scholarly journals Value of Shear Wave Elastography for differentiating benign and malignant renal lesions

2018 ◽  
Vol 1 (1) ◽  
pp. 21 ◽  
Author(s):  
Sinem Aydin ◽  
Seyma Yildiz ◽  
Ihsan Turkmen ◽  
Rasul Sharifov ◽  
Omer Uysal ◽  
...  

Aims: To investigate the diagnostic accuracy of shear-wave elastography (SWE) for assessing malignant and benign kidneymasses.Materials and methods: Forty patients with solid renal masses underwent US elastographic evaluation. SWE values of the lesions and adjacent cortical renal parenchyma and SWER were detected prospectively. Malignant tumors were recorded as group 1 and benign tumors were recorded as group 2.Results: The highest elasticity values were 27.27±25.66 kPa for group 1 and 16.13±8.89 kPa for group 2. The mean±SD elasticity values for adjacent renal cortex for groups 1 and 2 were 2.7±2.08 and 2.75±1.35, respectively. For group 1, a negative correlation was observed between the age of the patients and SWER value (p=0.047, rs=‑0.401). There was also a negative correlation between the SWER value and the SWE value of adjacent renal cortex (p=0.004, rs=‑0.555).Conclusion: SWE is a noninvasive method that provides quantitative elasticity informationon tissues. Overlaps among different types of renal lesions may be due to heterogeneity of the lesions. Larger studygroups may clarify the other factors affecting SWE values under both normal and pathological conditions.

Ultrasound ◽  
2017 ◽  
Vol 25 (3) ◽  
pp. 150-155 ◽  
Author(s):  
Rustu Turkay ◽  
Ercan Inci ◽  
Mustafa Gurkan Yenice ◽  
Volkan Tugcu

Introduction Erectile dysfunction (ED) is a common health problem among males, and radiology has limited use in its diagnosis and treatment. Shear wave elastography (SWE) is a new sonographic technique. In this study, we examined the significance of SWE in the diagnosis of ED. Methods The study included a total number of 70 participants. The mean age of the participants was 54.14 ± 8.03 years (range: 39 and 71 years old). We composed two groups. Group 1 had 35 patients who presented to the urology clinic in our hospital complaining of ED, and had a score of 17 or lower from the International Index of Erectile Function (IIEF) questionnaire. Group 2 consisted of 35 healthy volunteers who did not have ED. SWE measurements were performed from corpus cavernosum penis in both groups, and the results were noted. Differences between the groups were evaluated statistically. Results The difference between the mean SWE measurements of two groups (Group 1: 20.94 ± 6.23 kPa and group 2: 24.63 ± 7.58 kPa) was found to be statistically significant ( p = 0.027; p < 0.05). For a cut-off value of 17.1 kPa, the SWE method has specificity, sensitivity, positive predictive value, and negative predictive value regarding diagnosis of ED as 94.29%, 34.29%, 85.71%, and 58.93%, respectively. The mean age of the groups did not show a statistically significant difference ( p = 0.287; p > 0.05). Conclusions Due to its high specificity and positive predictive value, SWE can offer useful data in the radiologic evaluation of ED cases.


2020 ◽  
Vol 12 (4) ◽  
pp. 373-381 ◽  
Author(s):  
Matthias Gatz ◽  
Marcel Betsch ◽  
Timm Dirrichs ◽  
Simone Schrading ◽  
Markus Tingart ◽  
...  

Background: Apart from eccentric exercises (EE), isometric exercises (ISO) might be a treatment option for Achilles tendinopathy. Shear wave elastography (SWE) provides information for diagnosis and for monitoring tissue elasticity, which is altered in symptomatic tendons. Hypothesis: Isometric exercises will have a beneficial effect on patients’ outcome scores. Based on SWE, insertional and midportion tendon parts will differ in their elastic properties according to current symptoms. Study Design: Randomized clinical trial. Level of Evidence: Level 2. Methods: Group 1 (EE; n = 20; 12 males, 8 females; mean age, 52 ± 8.98 years) and group 2 (EE + ISO; n = 22; 15 males, 7 females; mean age, 47 ± 15.11 years) performed exercises for 3 months. Measurement points were before exercises were initiated as well as after 1 and 3 months using the Victorian Institute of Sports Assessment–Achilles (VISA-A) score, American Orthopaedic Foot & Ankle Society score, and SWE (insertion and midportion). Results: Both groups improved significantly, but there were no significant interindividual differences (VISA-A; P = 0.362) between group 1 (n = 15; +15 VISA-A) and group 2 (n = 15; +15 VISA-A). The symptomatic insertion (symptomatic, 136.89 kPa; asymptomatic, 174.68 kPa; P = 0.045) and the symptomatic midportion of the Achilles tendon (symptomatic, 184.40 kPa; asymptomatic, 215.41 kPa; P = 0.039) had significantly lower Young modulus compared with the asymptomatic tendons. The midportion location had significantly higher Young modulus than the insertional part of the tendon ( P = 0.005). Conclusion: Isometric exercises do not have additional benefit when combined with eccentric exercises, as assessed over a 3-month intervention period. SWE is able to distinguish between insertional and midportion tendon parts in a symptomatic and asymptomatic state. Clinical Relevance: The present study shows no additional effect of ISO when added to baseline EE in treating Achilles tendinopathy. Different elastic properties of the insertional and midportion tendon have to be taken into consideration when rating a tendon as pathologic.


