A Novel, Reliable Protocol to Objectively Assess Scar Stiffness Using Shear Wave Elastography

DeJong, Helen; Abbott, Steve; Zelesco, Marilyn; Spilsbury, Katrina; Martin, Lisa; Sanderson, Rowan W.; Ziman, Melanie; Kennedy, Brendan F.; Wood, Fiona

doi:10.1016/j.ultrasmedbio.2020.03.003

Cited by 14 publications

(9 citation statements)

References 65 publications

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“…83,84 More recently, shear wave elastography has been applied to objectively measuring human scar stiffness, where it reliably measured the stiffness of burn scars in a non-invasive manner. 85 This study further demonstrated that novice ultrasonographers became just as reliable as experienced ultrasonographers following a short training session in, further supporting elastography's possible role in a bedside clinical environment of wound evaluation. Elastography is limited in its use, however, as its spatial resolution is large and is unable to resolve microscopic details necessary for evaluation of collagen microstructures.…”

Section: High Frequency High Resolution Ultrasound Imagingsupporting

confidence: 65%

Advances in Non-invasive Biosensing Measures to Monitor Wound Healing Progression

Short¹,

Parikh²,

Colchado³

et al. 2022

Preprint

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Impaired wound healing is a significant financial and medical burden. The synthesis and deposition of extracellular matrix (ECM) in a new wound is a dynamic process that is constantly changing and adapting to the biochemical and biomechanical signaling from the extracellular microenvironments of the wound. This drives either a regenerative or fibrotic and scar-forming healing outcome. Disruptions in ECM deposition, structure, and composition lead to impaired healing in diseased states, such as in diabetes. Valid measures of the principal determinants of successful ECM deposition include bacterial contamination, tissue perfusion, and mechanical injury and strain. These measures are used by wound-care providers to intervene upon the healing wound to steer healing toward a more functional phenotype with improved structural integrity and healing outcomes and to prevent adverse wound developments.In this review, we discuss bioengineering advances in non-invasive detection of biologic and physiologic factors of the healing wound, visualizing and modeling the ECM, and computational tools to efficiently evaluate the complex data acquired from the wounds to prognosticate healing outcomes and intervene effectively. We focus on bioelectronics and biologic interfaces of the sensors and actuators for real time biosensing and actuation. We also discuss high-resolution, advanced imaging techniques, which go beyond traditional confocal and fluorescence microscopy to visualize microscopic details of the composition of the matrix, linearity of collagen, and live tracking of components within the ECM. Computational modeling of the matrix, including partial differential equation datasets as well as machine learning models that can serve as powerful tools for physicians to guide their decision-making process are discussed.

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Section: High Frequency High Resolution Ultrasound Imagingsupporting

confidence: 65%

Advances in Non-invasive Biosensing Measures to Monitor Wound Healing Progression

Short¹,

Parikh²,

Colchado³

et al. 2022

Preprint

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“…Moreover, it is documented in the literature that hamstring muscle stiffness results may be influenced by age [ 88 , 89 ], genetics [ 88 , 90 ], sex [ 91 ], sports profession [ 39 , 92 ], pelvic tilt type [ 93 ], hip and knee positions [ 94 ], injury and scar status [ 32 – 34 ], and operator of the shear-wave elastography [ 95 ]. Besides reasons based on the characteristics and history of the individual, stiffness results of the BFlh vary between different ultrasound brands and versions even at similar measurement positions in healthy participants.…”

Section: Discussionmentioning

confidence: 99%

A retrospective comparison of the biceps femoris long head muscle structure in athletes with and without hamstring strain injury history

