Real time elastography endoscopic ultrasound (RTE-EUS), a comprehensive review

Dietrich, Christoph F.; Săftoiu, Adrian; Jenssen, Christian

doi:10.1016/j.ejrad.2013.03.023

Cited by 97 publications

(76 citation statements)

References 51 publications

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“…For EUS-EG, high sensitivity and non-invasiveness is its obvious superiority. But there are still limitations [39]. The selection bias and the reproducibility of interpretation of EUS-EG is the main concern, especially among endoscopists with different experience levels.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic utility of endoscopic ultrasonography-elastography in the evaluation of solid pancreatic masses: a meta-analysis and systematic review

Lü

Chen

et al. 2017

Med Ultrason

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Aim: The accuracy for endoscopic ultrasonography-elastography (EUS-EG) in the evaluation of solid pancreatic masses varies greatly and the pooled results have not been updated since 2013. Also, there still lack a comprehensive comparison among EUS-EG, contrast-enhanced EUS (CE-EUS), and EUS-guided fine needle aspiration (EUS-FNA).Material and methods: A thorough search was made for diagnostic trials investigating the role of EUS-EG in solid pancreatic masses. Meta-Disc was used to calculate the pooled sensitivity, specificity, diagnostic odds ratio and summary receiver operator characteristics. Results: Finally, 17 studies (1537 patients, 1544 lesions) were selected. The pooled sensitivity and specificity for qualitative methods were 0.97 (95%CI, 0.95-0.99) and 0.67 (95%CI, 0.59-0.74), respectively; the pooled sensitivity and specificity for strain histograms were 0.97 (95%CI, 0.95-0.98) and 0.67(95%CI, 0.61-0.73), respectively; the pooled sensitivity and specificity for strain ratio were 0.98 (95%CI, 0.96-0.99) and 0.62 (95%CI, 0.56-0.68), respectively; the pooled sensitivity and specificity for CE-EUS were 0.90 (95%CI, 0.83-0.95) and 0.76 (95%CI, 0.67-0.84), respectively; the pooled sensitivity and specificity for EUS-FNA were 0.84 (95%CI, 0.77-0.90) and 0.96(95%CI, 0.88-1.00), respectively. Conclusion: EUS-EG is reliable for distinguishing solid pancreatic masses; the sensitivity and specificity for different diagnostic methods were very close. Both EUS-EG and CE-EUS can be valuable complementary supplements for EUS-FNA.

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Section: Discussionmentioning

confidence: 99%

Diagnostic utility of endoscopic ultrasonography-elastography in the evaluation of solid pancreatic masses: a meta-analysis and systematic review

Lü

Chen

et al. 2017

Med Ultrason

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“…In this case the post contrast intravaginal sonography and SE did not detect the tumor relapse. These results are of no clinical importance because in case of microscopic relapse or in tumor free cervix post-therapy, the management is surgery [14].…”

Section: Discussionmentioning

confidence: 99%

“…However, TVUS has been used for the assessment of cervical cancer vascularisation using contrast enhanced US (CETVUS) [13]. Strain elastography (SE) is a rather new US technique and its usefulness in the assessment of cervical cancer has been scarcely reported [14]. The association of gray scale, Doppler, CEUS, and SE represents a multiparametric US approach to cervical cancer that may add complementary information to MRI at a lower cost and with greater accessibility for non radiologists.…”

Section: Introductionmentioning

confidence: 99%

Multimodal endocavitary ultrasound versus MRI and clinical findings in pre- and post-treatment advanced cervical cancer. Preliminary report.

et al. 2016

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Aims: The aim of this study was to evaluate the use of pre and post-therapy transrectal and transvaginal ultrasonography (TRUS, TVUS) with contrast enhancement and strain elastography compared with clinical examination and magnetic resonance imaging (MRI) in the assessment of advanced stage cervical cancer. Material and methods: This was a prospective study, carried out over a period of nine months on subjects with advanced-stage cervical cancer (stage ≥IIB). All included patients were examined clinically and underwent abdomino-pelvic contrast enhanced MRI and multimodal US examinations (TRUS with strain elastography and contrast enhanced TVUS) at the time of diagnosis and after radiochemotherapy. Tumor size and staging at TRUS and TVUS was compared with the same data obtained by clinical examination and MRI. Pathology was the golden standard. Results: Eight patients accomplished the inclusion criteria. In five cases the tumor stage was identical on clinical and MRI examinations. In all cases parametrial infiltration was diagnosed by all pre-treatment examinations. No significant differences were observed in tumor size between clinical, US and MRI exams either at baseline or post-therapy, in native or post-contrast examinations. The size of the tumor evaluated pre-treatment proved to be significantly smaller post-contrast in both US and MRI examinations compared with the native images. Post-therapy, no significant differences were observed on US measured tumor dimensions when comparing native with post-contrast images. Oppositely, significant smaller dimensions were observed on post-contrast MRI compared with native scans. Conclusions: TRUS is accurate in the estimation of pre-therapy cervical cancer dimension. The post therapy tumor evaluation is better performed with MRI. The use of intravenous contrast agents on both examinations did not improved the accuracy of tumor evaluation pre-or post-therapy.