Ultrasound ◽  
2021 ◽  
pp. 1742271X2110358
Author(s):  
Mohsen Mosadegh ◽  
Mehdi Khazaei ◽  
Zohreh D Abdollahpour ◽  
Sam Alahyari ◽  
Yashar Moharamzad ◽  
...  

Introduction Post-mortem rigidity of the tissues is one of the basic principles in forensic medicine to estimate the time of death. Qualitative methods to determine the stiffness of the corpse may have some limitations. Methods that provide quantitative values may be useful. We intended to evaluate the applicability of ultrasound shear-wave elastography of the tissues to estimate the post-mortem interval (PMI). Methods For 80 corpses, shear-wave elastography of the liver, sartorius muscle, testis, thyroid and parotid was performed before autopsy. Based on the forensic reports as the reference method to define post-mortem interval, the corpses were divided into four groups: group 0 (PMI < 24 hours), group 1 (PMI ≥24 hours and <48 hours), group 2 (PMI ≥ 48 hours and <72 hours), and group 3 (PMI ≥ 72 hours). There were 24, 38, 13, and 5 corpses, respectively, in groups 0, 1, 2, and 3. Results A significant rise in the elasticity values in comparison to elasticity of normal tissues in live adults was seen very early in the post-mortem period. Between-group comparisons showed that a significant difference in the liver elasticity was present among the groups. The mean (SD) liver elasticity was 10.29 (±0.83) in group 0, 14.98 (±1.56) in group 1, 12.49 (±1.09) in group 2, and 15.64 (±1.68) kilopascals (kPa) in group 3 ( P = 0.035). Nevertheless, elasticity measurements in other tissues were not helpful in distinguishing post-mortem interval groups. Conclusion It is possible to use liver quantitative shear-wave elastography to estimate the time of death.


Author(s):  
Jonathan Lyske ◽  
Rishi Philip Mathew ◽  
Christopher Hutchinson ◽  
Vimal Patel ◽  
Gavin Low

Abstract Background Focal lesions of the kidney comprise a spectrum of entities that can be broadly classified as malignant tumors, benign tumors, and non-neoplastic lesions. Malignant tumors include renal cell carcinoma subtypes, urothelial carcinoma, lymphoma, post-transplant lymphoproliferative disease, metastases to the kidney, and rare malignant lesions. Benign tumors include angiomyolipoma (fat-rich and fat-poor) and oncocytoma. Non-neoplastic lesions include infective, inflammatory, and vascular entities. Anatomical variants can also mimic focal masses. Main body of the abstract A range of imaging modalities are available to facilitate characterization; ultrasound (US), contrast-enhanced ultrasound (CEUS), computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET), each with their own strengths and limitations. Renal lesions are being detected with increasing frequency due to escalating imaging volumes. Accurate diagnosis is central to guiding clinical management and determining prognosis. Certain lesions require intervention, whereas others may be managed conservatively or deemed clinically insignificant. Challenging cases often benefit from a multimodality imaging approach combining the morphology, enhancement and metabolic features. Short conclusion Knowledge of the relevant clinical details and key imaging features is crucial for accurate characterization and differentiation of renal lesions.


