scholarly journals Carotid plaque vulnerability assessed by combined shear wave elastography and ultrafast doppler compared to histology: the UF-plaque study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
G Goudot ◽  
J Sitruk ◽  
A Jimenez ◽  
L Khider ◽  
P Julia ◽  
...  
Keyword(s):  
Shear Wave ◽  
Ultrasound Imaging ◽  
Carotid Plaque ◽  
Flow Analysis ◽  
Shear Wave Elastography ◽  
Plaque Vulnerability ◽  
Funding Sources ◽  
Vulnerable Plaques ◽  
Significant Difference ◽  
New Biomarkers

Abstract Purpose New biomarkers are needed to assess the vulnerability of carotid plaque to guide carotid surgery decision. Ultrafast Ultrasound Imaging (UUI) provides an estimation of plaque stiffness by Shear Wave Elastography (SWE) and the quantification of wall shear stress (WSS) by ultrafast Doppler. We aimed at evaluating the plaque stiffness and WSS applied on the plaque as potential biomarkers of plaque vulnerability. Methods Patients were referred for carotid endarterectomy because of symptomatic or asymptomatic carotid stenosis. Their plaques were evaluated by UUI within 48 hours before surgery. For each plaque, WSS and SWE were obtained on a longitudinal view at the stenosis. After endarterectomy, gross analysis and histology were performed on each removed plaque. Results 46 plaques with SWE data and 29 with WSS data were analysed. Histological analysis revealed 29 vulnerable and 17 stable plaques. Analysis of the Gray Scale Median by B mode, mean and standard deviation of stiffness by SWE were not helpful in identifying vulnerable plaques. Figure 1 presents the SWE acquisition on one plaque (A) and the distribution of plaque's stiffness average over all plaques showing the 4 ranges of stiffness (B). SWE analysis revealed that the percentage of stiffness range of [3–5] m/s was significantly increased in vulnerable plaques (p=0.048) (Figure 2A). WSS alone showed no significant difference between stable and vulnerable plaques regardless of which segment of the plaque was analysed. A multiparametric score using maximal WSS at the peak of the plaque associated with SWE texture analysis parameters was created by a stepwise analysis, leading to a score with a sensitivity of 80% and a specificity of 78%. The ROC curve of this score found an AUC of 0.85 (Figure 2B). Conclusions Multiparameter scoring including plaque stiffness and flow analysis using ultrafast ultrasound imaging allows an effective identification of histologically vulnerable carotid plaques. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Fédération Française de cardiologieSociété Française de Cardiologie Figure 1 Figure 2

scholarly journals Ultrasound Elastography: another piece in the puzzle of carotid plaque vulnerability?

2021 ◽  
Author(s):  
Andjoli Davidhi ◽  
Vasileios Rafailidis ◽  
Evangelos Destanis ◽  
Panos Prassopoulos ◽  
Stefanos Foinitsis
Keyword(s):  
Shear Wave ◽  
Carotid Plaque ◽  
Diagnostic Yield ◽  
Imaging Modality ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Intraplaque Hemorrhage ◽  
Plaque Vulnerability ◽  
Carotid Plaques ◽  
Increased Risk

Recent literature has shown that various carotid plaque features, other than stenosis, contribute to plaque vulnerability. Features such as surface morphology and plaque composition with distinct components (e.g. intraplaque hemorrhage, lipid core) have been associated with the increased risk of future cerebrovascular events. Ultrasonography constitutes the first line modality for the assessment of carotid disease and has traditionally been used to grade stenosis with high accuracy. Recenttechnological advances such as contrast-enhanced ultrasound and elastography increased the diagnostic yield of ultrasound in assessing the morphology of carotid plaques. The purpose of this review is to present the available literature on ultrasound elastography of the atherosclerotic carotid. Strain and shear wave elastography allow for the characterization of plaque components, thus indicating its nature and importantly, the plaque’s vulnerability. Shear wave elastography indices appear morerobust than Strain indices. Overall, elastography is a feasible method to distinguish vulnerable carotid plaques. There is, however, a need for larger and longer prospective controlled clinical studies in order to validate elastography as an imaging modality used for the detection of unstable carotid plaques.

scholarly journals Evaluation of carotid plaque vulnerability using shear-wave elastography: An observational comparative study

2019 ◽  
Vol 21 (2) ◽  
pp. 134 ◽  
Author(s):  
Rajeev Sivasankar ◽  
Ramandeep Singh ◽  
PI Hashim ◽  
BrijeshKumar Soni ◽  
RajneeshKumar Patel ◽  
...  
Keyword(s):  
Comparative Study ◽  
Shear Wave ◽  
Carotid Plaque ◽  
Shear Wave Elastography ◽  
Plaque Vulnerability

Carotid Plaque Vulnerability Assessed by Combined Shear Wave Elastography and Ultrafast Doppler Compared to Histology

2021 ◽  
Author(s):  
Guillaume Goudot ◽  
Jonas Sitruk ◽  
Anatole Jimenez ◽  
Pierre Julia ◽  
Lina Khider ◽  
...  
Keyword(s):  
Shear Wave ◽  
Carotid Plaque ◽  
Shear Wave Elastography ◽  
Plaque Vulnerability

Liver Elastography in Healthy Children Using Three Different Systems – How Many Measurements Are Necessary?

