In vivo visualization of abdominal malignancies with acoustic radiation force elastography

Fahey, B.J.; Nelson, Rendon C.; Bradway, David; Hsu, Stephen J.; Dumont, Douglas M.; Trahey, Gregg E.

doi:10.1088/0031-9155/53/1/020

Cited by 157 publications

(105 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These qualitative images do, however, provide improved contrast that can be used concurrently with the B-mode images to improve the visualization of anatomical structures and lesions. Figure 3 shows ARFI images of liver masses in a study by Fahey et al [32], where the masses have different displacement contrast relative to the background liver tissue depending on the health of that liver tissue.…”

Section: Qualitative Methodsmentioning

confidence: 99%

Acoustic radiation force-based elasticity imaging methods

2011

View full text Add to dashboard Cite

Conventional diagnostic ultrasound images portray differences in the acoustic properties of soft tissues, whereas ultrasound-based elasticity images portray differences in the elastic properties of soft tissues (i.e. stiffness, viscosity). The benefit of elasticity imaging lies in the fact that many soft tissues can share similar ultrasonic echogenicities, but may have different mechanical properties that can be used to clearly visualize normal anatomy and delineate pathological lesions. Acoustic radiation force-based elasticity imaging methods use acoustic radiation force to transiently deform soft tissues, and the dynamic displacement response of those tissues is measured ultrasonically and is used to estimate the tissue's mechanical properties. Both qualitative images and quantitative elasticity metrics can be reconstructed from these measured data, providing complimentary information to both diagnose and longitudinally monitor disease progression. Recently, acoustic radiation force-based elasticity imaging techniques have moved from the laboratory to the clinical setting, where clinicians are beginning to characterize tissue stiffness as a diagnostic metric, and commercial implementations of radiation forcebased ultrasonic elasticity imaging are beginning to appear on the commercial market. This article provides an overview of acoustic radiation force-based elasticity imaging, including a review of the relevant soft tissue material properties, a review of radiation force-based methods that have been proposed for elasticity imaging, and a discussion of current research and commercial realizations of radiation force based-elasticity imaging technologies.

show abstract

Section: Qualitative Methodsmentioning

confidence: 99%

Acoustic radiation force-based elasticity imaging methods

2011

View full text Add to dashboard Cite

show abstract

“…Voxel size was fixed at 106565 mm. The energy used for SWV measurements is similar to that in colour Doppler imaging (compliant with Food and Drug Administration guidelines) [5]. Typical spatial-peak, pulse average intensities were of the order of 820 W cm…”

Section: Technique Of Elastographymentioning

confidence: 99%

“…This is clinically relevant because the liver can have non-homogeneous areas which may show changes in their elasticity before abnormalities can be adequately characterised by conventional ultrasound [5]. ARFI uses short-duration acoustic pulses to produce localised displacements in tissue and to track them.…”

mentioning

confidence: 99%

Acoustic radiation force impulse elastography in distinguishing hepatic haemangiomata from metastases: preliminary observations

Davies

Koenen²

2011

BJR

View full text Add to dashboard Cite

Objective: The increasing quality of diagnostic ultrasound has resulted in the detection of greater numbers of potentially benign hepatic lesions. Current radiological practice requires contrast enhanced ultrasound, CT or MRI to confirm the diagnosis. Acoustic radiation force impulse (ARFI) elastography is an imaging technique measuring the elasticity of biological tissues. Recent technical advances in ultrasound have made it possible to generate shear waves, whose velocity in the liver is proportional to the degree of hepatic elasticity. Methods: This shear wave velocity (SWV) may be used as a marker for both focal and diffuse liver pathology.We used this technique to examine patients with normal livers and those with haemangiomata and metastases. , the sensitivity and specificity for haemangiomata were 97.1% and 100%, respectively, with an area under the curve of 0.999. Conclusion: ARFI elastography with SWV measurements is a promising new technique which could replace invasive investigations for benign hepatic lesions.

show abstract

“…In clinical settings, liver metastases appear as stiff structures surrounded by more compliant regional liver parenchyma, while primary liver tumours (hepatocellular carcinomas) appear as compliant structures surrounded by relatively stiffer regional liver parenchyma [34,35]. In our experimental conditions, liver tumours implanted in rabbits appeared as stiff tissue regions surrounded by more compliant regional liver.…”

Section: Discussionmentioning

confidence: 68%

Visualisation of liver tumours using hand-held real-time strain imaging: results of animal experiments

Melodelima

Chenot²,

Souchon³

et al. 2012

BJR

View full text Add to dashboard Cite

Objective: Surgical resection is the only curative option for colorectal hepatic metastases. Intra-operative localisation of these metastases during hepatic resection is performed by intra-operative B-mode imaging and palpation. Because liver metastases are stiffer than normal tissues, elastography may be a useful complement to B-mode imaging. This paper reports quantitative measures of the image quality attained during intra-operative real-time elastographic visualisation of liver metastasis. Methods: VX2 tumours were implanted in the liver of eight rabbits and were scanned in vivo. Measurements of the tumour dimensions obtained via elastography were compared with those obtained using B-mode imaging and with gross pathology. Results: Measurements of tumour diameters were similar when obtained by intraoperative elastography and pathological measurement methods (mean difference ¡ standard deviation, 0.1¡0.9 mm). The contrast between tumours and normal tissues was significantly higher (p,0.05) in elastograms (26¡10 dB contrast) than in sonograms (1¡1 dB contrast). Sensitivity and specificity for detecting tumours using intra-operative elastography were 100% and 88%, respectively, and positive and negative predictive values were 89% and 100%, respectively. In two cases elastograms were able to detect a tumour that was ambiguous in B-mode images. Conclusion: Combined hand-held B-mode/strain imaging may provide additional information that is relevant for detection of liver metastases that may be missed by standard B-mode imaging alone, such as small and/or isoechoic tumours. Colorectal cancer is the fourth most common cancer in males and the third most common cancer in females worldwide [1,2]. Approximately half of these patients either present with hepatic metastases or develop them during the course of their disease. Although ablative therapies are frequently used, resection of liver metastases, when possible, remains the preferred therapy for potential cure [3,4]. The overall 5 year survival rates are in the range of 35-58% in several studies reporting on the results of hepatectomy conducted with curative intent [4,5]. The pre-operative and intra-operative staging of metastases is essential to remove all metastases and increase the rate of cure. At the pre-operative stage, contrast-enhanced CT is the most commonly used modality to screen for metastases. It is highly sensitive, particularly since the introduction of helical CT and multidetector systems capable of scanning the entire liver in a few seconds, allowing for several scans during the liver's different circulatory phases [6]. MRI is very sensitive as well, and has the advantage of liver-specific contrast if required. MRI is also used for screening purposes, despite the fact that it is more time-consuming than other methodologies and may be subject to motion artefacts [7]. According to different reports, these modalities detect .90% of liver metastases if their diameter is .5 mm [7,8]. There is still a group of patients who undergo hepatic surgery without c...

show abstract

In vivo visualization of abdominal malignancies with acoustic radiation force elastography

Cited by 157 publications

References 66 publications

Acoustic radiation force-based elasticity imaging methods

Acoustic radiation force-based elasticity imaging methods

Acoustic radiation force impulse elastography in distinguishing hepatic haemangiomata from metastases: preliminary observations

Visualisation of liver tumours using hand-held real-time strain imaging: results of animal experiments

Contact Info

Product

Resources

About