2017 ◽  
Vol 118 (4) ◽  
pp. 119-127
Author(s):  
Selahattin Çalışkan ◽  
Orhan Koca ◽  
Mehmet Akyüz ◽  
Metin İshak Öztürk ◽  
Muhammet Ihsan Karaman

Renal cell carcinomas (RCCs) account 80–85% of all primary renal neoplasms and originate from the renal cortex. The patients who underwent radical or partial nephrectomy for renal tumour in our unit between January 2005 and 2015 were evaluated retrospectively. The patients were divided into two groups; group 1 includes patients who were treated between January 2005 and December 2009, group 2 those from January 2010 to 2015. There were 103 patients in group 1. The patients were between 21 and 89 years with mean age of 61.46 year. Renal cell carcinomas account 83.4% of the patients, benign renal tumours were 8.7% and transitional cell carcinomas were 7.7% of the patients in group 1. A total of 32.5% RCCs were classified as pT1a, 24.4% as pT1b, 15.1% as pT2a, 11.6% as pT2b, 15.1% as pT3a and 1.1% as pT4. There were 202 patients in group 2 and the patients were between 27 and 81 years with mean age of 58.5 year. Renal cell carcinomas comprised the main bulk of the tumours with 182 nephrectomy specimens. According to the pathological classification of RCCs, 51 specimens were found as pT1a, 54 were pT1b, 13 were pT2a, 14 were pT2b, 48 were pT3a and 2 were pT4. Although, the incidence of small renal masses has been increasing with widespread use of imaging techniques and recent advancements, the proportion of high grade and advanced stage renal tumours increased during the study period.


2019 ◽  
Vol 8 (4) ◽  
pp. 37-44 ◽  
Author(s):  
E. V. Kovaleva ◽  
T. Yu. Danzanova ◽  
G. T. Sinyukova ◽  
P. I. Lepedatu ◽  
E. A. Gudilina ◽  
...  

In this article, based on two clinical examples, the possibilities of multiparametric ultrasound in the differential diagnosis of metastatic and lymphoproliferative changes in lymph nodes in primary-multiple malignant tumors, including breast cancer and lym - phoma, are evaluated. Multiparameteric ultrasound includes B-mode, color and energy Doppler imaging, strain elastography, shear wave elastography and contrast-enhanced ultrasound (CEUS). Standardization and reproducibility of these ultrasound techniques will allow to objectify the study, obtaining specific indicators of shear wave velocity in the zones of interest and specific signs of contrast enhancement, which can be used as impor tant differential diagnostic tool in oncology.


2018 ◽  
Vol 59 (10) ◽  
pp. 1168-1175 ◽  
Author(s):  
Hye Sun Park ◽  
Hee Jung Shin ◽  
Ki Chang Shin ◽  
Joo Hee Cha ◽  
Eun Young Chae ◽  
...  

Background Aggressive breast cancers produce abnormal peritumoral stiff areas, which can differ between benign and malignant lesions and between different subtypes of breast cancer. Purpose To compare the tissue stiffness of the inner tumor, tumor border, and peritumoral stroma (PS) between benign and malignant breast masses by shear wave elastography (SWE). Material and Methods We enrolled 133 consecutive patients who underwent preoperative SWE. Using OsiriX commercial software, we generated multiple 2-mm regions of interest (ROIs) in a linear arrangement on the inner tumor, tumor border, and PS. We obtained the mean elasticity value (Emean) of each ROI, and compared the Emean between benign and malignant tumors. Odds ratios (ORs) for prediction of malignancy were calculated. Subgroup analyses were performed among tumor subtypes. Results There were 85 malignant and 48 benign masses. The Emean of the tumor border and PS were significantly different between benign and malignant masses ( P < 0.05 for all). ORs for malignancy were 1.06, 1.08, 1.05, and 1.04 for stiffness of the tumor border, proximal PS, middle PS, and distal PS, respectively ( P < 0.05 for all). Malignant masses with a stiff rim were significantly larger than malignant masses without a stiff rim, and were more commonly associated with the luminal B and triple negative subtypes. Conclusion Stiffness of the tumor border and PS obtained by SWE were significantly different between benign and malignant masses. Malignant masses with a stiff rim were larger in size and associated with more aggressive pathologic subtypes.


1975 ◽  
Author(s):  
K. Korsan-Bengtsen ◽  
B. Hallgren ◽  
A.-C Teger-Nilsson

The study group was 40 male post myocardial infarction patients 47-57 years old. All the participants were investigated two times with two weeks interval after which they were randomly divided into four groups with 10 subjects in each. Group 1 was given alpha-tocopherol 300 mg/day, group 2 was given alpha tocopherol 300 mg/day and a diet containing extra polyunsaturated fats, group 3 was given extra polyunsaturated fats but no extra alpha-tocopherol and group 4 served as a control group – thus continued their ordinary diet. After three months all participants were again investigated twice with two weeks interval.On the values from all 40 subjects before the start of the dietary regimens linear regression analyses showed that there was a significant correlation between the content of the fatty acid 18 : 0 in the serin cephalin fraction and re calcification time in platelet rich plasma (RPRP), and a negative correlation between 20: 4 and RPRP. There was also a correlation between the ratio 18: 0/20: 4 and RPRP and a negative correlation between 18: 0/20: 4 and platelet factor 3 activity in plasma.In group 2 there was a significant decrease in 18:0 and an increase in 20: 4 in the serin cephalin fraction from platelets after the diet period compared to preexperimental values. Russel’s viper venom clotting time (RVV) decreased significantly in group 1. There was a significant correlation between the decrease in RVV and the increase in plasma alphatocopherol.