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“…CEUS + RTE presented with higher sensitivity and specificity when compared with CEUS or RTE alone in differentiating between the nodules. This may be due to CEUS + RTE providing noninvasive imaging of the mechanical characteristics of tissues, along with the use of a contrast medium providing an indirect description of intra-nodular vascularisation (38,39). RTE conducted during endoscopic ultrasound allows the evaluation of tissue stiffness for better characterization of the lesions (39).…”

mentioning

confidence: 99%

“…This may be due to CEUS + RTE providing noninvasive imaging of the mechanical characteristics of tissues, along with the use of a contrast medium providing an indirect description of intra-nodular vascularisation (38,39). RTE conducted during endoscopic ultrasound allows the evaluation of tissue stiffness for better characterization of the lesions (39). In a previous study, liver metastases were not visible on conventional US, while multiple metastases were observed with the application of contrast agents, which indicates the usefulness of CEUS in the prediction of liver metastases (40).…”

mentioning

confidence: 99%

Contrast-enhanced ultrasound and real-time elastography in the differential diagnosis of malignant and benign thyroid nodules

Xin

Liu

Jia

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. The diagnostic value of contrast-enhanced ultrasound (CEUS) or real-time elastography (RTE) alone, as well as a combination of CEUS and RTE, in distinguishing benign from malignant thyroid nodules was investigated. Between August 2012 and June 2014, a total of 97 consecutive patients (50 male and 47 female patients; mean age, 48.6±12.4; age range, 27-70 years) with thyroid nodules referred for surgical treatment were examined by CEUS and RTE. The final diagnosis was obtained based on histological findings. Image analysis of the CEUS and RTE scans was performed. Considering the postoperative pathological results as the golden standard, a receiver operating characteristic (ROC) curve was constructed. Subsequently, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of CEUS alone, RTE alone and CEUS + RTE combination were calculated. Pathological examination showed 66 papillary carcinomas and 43 benign lesions, including 21 adenomas and 22 nodular goiters. The sensitivity, specificity, PPV, NPV and accuracy of CEUS were 81.82, 90.70, 93.10, 90.70 and 85.32%, respectively. In the case of RTE, the sensitivity, specificity, PPV, NPV and accuracy were 80.30, 88.37, 91.38, 88.37 and 83.49%, respectively. Furthermore, the combination of CEUS + RTE had a sensitivity of 95.45%, specificity of 95.35%, PPV of 96.92%, NPV of 95.35% and accuracy of 95.41%. Therefore, the CEUS + RTE combination showed a significantly higher sensitivity and specificity compared with CEUS or RTE alone (all P<0.05). Based on ROC analysis, the area under the curve (AUC) for CEUS, RTE and CEUS + RTE combination was 0.883, 0.863 and 0.959, respectively. The AUC of RTE alone was significantly lower compared with that of the CEUS + RTE combination. In conclusion, our results demonstrate that CEUS + RTE combination significantly increases the diagnostic performance for differential diagnosis of malignant and benign thyroid nodules compared with CEUS or RTE alone.

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Real time elastography endoscopic ultrasound (RTE-EUS), a comprehensive review

Cited by 97 publications

References 51 publications

Diagnostic utility of endoscopic ultrasonography-elastography in the evaluation of solid pancreatic masses: a meta-analysis and systematic review

Diagnostic utility of endoscopic ultrasonography-elastography in the evaluation of solid pancreatic masses: a meta-analysis and systematic review

Multimodal endocavitary ultrasound versus MRI and clinical findings in pre- and post-treatment advanced cervical cancer. Preliminary report.

Contrast-enhanced ultrasound and real-time elastography in the differential diagnosis of malignant and benign thyroid nodules

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