Liver and Spleen Stiffness Measurements by Point Shear Wave Elastography via Acoustic Radiation Force Impulse

Balakrishnan, Maya; Souza, Fernanda Fernandes; Muñoz, Carolina; Augustín, Salvador; Loo, Nicole; Deng, Yanhong; Ciarleglio, Maria; García–Tsao, Guadalupe

doi:10.7863/ultra.15.10056

Cited by 37 publications

(12 citation statements)

References 24 publications

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“…There are several studies discussing the reproducibility of SWS measurement in the liver. Our estimate of the intraoperator ICC for the right hepatic lobe at 4 cm depth was similar to that of previous studies using ARFI [12, 35, 36], but our interoperator ICC was worse than that in the results of Woo et al [12] where SWS was measured nine times. Some studies [37, 38] have shown that five SWE measurements could be used instead of ten without a significant effect on diagnostic performance.…”

Section: Discussionsupporting

confidence: 84%

Intra- and inter-operator reproducibility of US point shear-wave elastography in various organs: evaluation in phantoms and healthy volunteers

et al. 2019

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PurposeThis study was conducted in order to assess the intra- and interoperator reproducibility of shear-wave speed (SWS) measurement on elasticity phantoms and healthy volunteers using ultrasound-based point shear-wave elastography.Materials and methodsThis study was approved by the institutional review board. Two operators measured the SWS of five elasticity phantoms and seven organs (thyroid, lymph node, muscle, spleen, kidney, pancreas, and liver) of 30 healthy volunteers with 1.0–4.5 MHz convex (4C1) and 4.0–9.0 MHz linear (9L4) transducers. The phantom measurements were repeated ten times, while the volunteer measurements were performed five times each. Intra- and interoperator reproducibility was assessed. Interoperator reproducibility was also evaluated with the 95% Bland–Altman limits of agreement (LOA).ResultsIn phantoms, all intraclass correlation coefficients (ICCs) were above 0.90 and the 95% LOA between the two operators were less than ± 18%. In volunteers, intraoperator ICCs were > 0.75 for all regions except the pancreas. Interoperator ICC was above 0.75 for the right lobe of the liver (depth 4 cm) and the kidney, but the 95% LOA was less than ± 25% only for the liver.ConclusionAlthough excellent in phantoms, interoperator reproducibility was insufficient for all regions in the volunteers other than the right hepatic lobe at a depth of 4 cm. Clinicians should be aware of the 95% LOA when using SWS in patients.Key Points • Our phantom study indicated a high reproducibility for shear-wave speed (SWS) measurements with point shear-wave elastography (pSWE). • In volunteers, intraoperator reproducibility was generally high, but the interoperator reproducibility was not high enough except for the right hepatic lobe at 4 cm depth. • To evaluate interoperator reproducibility, the 95% limits of agreement (LOA) between operators should be considered in addition to the intraclass correlation coefficient (ICC). Electronic supplementary materialThe online version of this article (10.1007/s00330-019-06195-8) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 84%

Intra- and inter-operator reproducibility of US point shear-wave elastography in various organs: evaluation in phantoms and healthy volunteers

et al. 2019

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“…14,29 Reliability and failure rate pSWE has shown excellent repeatability and reproducibility, with both reported intraobserver and interobserver intraclass correlation coefficients (ICCs) higher than 0.85. 41,42 The technique failure rate is low (1-2%). 43 Obesity is the main cause of failed or unreliable measurements of pSWE.…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

Elastography for Longitudinal Assessment of Liver Fibrosis after Antiviral Therapy: A Review

Wei

Song

2020

Journal of Clinical and Translational Hepatology

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Chronic hepatitis B or C viral infection is a common cause of liver cirrhosis and hepatocellular carcinoma. Fibrosis regression can be achieved after long-term antiviral therapy (AVT). Monitoring of dynamic changes in liver fibrosis after treatment is essential for establishing prognosis and formulation of a follow-up surveillance program. Routine surveillance of fibrosis after AVT by liver biopsy, the gold standard for fibrosis assessment, is hindered by its invasive nature, sampling error and observer variability. Elastography is a noninvasive quantitative alternative that has been widely used and validated for the staging of liver fibrosis prior to treatment. Recently, increasing research interest has been focused on the role of elastography in longitudinal assessment of liver fibrosis after AVT. In this review, the basic principles, acquisition techniques, diagnostic performances, and strengths and limitations of ultrasound elastography and magnetic resonance elastography are presented. Emerging evidence regarding the use of elastography techniques for the monitoring of liver fibrosis after AVT is summarized. Current challenges and future directions are also discussed, designed to optimize the application of these techniques in clinical practice.

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“…Therefore considerable intra-observer and inter-observer variability existed in elastography measurement and were reported in breast lesions 25 , circumscribed objects 26 , and potentially in our study. In order to avoid inter-observer variation, in the current study, the US procedure was performed by one physician and the images were interpreted by the same examiner, while inter-observer reproducibility for liver and spleen was reported to be excellent 27,28 .…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic and elastographic biometry in adult major salivary glands: a preliminary case-control report

Fang

Wen

Hsu

et al. 2019

Sci Rep

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Specifications about the size and stiffness of healthy salivary glands with ultrasound (US) are not available for Asian people. Using a Toshiba Apolio 500 US platform, we determined the size (including anterior-posterior median length, median paramandibular depth dimension, and cranio-caudal height) and hardness of 100 healthy submandibular and parotid glands in volunteers without a history of disease affecting the salivary glands or post-radiation, and compared the dimensions to those of 36 parotid glands and 37 submandibular glands in post-irradiated patients. The dimensions of the parotid and submandibular glands were significantly correlated with body weight. However, the dimension of the parotid glands was not significantly correlated with that of patients with prior radiation; the shear wave velocity (SWV) significantly increased (1.99 m/s versus 2.43 m/s, p-value < 0.01). The dimension of the submandibular glands was significantly correlated with prior radiation, where the SWV also significantly increased (2.32 m/s versus 2.50 m/s, p-values < 0.01). We find that US is a useful tool for assessment of the reference dimensions and hardness of major salivary glands that may be altered by irradiation.

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Liver and Spleen Stiffness Measurements by Point Shear Wave Elastography via Acoustic Radiation Force Impulse

Cited by 37 publications

References 24 publications

Intra- and inter-operator reproducibility of US point shear-wave elastography in various organs: evaluation in phantoms and healthy volunteers

Intra- and inter-operator reproducibility of US point shear-wave elastography in various organs: evaluation in phantoms and healthy volunteers

Elastography for Longitudinal Assessment of Liver Fibrosis after Antiviral Therapy: A Review

Ultrasonographic and elastographic biometry in adult major salivary glands: a preliminary case-control report

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