Qualitative strain elastography – strain ratio evaluation - an important tool in breast cancer diagnostic

Stoian, Dana; Timar, Bogdan; Craina, Marius; Bernad, Elena; Petre, Izabela; Craciunescu, Mihaela

doi:10.11152/mu.2013.2066.182.bcd

Cited by 34 publications

(28 citation statements)

References 27 publications

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“…Elastography is widely used in the diagnosis of liver fibrosis and in the differential diagnosis of liver, breast and thyroid tumors. By evaluating the hardness of the pathological tissue of these organs, the nature and de-gree of the lesion can be determined [19][20][21]. Elastography was also applied in testicular pathology, including tumors and spermatogenic function in infertile patients [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Application value of real-time shear wave elastography in differential diagnosis of testicular torsion

Xue

Lin

et al. 2020

Med Ultrason

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Aim: To evaluate the clinical value of real-time shear wave elastography (SWE) in differential diagnosis of testicular torsion and acute orchiditis.Material and methods: During a 3-year period, 14 cases of testicular torsion and 16 cases of acute orchiditis met the inclusion criteria. Young’s modulus maximum hardness (Emax) of testicular capsule region, middle testicular parenchyma, warped spermatic segment or inferior spermatic segment was measured in each group. SWE “stiff ring sign” of testis refers to the appearance of a red ring in the testicular capsule area and “stiff knot sign” of spermatic cord refers to the appearance of a red knot in the lower segment of the spermatic cord.Results: Emax value of the testicular capsule in the torsion group was higher than in the acute inflammation group (138.76±58.27 vs 16.40±4.71 kPa, p=0.0001). Emax value in the middle parenchyma of the testis showed no statistically significant difference between groups (p=0.053). Emax value in the twisted spermatic segment was higher than that in the lower spermatic segment with acute inflammation (166.61±60.07 vs 14.14±4.93, p=0.0001). In the torsion group, 12 testicular capsule areas showed “stiff ring sign” and all twisted segments of spermatic cord showed “stiff knot sign” but no signs were found in the inflammatory group.Conclusions: “Stiff ring sign” of testis, “stiff knot sign” of spermatic cord, high stiffness of the testicular capsule and in the twisted spermatic segment are the typical SWE findings of testicular torsion, with important clinical value in the differential diagnosis of testicular torsion and acute orchiditis.

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Section: Discussionmentioning

confidence: 99%

Application value of real-time shear wave elastography in differential diagnosis of testicular torsion

Xue

Lin

et al. 2020

Med Ultrason

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“…Complementary to conventional ultrasound, elastography can be used to assess quantitative and qualitative information about tissue stiffness and can make the correlation between healthy tissue and pathological tissue. By measuring tissue elasticity, elastography has been validated as a marker of pathological states in many clinical areas [24], by improving diagnostic methods and establishing its role in breast tumours characterization [25], thyroid nodules [22], testicular cancer [26,27], and liver pathology [28]. ere are also studies conducted on primary and secondary hyperparathyroidism [29][30][31][32].…”

Section: Introductionmentioning

confidence: 99%

Shear Wave Elastography versus Strain Elastography in Diagnosing Parathyroid Adenomas

