Elastography Assessment of Liver Fibrosis: Society of Radiologists in Ultrasound Consensus Conference Statement

Barr, Richard G.; Ferraioli, Giovanna; Palmeri, Mark L.; Goodman, Zachary; García–Tsao, Guadalupe; Rubin, Jonathan M.; Garra, Brian S.; Myers, Robert P.; Wilson, Stephanie R.; Rubens, Deborah J.; Levine, Deborah

doi:10.1148/radiol.2015150619

Cited by 551 publications

(657 citation statements)

References 111 publications

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“…Mean, median, and average velocities are calculated automatically. Barr et al (48) recommended using the median velocity for interpretation (Fig 5).…”

Section: One-dimensional Transient Elastography-mentioning

confidence: 99%

“…As discussed previously, a depth of 2-7 cm from the liver capsule is ideal. The acoustic radiation force impulse (ARFI) push pulse is attenuated as it traverses the patient and reaches a point at which adequate shear waves are not generated for accurate measurement; this problem results in false low-velocity measurements from deeper tissues (48). The degree of attenuation depends on the amplitude of the ARFI pulse (which is restricted by U.S. Food and Drug Administration limits); low-amplitude pulses are attenuated at more superficial depths.…”

Section: Us Elastographic Confoundersmentioning

confidence: 99%

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Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

Babu¹,

Wells²,

Teytelboym³

et al. 2016

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“…Mean, median, and average velocities are calculated automatically. Barr et al (48) recommended using the median velocity for interpretation (Fig 5).…”

Section: One-dimensional Transient Elastography-mentioning

confidence: 99%

Section: Us Elastographic Confoundersmentioning

confidence: 99%

Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

Babu¹,

Wells²,

Teytelboym³

et al. 2016

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169

100

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“…An unsuccessful measurement was excluded from further analysis. 22,23 The main portal vein velocity (PVV) and splenic vein velocity (SVV) were measured at the hepatic hilus ( Figure 2) and splenic hilus (Figure 3), respectively. Doppler settings, including Doppler angle correction (the sound beam should be as parallel to the flow direction as possible, at least <60°), sample gate (3 mm), pulse repetition frequency, scale, and Doppler gain, were adjusted according to the depth of the portal and splenic veins and venous flow status.…”

Section: Elastography and Splenoportal Vein Doppler Sonographymentioning

confidence: 99%

“…Furthermore, we obtained 9 splenic SWV measurements in our study, whereas 10 SWV measurements in the liver are currently recommended. 22 The recommended protocol of 10 SWV measurements for assessing tissue stiffness is taken into consideration for standardization of abdominal organ (eg, spleen) stiffness assessments in future studies. Finally, we are not able to test whether the same splenic SWV could be measured by using ultrasound scanners designed by different manufactures.…”

Section: Figurementioning

confidence: 99%

Shear Wave Elastography of the Spleen for Monitoring Transjugular Intrahepatic Portosystemic Shunt Function

Gao¹,

Xiao

Zheng

et al. 2016

J of Ultrasound Medicine

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A Pilot Studyhe transjugular intrahepatic portosystemic shunt (TIPS) is used for management of refractory acute variceal hemorrhage and intractable ascites in late-stage liver diseases with portal hypertension. 1 In addition to monitoring the clinical status, it is important to monitor TIPS hemodynamic function objectively. 2,3 Although the portosystemic pressure gradient (PPG) and hepatic venous pressure gradient are still considered the reference standards for diagnosis and monitoring of portal hypertension, they Jing Gao, MD, Xiao Zheng, MS, Yuan-Yi Zheng, MD, Guo-Qing Zuo, MD, Hai-Tao Ran, MD, Yong Ho Auh, MD, Levi Waldron, PhD, Tiffany Chan, MS, Zhi-Gang Wang, MD Received July 6, 2015, Objectives-To assess the feasibility of splenic shear wave elastography in monitoring transjugular intrahepatic portosystemic shunt (TIPS) function.Methods-We measured splenic shear wave velocity (SWV), main portal vein velocity (PVV), and splenic vein velocity (SVV) in 33 patients 1 day before and 3 days to 12 months after TIPS placement. We also measured PVV, SVV, and SWV in 10 of 33 patients with TIPS dysfunction 1 day before and 3 to 6 days after TIPS revision. Analyses included differences in portosystemic pressure gradient (PPG), PVV, SVV, and mean SWV before and after TIPS procedures; comparison of median SWV before and after TIPS procedures; differences in PVV, SVV, and SWV before and at different times up to 12 months after TIPS placement; accuracy of PVV, SVV, and SWV in determining TIPS dysfunction; and correlation between PPG and SWV.Results-During 12 months of follow-up, 23 of 33 patients had functioning TIPS, and 10 had TIPS dysfunction. The median SWV was significantly different before and after primary TIPS placement (3.60 versus 3.05 m/s; P = .005), as well as before and after revision (3.73 versus 3.06 m/s; P = .003). The PPG, PVV, and SVV were also significantly different before and after TIPS placement and revision (P < .001). The PPG and SWV decreased, whereas PVV and SVV increased, after successful TIPS procedures. A positive correlation was observed between PPG and SWV (r = 0.70; P < .001), and a negative correlation was observed between PPG and PVV and SVV (r = -0.65; P < .001). The areas under the receiver operating characteristic curve for PVV, SVV, and SWV in determining TIPS dysfunction were 0.82, 0.84, and 0.81, respectively.Conclusions-Splenic SWV is compatible with splenoportal venous velocity in quantitatively monitoring TIPS function and determining TIPS dysfunction.

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“…1,[3][4][5] HF is the hallmark of CLD. 2,[6][7][8] Monitoring for the presence of HF and staging (quantifying) the severity and progression over time are essential for the diagnosis and therapeutic management of CLD.…”

Section: Introductionmentioning

confidence: 99%

Task-based optimization of flip angle for fibrosis detection in T1-weighted MRI of liver

et al. 2016

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Abstract. Chronic liver disease is a worldwide health problem, and hepatic fibrosis (HF) is one of the hallmarks of the disease. The current reference standard for diagnosing HF is biopsy followed by pathologist examination; however, this is limited by sampling error and carries a risk of complications. Pathology diagnosis of HF is based on textural change in the liver as a lobular collagen network that develops within portal triads. The scale of collagen lobules is characteristically in the order of 1 to 5 mm, which approximates the resolution limit of in vivo gadolinium-enhanced magnetic resonance imaging in the delayed phase. We use MRI of formalin-fixed human ex vivo liver samples as phantoms that mimic the textural contrast of in vivo Gd-MRI. We have developed a local texture analysis that is applied to phantom images, and the results are used to train model observers to detect HF. The performance of the observer is assessed with the area-under-the-receiver-operator-characteristic curve (AUROC) as the figure-of-merit. To optimize the MRI pulse sequence, phantoms were scanned with multiple times at a range of flip angles. The flip angle that was associated with the highest AUROC was chosen as optimal for the task of detecting HF.

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Elastography Assessment of Liver Fibrosis: Society of Radiologists in Ultrasound Consensus Conference Statement

Cited by 551 publications

References 111 publications

Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

Elastography in Chronic Liver Disease: Modalities, Techniques, Limitations, and Future Directions

Shear Wave Elastography of the Spleen for Monitoring Transjugular Intrahepatic Portosystemic Shunt Function

Task-based optimization of flip angle for fibrosis detection in T1-weighted MRI of liver

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