. Kidney Int 2016; 90:1199-1210. [PMID: 27665116 DOI: 10.1016/j.kint.2016.06.042] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 06/05/2016] [Accepted: 06/14/2016] [Indexed: 12/11/2022]
Abstract
In recent years, several novel ultrasound (US)-based techniques have emerged for kidney diagnostic imaging, including tissue stiffness assessment with elastography, Ultrasensitive Doppler techniques, and contrast-enhanced ultrasonography to assess renal microvascularization. Renal elastography has become available with the development of noninvasive quantitative techniques, following the rapidly growing field of liver fibrosis diagnosis. With the increased incidence of chronic kidney disease, noninvasive diagnosis of renal fibrosis can be of critical value. However, it is difficult to simply extend the application of US elastography from one organ to the other due to anatomic and technical issues. Today, renal elastography appears to be a promising application that, however, still requires optimization and validation. New ultrasensitive Doppler techniques improve the detection of slow blood flow and can be used alone or after administration of US contrast agents. These microbubble-based agents are extremely well tolerated and can be administered even in cases of impaired renal function. Despite the lack of approval, they improve the characterization of atypical renal masses, complex cystic renal masses, and peripheral vascular disorders. Dynamic contrast-enhanced US is based on quantification of the signal intensity from region of interest and mathematical fits of the time-intensity curves. Perfusion-related parameters can be extracted for the monitoring of vascular changes in the renal parenchyma and in tumors in order to evaluate drug response. This estimation of renal perfusion depends on many parameters that should be kept constant for follow-up studies, and, when possible, an internal reference should be used to normalize the measurements.
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Affiliation(s)
- Jean-Michel Correas
- Paris-Descartes Sorbonne University, Paris, France; Department of Adult Radiology, Necker University Hospital, Paris, France; Langevin Institute, ESPCI Paris, PSL Research University CNRS UMR 7587, INSERM ERL U-979, Paris, France.
| | - Dany Anglicheau
- Paris-Descartes Sorbonne University, Paris, France; Department of Adult Nephrology and Transplantation, Necker University Hospital, Paris, France; Necker - Sick Children Institute, INSERM U1151, Paris, France
| | - Dominique Joly
- Paris-Descartes Sorbonne University, Paris, France; Department of Adult Nephrology and Transplantation, Necker University Hospital, Paris, France
| | - Jean-Luc Gennisson
- Langevin Institute, ESPCI Paris, PSL Research University CNRS UMR 7587, INSERM ERL U-979, Paris, France
| | - Mickael Tanter
- Langevin Institute, ESPCI Paris, PSL Research University CNRS UMR 7587, INSERM ERL U-979, Paris, France
| | - Olivier Hélénon
- Paris-Descartes Sorbonne University, Paris, France; Department of Adult Radiology, Necker University Hospital, Paris, France
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Yurttutan N, Gungor G, Bilal N, Kizildag B, Baykara M, Sarica MA. Interpretation of thyroid glands in a group of healthy children: real-time ultrasonography elastography study. J Pediatr Endocrinol Metab 2016; 29:933-7. [PMID: 27159916 DOI: 10.1515/jpem-2015-0409] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 03/29/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND This study aimed to determine the strain index (SI) of normal thyroid parenchyma in a group of healthy children, using ultrasound elastography (USE). METHODS The participants consisted of 54 healthy children. The USE of the normal thyroid parenchyma was performed by using the Hitachi Hi VisionPreirus model ultrasonography (US) device. By following sinusoidal waves at the base of the screen, regular and slight compressions and decompressions were made by the transducer. After the regular sinusoidal waves were acquired, standard region of interest (ROI) circles were used to measure the SI values of the thyroid glands by placing one ROI on a superficial part of the normal thyroid gland parenchyma and the other on the adjacent soft tissue at the same depth (within 10-mm proximity). Three measurements were obtained for each (right and left) thyroid gland, and the mean value was used for statistics. RESULTS The mean SI value of normal thyroid glands was 0.54±0.38 for the whole group. There was no statistically significant difference between girls and boys on the basis of age, weight, height, BMI (body mass index), and thyroid SI values (p=0.15, p=0.18, p=0.12, p=0.31, and p=0.96, respectively). No correlation was found between thyroid gland SI values and each of the following variables: age (r=0.22, p=0.15), gender (r=0.007, p=0.96), and BMI (r=0.26, p=0.09). CONCLUSIONS The study determined the normal elasticity values of thyroid glands in healthy children. Such information can serve as a baseline from which thyroid diseases can be examined.
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Shin HJ, Kim MJ, Kim HY, Roh YH, Lee MJ. Comparison of shear wave velocities on ultrasound elastography between different machines, transducers, and acquisition depths: a phantom study. Eur Radiol 2016; 26:3361-7. [PMID: 26815368 DOI: 10.1007/s00330-016-4212-y] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 01/11/2016] [Accepted: 01/13/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To investigate consistency in shear wave velocities (SWVs) on ultrasound elastography using different machines, transducers and acquisition depths. METHODS The SWVs were measured using an elasticity phantom with a Young's modulus of 16.9 kPa, with three recently introduced ultrasound elastography machines (A, B and C from different vendors) and two transducers (low and high frequencies) at four depths (2, 3, 4 and 5 cm). Mean SWVs from 15 measurements and coefficient of variations (CVs) were compared between three machines, two transducers and four acquisition depths. RESULTS The SWVs using the high frequency transducer were not acquired at 5 cm depth in machine B, and a high frequency transducer was not available in machine C. The mean SWVs in the three machines were different (p ≤ 0.002). The CVs were 0-0.09 in three machines. The mean SWVs between the two transducers were different (p < 0.001) except at 4 and 5 cm depths in machine A. The SWVs were affected by the acquisition depths in all conditions (p < 0.001). CONCLUSION There is considerable difference in SWVs on ultrasound elastography depending on different machines, transducers and acquisition depths. Caution is needed when using the cutoff values of SWVs in different conditions. KEY POINTS • The shear wave velocities (SWVs) are different between different ultrasound elastography machines • The SWVs are also different between different transducers and acquisition depths • Caution is needed when using the cutoff SWVs measured under different conditions.
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Affiliation(s)
- Hyun Joo Shin
- Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Myung-Joon Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Ha Yan Kim
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Yun Ho Roh
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Mi-Jung Lee
- Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
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Huet N, Denis I, Martino A, Gallix B, Sturm N, Leroy V, Bricault I. Ultrasonographic assessment of liver fibrosis with computer-assisted analysis of liver surface irregularities. Diagn Interv Imaging 2015; 96:941-6. [DOI: 10.1016/j.diii.2015.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 01/06/2015] [Accepted: 02/16/2015] [Indexed: 01/10/2023]
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