2020 ◽  
Author(s):  
Anders Batman Mjelle ◽  
Anesa Mulabecirovic ◽  
Roald Flesland Havre ◽  
Edda Jonina Olafsdottir ◽  
Odd Helge Gilja ◽  
...  
Keyword(s):  
Shear Wave ◽  
Transient Elastography ◽  
Intraclass Correlation ◽  
Age Groups ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Healthy Children ◽  
Significant Difference ◽  
Pediatric Liver Disease ◽  
Liver Elastography

Abstract Purpose Liver elastography is increasingly being applied in screening for and follow-up of pediatric liver disease, and has been shown to correlate well with fibrosis staging through liver biopsy. Because time is of the essence when examining children, we wanted to evaluate if a reliable result can be achieved with fewer acquisitions. Materials and Methods 243 healthy children aged 4–17 years were examined after three hours of fasting. Participants were divided into four age groups: 4–7 years; 8–11 years; 12–14 years and 15–17 years. Both two-dimensional shear wave elastography (2D-SWE; GE Logiq E9) and point shear wave elastography (pSWE; Samsung RS80A with Prestige) were performed in all participants, while transient elastography (TE, Fibroscan) was performed in a subset of 87 children aged 8–17 years. Median liver stiffness measurement (LSM) values of 3, 4, 5, 6, 7, and 8 acquisitions were compared with the median value of 10 acquisitions (reference standard). Comparison was performed for all participants together as well as within every specific age group. We investigated both the intraclass correlation coefficient (ICC) with absolute agreement and all outliers more than 10 %, 20 % or ≥ 0.5 or 1.0 kPa from the median of 10 acquisitions. Results For all three systems there was no significant difference between three and ten acquisitions, with ICCs ≥ 0.97. All systems needed 4 acquisitions to achieve no LSM deviating ≥ 1.0 kPa of a median of ten. To achieve no LSM deviating ≥ 20 % of a median of ten acquisitions, pSWE and TE needed 4 acquisitions, while 2D-SWE required 6 acquisitions. Conclusion Our results contradict recommendations of 10 acquisitions for pSWE and TE and only 3 for 2D-SWE.

scholarly journals Effect of Resonant Frequency Vibration on Delayed Onset Muscle Soreness and Resulting Stiffness as Measured by Shear-Wave Elastography

2021 ◽  
Vol 18 (15) ◽  
pp. 7853
Author(s):  
Garrett C. Jones ◽  
Jonathan D. Blotter ◽  
Cameron D. Smallwood ◽  
Dennis L. Eggett ◽  
Darryl J. Cochrane ◽  
...  
Keyword(s):  
Resonant Frequency ◽  
Shear Wave ◽  
Time Course ◽  
Biceps Brachii ◽  
Shear Wave Elastography ◽  
Upper Body ◽  
Maximum Voluntary Isometric Contraction ◽  
Post Exercise ◽  
Significant Difference ◽  
Pain Ratings

This study utilized resonant frequency vibration to the upper body to determine changes in pain, stiffness and isometric strength of the biceps brachii after eccentric damage. Thirty-one participants without recent resistance training were randomized into three groups: a Control (C) group and two eccentric exercise groups (No vibration (NV) and Vibration (V)). After muscle damage, participants in the V group received upper body vibration (UBV) therapy for 5 min on days 1–4. All participants completed a visual analog scale (VAS), maximum voluntary isometric contraction (MVIC), and shear wave elastography (SWE) of the bicep at baseline (pre-exercise), 24 h, 48 h, and 1-week post exercise. There was a significant difference between V and NV at 24 h for VAS (p = 0.0051), at 24 h and 1-week for MVIC (p = 0.0017 and p = 0.0016, respectively). There was a significant decrease in SWE for the V group from 24–48 h (p = 0.0003), while there was no significant change in the NV group (p = 0.9341). The use of UBV resonant vibration decreased MVIC decrement and reduced VAS pain ratings at 24 h post eccentric damage. SWE was strongly negatively correlated with MVIC and may function as a predictor of intrinsic muscle state in the time course of recovery of the biceps brachii.

scholarly journals Early assessment of shear wave elastography parameters foresees the response to neoadjuvant chemotherapy in patients with invasive breast cancer

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Juanjuan Gu ◽  
Eric C. Polley ◽  
Max Denis ◽  
Jodi M. Carter ◽  
Sandhya Pruthi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Shear Wave ◽  
Invasive Breast Cancer ◽  
Shear Wave Elastography ◽  
Early Prediction ◽  
Early Assessment ◽  
Significant Difference ◽  
Mass Size ◽  
Response To Neoadjuvant Chemotherapy

Abstract Background Early prediction of tumor response to neoadjuvant chemotherapy (NACT) is crucial for optimal treatment and improved outcome in breast cancer patients. The purpose of this study is to investigate the role of shear wave elastography (SWE) for early assessment of response to NACT in patients with invasive breast cancer. Methods In a prospective study, 62 patients with biopsy-proven invasive breast cancer were enrolled. Three SWE studies were conducted on each patient: before, at mid-course, and after NACT but before surgery. A new parameter, mass characteristic frequency (fmass), along with SWE measurements and mass size was obtained from each SWE study visit. The clinical biomarkers were acquired from the pre-NACT core-needle biopsy. The efficacy of different models, generated with the leave-one-out cross-validation, in predicting response to NACT was shown by the area under the receiver operating characteristic curve and the corresponding sensitivity and specificity. Results A significant difference was found for SWE parameters measured before, at mid-course, and after NACT between the responders and non-responders. The combination of Emean2 and mass size (s2) gave an AUC of 0.75 (0.95 CI 0.62–0.88). For the ER+ tumors, the combination of Emean_ratio1, s1, and Ki-67 index gave an improved AUC of 0.84 (0.95 CI 0.65–0.96). For responders, fmass was significantly higher during the third visit. Conclusions Our study findings highlight the value of SWE estimation in the mid-course of NACT for the early prediction of treatment response. For ER+ tumors, the addition of Ki-67improves the predictive power of SWE. Moreover, fmass is presented as a new marker in predicting the endpoint of NACT in responders.

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