Evaluation Short-term Efficacy of Cervical Cancer Under Radiotherapy by Shear Wave Elastography: a Preliminary Study

Abstract Background To find a reliable, safe, convenient and low-cost imaging technology in evaluation of the short-term clinical efficacy of cervical cancer. Here, we performed a preliminary examination of the value of shear wave elastography (SWE) in assessing short-term efficacy of radiotherapy in cervical cancer. Methods In this study, we used SWE to measure the elastic modulus of cervical masses and healthy paracervical tissues and record the maximum elastic modulus (Emax) and the mean elastic modulus (Emean) in 46 patients with cervical cancer. The 46 patients who were naive to treatment were monitored at 5 time points. We divided those into sensitive and non-sensitive groups based on MRI in combination with RECIST1.1. The relative changes in the elastic modulus of the mass before and after radiotherapy were calculated in all patients. MRI was also combined with gynecological examinations to determine if any residual masses remained. Results In this study, 25 patients completed all 5 time points examinations showing the elastic modulus of the cervix decreased while healthy paracervical tissues first increased and then decreased. Then, all 46 patients underwent SWE at 3 time points: prior to radiotherapy, the 15th radiotherapy session, and at completed radiotherapy. The results revealed that the relative changes in cervical masses in the sensitive group were larger than that in the non-sensitive group (P < 0.05). We further discovered the Emax and the Emean of cervical tissues in the residual group were higher than that in the non-residual group (135.69 ± 35.18, 128.25 ± 35.55 vs 104.13 ± 20.19, 98.14 ± 18.9, respectively; P < 0.05), and the area under the curve (AUCs) of the receiver operating characteristic (ROC)were 0.770 and 0.767, respectively (P < 0.05). Conclusions SWE can be used to monitor changes in cervix and paracervical stiffness, and to assist in assessments of the efficacy of radiotherapy in cervical cancer.

Download Full-text

Diagnostic Value of Real-Time Shear Wave Elastography in Diagnosing Thyroid Cancer

Revista de Chimie ◽

10.37358/rc.17.12.5985 ◽

2018 ◽

Vol 68 (12) ◽

pp. 2818-2822

Author(s):

Maria Cristina Oprea ◽

Mihaela Vlad ◽

Ioana Golu ◽

Ioan Sporea ◽

Lazar Fulger

Keyword(s):

Shear Wave ◽

Predictive Value ◽

Thyroid Nodules ◽

Imaging Techniques ◽

Area Under The Curve ◽

Thyroid Volume ◽

Shear Wave Elastography ◽

Maximum Diameter ◽

Diagnostic Tools ◽

Tissue Elasticity

Thyroid nodules are a common pathology found in 50 to 60% of otherwise healthy people. Diagnostic imaging techniques are help discriminating between benign and malignant nodules, while fine needle aspiration is still a gold standard. Shear wave elastography, a recent imaging technique, holds the promise to become reliable diagnostic tools and is currently used in combination with ultrasound. We here report data obtained in a series of 52 thyroid nodules analysed by means of elastography, as well as conventional and Doppler ultrasound. We found no differences in age, nodule and thyroid volume, length, width, thickness and maximum diameter between benign and malignant lesions. Several sonographic patterns are considered to be predictive of malignancy, out of which we only found the intranodular blood flow to be statistically significant. By the means of shear wave elastography we have first assessed tissue elasticities, which are shown in a range of colours, depending on tissue elasticity/stiffness. Then, we have measured and recorded four parameters automatically displayed by the system, namely SWE-mean, SWE-max, SWE-SD and SWE-ratio. Data analysis showed all these quantitative parameters had good sensitivity, specificity, positive predictive value, negative predictive value and area under the curve, as calculated by the ROC curve. As with these parameters, the cut-off points were lower than in literature, still able to indicate reliable diagnoses, which were confirmed by histopathological exam. Our conclusion is that shear wave elastography has great potential for reliably and accurately diagnosing thyroid malignancies.

Download Full-text

Elastic Modulus and Elasticity Ratio of Malignant Breast Lesions with Shear Wave Ultrasound Elastography: Variations with Different Region of Interest and Lesion Size

Diagnostics ◽

10.3390/diagnostics11061015 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1015

Author(s):

Antonio Bulum ◽

Gordana Ivanac ◽

Eugen Divjak ◽

Iva Biondić Špoljar ◽

Martina Džoić Dominković ◽

...

