Spleen Stiffness Measurement Using 2‐Dimensional Shear Wave Elastography: The Predictors of Measurability and the Normal Spleen Stiffness Value

Cho, Young Seo; Lim, Sanghyeok; Kim, Yongsoo; Sohn, Joo Hyun; Jeong, Jae Yoon

doi:10.1002/jum.14708

Cited by 27 publications

(38 citation statements)

References 21 publications

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“…We could not demonstrate any correlation between age and the measured shear wave velocities. This finding is in accordance with the results of recent publications that could not demonstrate any influence of age on the measured shear wave velocities regardless of the shear wave elastography technique used[ 20 , 21 , 33 , 40 , 41 ]. However, an age-related correlation was previously demonstrated in children and adolescents younger than 18 years[ 42 , 43 ].…”

Section: Discussionsupporting

confidence: 93%

Comparison of point and two-dimensional shear wave elastography of the spleen in healthy subjects

Nowotny¹,

Schmidberger²,

Schlingeloff³

et al. 2021

WJR

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BACKGROUND Few systematic comparative studies of the different methods of physical elastography of the spleen are currently available. AIM To compare point shear wave and two-dimensional elastography of the spleen considering the anatomical location (upper, hilar, and lower pole). METHODS As part of a prospective clinical study, healthy volunteers were examined for splenic elasticity using four different ultrasound devices between May 2015 and April 2017. The devices used for point shear wave elastography were from Siemens (S 3000) and Philips (Epiq 7), and those used for two-dimensional shear wave elastography were from GE (Logiq E9) and Toshiba (Aplio 500). In addition, two different software versions (5.0 and 6.0) were evaluated for the Toshiba ultrasound device (Aplio 500). The study consisted of three arms: A, B, and C. RESULTS In study arm A, 200 subjects were evaluated (78 males and 122 females, mean age 27.9 ± 8.1 years). In study arm B, 113 subjects were evaluated (38 men and 75 women, mean age 26.0 ± 6.3 years). In study arm C, 44 subjects were enrolled. A significant correlation of the shear wave velocities at the upper third of the spleen ( r = 0.33088, P < 0.0001) was demonstrated only for the Philips Epiq 7 device compared to the Siemens Acuson S 3000. In comparisons of the other ultrasound devices (GE, Siemens, Toshiba), no comparable results could be obtained for any anatomical position of the spleen. The influencing factors age, gender, and body mass index did not show a clear correlation with the measured shear wave velocities. CONCLUSION The absolute values of the shear wave elastography measurements of the spleen and the two different elastography methods are not comparable between different manufacturers or models.

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Section: Discussionsupporting

confidence: 93%

Comparison of point and two-dimensional shear wave elastography of the spleen in healthy subjects

Nowotny¹,

Schmidberger²,

Schlingeloff³

et al. 2021

WJR

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“…However, there are differences in cut-off values between studies, and the level of evidence is still too low to recommend spleen stiffness in the diagnostic work-up of patients with cirrhosis. For ARFI-based techniques, limited studies suggest that abdominal wall thickness and splenic longitudinal diameter are independent predictors of successful spleen stiffness measurement (51,52). The feasibility of performing spleen congestion, increasing splenic stiffness.…”

Section: Follow-upmentioning

confidence: 99%

“…Normal values of spleen stiffness with ARFI-based techniques in published studies range from 20.5 kPa (2.6 m/sec) to 24.4 kPa (2.85 m/sec) (52,53,55). The suggested procedure When the acoustic radiation force impulse pulse is not perpendicular to the liver capsule, artifacts occur.…”

Section: Follow-upmentioning

confidence: 99%

Update to the Society of Radiologists in Ultrasound Liver Elastography Consensus Statement

Barr¹,

Wilson²,

Rubens³

et al. 2020

Radiology

301

295

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This multidisciplinary update of the Society of Radiologists in Ultrasound consensus statement on liver elastography incorporates the large volume of new information available in the literature since the initial publication. The recommended procedure for acquiring stiffness measurements is reviewed. There has been substantial improvement in the acoustic radiation force impulse (ARFI) technology-most notably the addition of a quality assessment of the shear wave propagation. Due to the efforts of the Quantitative Imaging Biomarkers Alliance, or QIBA, the variability of liver stiffness measurements between systems had decreased. There are now effective treatments for hepatitis B and hepatitis C, and follow-up after effective treatment should be based on the use of the delta change of the value obtained at viral eradication or suppression. Because the detection of compensated advanced chronic liver disease (cACLD) is very important, the new guidelines are made based on the probability of cACLD for given stiffness values. The panel recommends a vendor-neutral rule of four for interpretation for ARFI techniques. This new method simplifies interpretation of liver stiffness results and is more clinically relevant.

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“…As CHB patients who have been treated with antiviral therapy would need a lower LSM cutoff to define advanced fibrosis and cirrhosis, SSM would play a more important role than LSM in CHB patients. The remaining issue would be the lower success rate of SSM compared to LSM, not just limited to transient elastography but also in the measurements by two‐dimensional shear wave elastography . A model developed by Echosens (Paris, Frances), FibroScan Expert 630 with dedicated spleen stiffness module, has been available in Europe since 2018 .…”

Section: Discussionmentioning

confidence: 99%

Low Risk of Variceal Bleeding in Patients With Cirrhosis After Variceal Screening Stratified by Liver/Spleen Stiffness

et al. 2019

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We previously demonstrated the possible noninferiority of a screening strategy for varices guided by liver and spleen stiffness measurement (LSSM) compared to universal endoscopic screening in detecting clinically significant varices in patients with cirrhosis. We now report the long‐term outcome of the patients recruited in this trial for incident variceal bleeding and other hepatic events. This was a prospective follow‐up study of a noninferiority, open‐label, randomized controlled trial (NCT02024347) of 548 adult patients with known chronic liver diseases, radiological evidence of liver cirrhosis, and compensated liver function. The primary outcome of this prospective study was incident variceal bleeding confirmed with upper endoscopy. Between October 2013 and June 2016, 548 patients were randomized to an LSSM arm (n = 274) and a conventional arm (n = 274). Patients in both study arms were predominantly middle‐aged men (mean age 59 years, male 68.9%) with viral hepatitis–related cirrhosis (85%). Upper endoscopy examination was performed in 127 (46.4%) patients in the LSSM arm and 263 (96.0%) in the conventional arm. During the follow‐up period of 41.3 ± 12.6 months, 12/274 patients in the LSSM arm (4.4%) and 11/274 in the conventional arm (4.0%) developed incident variceal bleeding (log‐rank test P = 0.724). The incident rates of hepatic events were also similar in both arms (P = 0.327). Conclusions: Patients with liver cirrhosis who had undergone LSSM‐guided variceal screening were at similarly low risk of incident variceal bleeding in the future; patients with cirrhosis may first have LSSM measured to save up to half of the upper endoscopy examinations.

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Spleen Stiffness Measurement Using 2‐Dimensional Shear Wave Elastography: The Predictors of Measurability and the Normal Spleen Stiffness Value

Abstract: The success rate of spleen stiffness measurement is lower than that of liver stiffness measurement. Spleen stiffness measurement is affected by abdominal wall thickness and spleen size.

Cited by 27 publications

References 21 publications

Comparison of point and two-dimensional shear wave elastography of the spleen in healthy subjects

Comparison of point and two-dimensional shear wave elastography of the spleen in healthy subjects

Update to the Society of Radiologists in Ultrasound Liver Elastography Consensus Statement

Low Risk of Variceal Bleeding in Patients With Cirrhosis After Variceal Screening Stratified by Liver/Spleen Stiffness

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