Yagiz,

Fredianto,

Ulfa

et al. 2024

PLoS ONE

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Introduction Hamstring strain injuries (HSI) and re-injuries are endemic in high-speed running sports. The biceps femoris long head (BFlh) is the most frequently injured muscle among the hamstrings. Structural parameters of the hamstring muscle are stated to be susceptible to strain injuries at this location. This retrospective study targeted comparing the BFlh’s structural parameters between previously injured and uninjured athletes. Methods Nineteen male athletes with previous BFlh strain injury history and nineteen athletes without former lower extremity injury history were included in this study. Fascicle length, mid-muscle belly and distal musculotendinous (MTJ) passive stiffnesses of the biceps femoris long head (BFlh) were examined via b-mode panoramic ultrasound scanning and ultrasound-based shear-wave elastography. Parameter comparisons of both legs within and between athletes with and without injury history were performed. Results Comparison of the BFlh fascicle length between the injured leg of the injured group and the legs of the controls revealed a trend to shorter fascicle lengths in the injured leg (p = 0.067, d = -0.62). However, the mid-muscle belly passive stiffness of the BFlh was significantly higher in the injured legs (p = 0.009, d = 0.7) compared with the controls. Additionally, the distal MTJ stiffness was much higher in the previously injured legs compared with controls (p < 0.001, d = 1.6). Conclusions Outcomes support the importance of BFlh properties related to stiffness, and fascicle length for injury susceptibility in athletes. Future prospective studies should determine whether the higher stiffness in the injured athletes is a cause or consequence of the HSI. Physical therapy and rehabilitation programmes after HSI should focus on BFlh muscle properties i.e., elasticity and fascicle length for reducing re-injury and increasing sports performance.

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“…The process was repeated on the contralateral side, then repeated bilaterally with the arm in abduction. Additionally, extra SWE images were acquired of the skin using the same protocol and a previously developed custom 'gelwell' stand-off [21] . The 'gel-well' is a rectangular silicon structure with a central cut-out designed to contain transmission gel so that a standard thickness of 10mm gel is maintained.…”

Section: Procedurementioning

confidence: 99%

Ultra-sound Shear Wave Elastography Tissue Stiffness and Thickness Assessment After Adjuvant Radiotherapy for Breast Cancer Treatment; An Exploratory Study.

Hunt

Bourke

Dass

et al. 2021

Preprint

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Purpose: This research investigated the feasibility of using B-mode ultrasound with shear-wave elastography (SWE) to evaluate the structural and mechanical properties of multiple tissue layers in the pectoral region of women with chronic radiation fibrosis following breast cancer treatment. Method: Nine women between one and five years post unilateral conventional fractionated radiotherapy were evaluated. Both ultrasound and SWE were used to examine the thickness and stiffness of skin, subcutaneous adipose tissue, fascia and muscle in both their irradiated and non-irradiated sides. Linear mixed models were conducted to examine statistical differences in tissue thickness and stiffness between irradiated and non-irradiated sides with the arm resting by the side and also in abduction. Results: Significant differences were found between irradiated and non-irradiated tissues. Irradiated skin was significantly thicker (p=0.020) and stiffer (p<0.001) with the arm by the side. Irradiated subcutaneous adipose tissue was significantly thinner (p<0.001). Irradiated fascia and muscles thinned significantly with the arm moved out to abduction position. Irradiated pectoral muscle was significantly stiffer (p=0.004), this stiffness amplified with arm abduction (p<0.001) where the muscle thinned significantly (P<0.001).Conclusion: Ultrasound with SWE shows potential to provide novel objective evaluation of radiation induced soft tissue fibrosis at multiple tissue layers in the pectoral region. Tissue thickness changes in irradiated tissue were evident in ultrasound images. Quantifying these tissue changes supports research development and introduction of clinical interventions to ameliorate the symptoms of morbidity that is currently considered irreversible.

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A Novel, Reliable Protocol to Objectively Assess Scar Stiffness Using Shear Wave Elastography

Cited by 14 publications

References 65 publications

Advances in Non-invasive Biosensing Measures to Monitor Wound Healing Progression

Advances in Non-invasive Biosensing Measures to Monitor Wound Healing Progression

A retrospective comparison of the biceps femoris long head muscle structure in athletes with and without hamstring strain injury history

Ultra-sound Shear Wave Elastography Tissue Stiffness and Thickness Assessment After Adjuvant Radiotherapy for Breast Cancer Treatment; An Exploratory Study.

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