Keyword(s):

Elastic Modulus ◽

Shear Wave ◽

Large Diameter ◽

Small Diameter ◽

Shear Wave Elastography ◽

Lesion Size ◽

Ultrasound Elastography ◽

Breast Lesions ◽

Malignant Breast ◽

The Impact

Shear wave elastography (SWE) is a type of ultrasound elastography with which the elastic properties of breast tissues can be quantitatively assessed. The purpose of this study was to determine the impact of different regions of interest (ROI) and lesion size on the performance of SWE in differentiating malignant breast lesions. The study included 150 female patients with histopathologically confirmed malignant breast lesions. Minimal (Emin), mean (Emean), maximal (Emax) elastic modulus and elasticity ratio (e-ratio) values were measured using a circular ROI size of 2, 4 and 6 mm diameters and the lesions were divided into large (diameter ≥ 15 mm) and small (diameter < 15 mm). Highest Emin, Emean and e-ratio values and lowest variability were observed when using the 2 mm ROI. Emax values did not differ between different ROI sizes. Larger lesions had significantly higher Emean and Emax values, but there was no difference in e-ratio values between lesions of different sizes. In conclusion, when measuring the Emin, Emean and e-ratio of malignant breast lesions using SWE the smallest possible ROI size should be used regardless of lesion size. ROI size has no impact on Emax values while lesion size has no impact on e-ratio values.

Download Full-text

Post-Operative Assessment of Ulnar Nerve Tension Using Shear-Wave Elastography

Neurology International ◽

10.3390/neurolint13030046 ◽

2021 ◽

Vol 13 (3) ◽

pp. 469-476

Author(s):

Sebastien Durand ◽

Wassim Raffoul ◽

Thierry Christen ◽

Nadine Pedrazzi

Keyword(s):

Elastic Modulus ◽

Shear Wave ◽

Ulnar Nerve ◽

Shear Wave Elastography ◽

Elbow Flexion ◽

Ulnar Nerve Compression ◽

Nerve Decompression ◽

Shear Elastic Modulus ◽

Anterior Transposition ◽

Operative Assessment

Background: Ulnar nerve compression at the elbow level is the second-most common entrapment neuropathy. The aim of this study was to use shear-wave elastography for the quantification of ulnar nerve elasticity in patients after ulnar nerve decompression with anterior transposition and in the contralateral non-operative side. Method: Eleven patients with confirmed diagnosis and ulnar nerve decompression with anterior transposition were included and examinations were performed on an AixplorerTM ultrasound system (Supersonic Imagine, Aix-en-Provence, France). Results: We observed significant differences at 0-degree (p < 0.001), 45-degree (p < 0.05), 90-degree (p < 0.01) and 120-degree (p < 0.001) elbow flexion in the shear elastic modulus of the ulnar nerve in the operative and non-operative sides. There were no statistically significant differences between the elasticity values of the ulnar nerve after transposition at 0-degree elbow flexion and in the non-operative side at 120-degree elbow flexion (p = 0.39), or in the ulnar nerve after transposition at 120-degree elbow flexion and in the non-operative side at 0-degree elbow flexion (p = 0.09). Conclusion: Shear-wave elastography has the potential to be used postoperatively as a method for assessing nerve tension noninvasively by the estimation of mechanical properties, such as the shear elastic modulus.

Download Full-text

Effect of Rest Duration Between Static Stretching on Passive Stiffness of Medial Gastrocnemius Muscle In Vivo

Journal of Sport Rehabilitation ◽

10.1123/jsr.2018-0376 ◽

2020 ◽

Vol 29 (5) ◽

pp. 578-582

Author(s):

Masatoshi Nakamura ◽

Shigeru Sato ◽

Ryosuke Kiyono ◽

Nobushige Takahashi ◽

Tomoichi Yoshida

Keyword(s):