2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 357-357 ◽  
Author(s):  
Paul Russo ◽  
Robert G. Uzzo ◽  
William Thomas Lowrance ◽  
Aviva Asnis-Alibozek ◽  
Norman David LaFrance ◽  
...  

357 Background: Use of cross-sectional imaging has increased the detection rate for small renal tumors; more patients now present with early-stage renal cell carcinoma (RCC) or benign or indolent renal masses. Histopathology after surgical resection is the definitive method for characterizing renal tumors. Stage migration of renal masses creates uncertainty about the percentage of resected masses that will be benign vs malignant. We sought to better define these proportions through a targeted review of the literature. Methods: PubMed/select congresses were searched to identify the histologic classification of renal masses in a representative sample from the contemporary literature: [search] incidence AND (renal cell carcinoma AND benign); incidence AND (renal tumor AND benign); percentage AND (renal cell carcinoma AND benign); limit: 2003–2011. Results: Most representative studies included procedures conducted in the mid-1990s to the mid-to-late 2000s. Studies origin was US (n=8), Korea (n=3), China, Japan, Germany, Austria, Australia, and multisite (Israel/France/US; all n=1). Only 8 studies had n≥500 (range, 70–10,404). The proportion of benign masses are shown (see Table); half of the studies reported values between 16% and 17%. The majority found that benign tumors were more likely to be smaller in size (<4 or <7 cm) than malignant tumors. 11 studies reported the RCC subtype (% clear cell range, 46%–83%). Conclusions: Benign renal tumors occur ~15% of the time and are more prevalent among small masses. Nearly 25% of resected lesions are benign or indolent and may not require surgery. Preoperative discrimination of more aggressive renal masses would be an important clinical advance that could improve clinicians’ diagnostic confidence and guide patient management. Funding: Wilex AG/IBA Molecular. [Table: see text]


2017 ◽  
pp. 88-95
Author(s):  
A. N. Katrich ◽  
A. V. Okhotina ◽  
O. N. Ponkina ◽  
N. S. Ryabin

The aim:to study of the effect of NAFLD on the results of shear elastography (based on the results of liver biopsy).  Materials and methods.We have performed outcome analysis in 137 patients, treated from 2015 to 2016. All patients had chronic diffuse liver diseases and were hospitalized for morphological evaluation and diagnosis clarification. Group 1 (n = 117) with no fat changes in the liver parenchyma. Group 2 (n = 20) with steatosis of the liver.  In our work, we used: scanner Aixplorer (France). All patients underwent shear wave elastography (2DSWE) with the study of the quantitative index of stiffness of liver tissue, staging the results on the Metavir scale.Results.In the 1st group of patients (without steatosis), in the ROC analysis, cutoff values of elasticity were obtained, the diagnostic efficiency of the Metavir stage of fibrosis was the most optimal: for F2 > 6.8 kPa (sensitivity 85.7, specificity 52, 9, AUROC 0.684); For F3 > 8.5 kPa (sensitivity 91, specificity 57.1, AUROC 0.745); For F4 > 14 kPa (sensitivity 95.7, specificity 52.2, AUROC 0.791). It was found, that the presence of steatosis significantly increases the elasticity of the liver tissue. So, in the subgroup sF0 (with steatosis) was a significant increasing of young's module Ме = 11,2 kPa (95% CI 7,3–17,5) compared to Ме = 6,1 kPa (95% CI 5,4– 9,6) in the subgroup F0 (without steatosis) (P = 0,0168, AUROC = 0,741) and up to Ме=9,95 kPa (95% CI 6,8–13,0) in the subgroup sF0 + sF1 (with steatosis) compared with Ме=6,65 kPa (95%CI 5,6–9,5) of the subgroup F0 + F1 (without steatosis) (P = 0.0295, = 0.707). This increase was, respectively, 83,6% and 49.6%  Сonclusions.This study confirmed the effectiveness of the shear wave elastography method in assessing the relationship between stiffness parameters and the morphological fibrosis of the liver parenchyma and also contributed to the final confirmation of the effect of steatosis on  liver stiffness.


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