Cotoi

Amzar

Sporea

et al. 2020

International Journal of Endocrinology

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Objectives. e aim of the study was to compare elastographic means in parathyroid adenomas, using shear wave elastography and strain elastography. Methods. is prospective study examined 20 consecutive patients diagnosed with primary hyperparathyroidism and parathyroid adenoma, confirmed by biochemical assay, technetium-99 sestamibi scintigraphy, and pathology report, after parathyroid surgery. All patients were examined on conventional 2B ultrasound, 2D shear wave elastography, and strain elastography. We determined using 2D shear wave elastography (SWE) the elasticity index (EI) in parathyroid adenoma, thyroid parenchyma, and surrounding muscle and examined using strain elastography the parathyroid adenoma, and determined the strain ratio with the thyroid tissue and muscle tissue. Results. All patients had positive sestamibi scintigraphy and underwent surgery, with confirmation of parathyroid adenoma in all cases. e mean parathormone (PTH) value before surgery was 153.29 pg/ml (36.5, 464.8) and serum calcium concentration was 10.5 mg/dl (9, 11.5). We compared using 2D-SWE and strain elastography parathyroid adenoma with thyroid tissue and with surrounding muscle. e mean EI measured by SWE in parathyroid adenoma was 4.74 ± 2.74 kPa and in thyroid parenchyma was 11.718 ± 4.206 kPa (mean difference � 6.978 kPa, p < 0.001), and the mean EI value in muscle tissue was 16.362 ± 3.829 kPa (mean difference � 11.622, p < 0.001). Using ROC analysis, we found that an EI below 7 kPa correctly identifies parathyroid tissue. We evaluated parathyroid adenomas using strain elastography by color mapping and strain ratio as a semiquantitative measurement; however, we could not find any statistical correlation comparing the strain ratio obtained from the parathyroid adenoma with the thyroid tissue (p � 0.485). Conclusion. Ultrasound elastography is a helpful tool in identifying parathyroid adenomas. A cutoff value below 7 kPa can be used in 2D-SWE. Color maps in strain elastography without adding strain ratio can be used, parathyroid adenoma being identified as score 1 in the Rago criteria.

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“…Imaging using B‐mode ultrasonography only provides information about the shape, margins, and echogenicity of lesions, and may display similar features between neoplastic and benign soft tissue lesions, as reported in humans . In this context, elastosonography has been introduced into both human and veterinary medicine as a tool for classifying the nature of mammary lesions, suggesting malignancy if decreased plasticity is detected …”

Section: Introductionmentioning

confidence: 99%

“…6,7 In this context, elastosonography has been introduced into both human and veterinary medicine as a tool for classifying the nature of mammary lesions, suggesting malignancy if decreased plasticity is detected. [8][9][10][11][12][13] Elastosonography provides information on tissue elasticity, assigning different elastic strains to different chromatic patterns. The elastic strain of an object is related to its density and the amount of stress applied to deform it.…”

Section: Introductionmentioning

confidence: 99%

Real‐time elastosonography of lipomatous vs. malignant subcutaneous neoplasms in dogs: Preliminary results

Longo

Bavčar

Handel

et al. 2017

Vet Radiology Ultrasound

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Real-time elastography is a recently introduced ultrasound technique allowing the investigation of elastic properties of tissues. A diagnostic accuracy study was conducted to test the performance of this technique in the assessment of subcutaneous lesions in dogs. Fifty-two dogs were prospectively included in the preliminary study (34 malignant and 18 benign lesions). B-mode ultrasound was performed assessing the shape, margins, heterogeneity, and echotexture of the lesions. On elastosonography, assessment of the percentage of softness/hardness was recorded. A qualitative assessment was performed according to the Tsukuba elasticity score with a 1-5 score, representing the increased percentage of high stiffness areas. Results were compared with cytology/histopathology of the lesions. Receiver Operating Curves of the overall diagnostic sensitivity and specificity were obtained. Fisher's exact test and Pearsons's Chi-squared test estimated the relationship between the B-mode appearance of the lesions and final diagnosis. A hardness cutoff of 50.25% was identified between lesions, with malignant neoplasms having higher percentages. A 100% specificity and 89% sensitivity for correctly detecting the nature of the lesion on elastosonography was established. Qualitative assessment of the Tsukuba elasticity score established 1.5 as the cutoff between elastograms of lipomatous and malignant lesions, with 100% sensitivity and 61% specificity in differentiating them. Real-time elastosonography is a novel, noninvasive, and accurate technique for differentiating malignant from benign lipomatous lesions in dogs. This method could be considered as a complementary tool with additional diagnostic value for routine invasive procedures, such as fine needle aspirates.

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Qualitative strain elastography – strain ratio evaluation - an important tool in breast cancer diagnostic

Cited by 34 publications

References 27 publications

Application value of real-time shear wave elastography in differential diagnosis of testicular torsion

Application value of real-time shear wave elastography in differential diagnosis of testicular torsion

Shear Wave Elastography versus Strain Elastography in Diagnosing Parathyroid Adenomas

Real‐time elastosonography of lipomatous vs. malignant subcutaneous neoplasms in dogs: Preliminary results

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