Elastic Modulus ◽

Shear Wave ◽

Repeated Measures ◽

Shear Wave Elastography ◽

Muscle Stiffness ◽

Medial Gastrocnemius ◽

Static Stretching ◽

Shear Elastic Modulus ◽

Before And After

Context: In clinical and sports settings, static stretching (SS) is usually performed to increase range of motion (ROM) and decrease passive muscle stiffness. Recently, the shear elastic modulus was measured by ultrasonic shear wave elastography as an index of muscle stiffness. Previous studies reported that the shear elastic modulus measured by ultrasound shear wave elastography decreased after SS, and the effects of SS on shear elastic modulus were likely affected by rest duration between sets of SS. Objective: To investigate the acute effects of SS with different rest durations on ROM and shear elastic modulus of gastrocnemius and to clarify whether the rest duration between sets of SS decreases the shear elastic modulus. Design: A randomized, repeated-measures experimental design. Setting: University laboratory. Participants: Sixteen healthy males volunteered to participate in the study (age 21.3 [0.8] y; height 171.8 [5.1] cm; weight 63.1 [4.5] kg). Main Outcome Measures: Each participant underwent 3 different rest interval durations during SS (ie, long rest duration: 90 s; normal rest duration: 30 s; and short rest duration: 10 s). This SS technique was repeated 10 times, thus lasting a total of 300 seconds with different rest durations in each protocol. The dorsiflexion ROM and shear elastic modulus were measured before and after SS. Results: Our results revealed that dorsiflexion ROM and shear elastic modulus were changed after 300-second SS; however, no effects of the rest duration between sets of SS were observed. Conclusions: In terms of decreasing the shear elastic modulus, clinicians and coaches should not focus on the rest duration when SS intervention is performed.

Download Full-text

Change in Shear Elastic Modulus of Thigh Muscle by Changing Muscle Length Using Ultrasound Shear Wave Elastography in Beagle Dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0039-1692449 ◽

2019 ◽

Vol 32 (06) ◽

pp. 454-459 ◽

Cited By ~ 2

Author(s):

Miki Shimizu ◽

Yu Ito

Keyword(s):

Elastic Modulus ◽

Shear Wave ◽

Vastus Lateralis ◽

Muscle Length ◽

Shear Wave Elastography ◽

Biceps Femoris ◽

Percentage Change ◽

Thigh Muscle ◽

Beagle Dogs ◽

Shear Elastic Modulus

Objectives This study investigated the relationship between the change in the shear elastic modulus and the change in muscle length using ultrasound shear wave elastography. Study Design Four thigh muscles, cranial part of the sartorius, vastus lateralis, biceps femoris and semitendinosus muscles, of 21 pelvic limbs in 12 clinically healthy Beagle dogs were used. The muscle length was estimated using a radiograph and the flexed and extended positions of the coxofemoral and stifle joints, respectively. The shear elastic modulus (kPa) was measured in two joint positions using ultrasound shear wave elastography. Shear elastic modulus was expressed as median of 10 consecutive measurements. The percentage change of elastic modulus was calculated from the shear elastic modulus in elongated condition and pre-elongated condition of muscle. Results The elastic modulus of all muscles increased when the muscle was elongated. The shear elastic modulus for both joint positions and the percentage change of the shear elastic modulus (%) in cranial part of the sartorius were highest in all muscles. Intra-observer correlation coefficient (1.2) was 0.75 to 0.96 and intra-observer correlation coefficients (2.2) was 0.46 to 0.96. Conclusion This study revealed that the shear elastic modulus of muscle was changed by the change in muscle length and increased when the muscle was elongated. Ultrasound shear wave elastography can be used to assess the elastic properties of canine muscle.

Download Full-text

Shear wave elastography in differentiating between benign and malignant cervical lymph nodes in patients with oral carcinoma

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20180454 ◽

2019 ◽

Vol 48 (6) ◽

pp. 20180454 ◽

Cited By ~ 2

Author(s):

Yoshihiko Sasaki ◽

Ichiro Ogura

Keyword(s):

Elastic Modulus ◽

Lymph Nodes ◽

Shear Wave ◽

Rank Correlation ◽

Shear Wave Elastography ◽

Oral Carcinoma ◽

Cervical Lymph Nodes ◽

Significance Level ◽

Axial Diameter ◽

Shear Elastic Modulus

Objectives: To evaluate shear wave elastography in differentiating between benign and malignant cervical lymph nodes in patients with oral carcinoma. Methods: 77 patients with oral squamous cell carcinoma were examined by B-mode and shear wave elastography with a 14 MHz linear transducer. The integrated shear wave elastography software allowed the operator to place regions of interest of various sizes within the elastography window, and automatically displayed shear elastic modulus data (kPa) for each region of interest. The relationship between size and shear elastic modulus of cervical lymph nodes was assessed by Pearson's rank correlation test. The shear elastic modulus of cervical lymph nodes in benign and malignant were evaluated using the Mann–Whitney U test. The analyses were used with a 5% significance level. Results: We plotted shear elastic modulus (X) against minimal axial diameter of cervical lymph nodes (Y), and observed a significant correlation [ Y = 0.091 X + 4.648 (R2 = 0.603, p = 0.000, N = 77)]. Furthermore, the shear elastic modulus of the malignant cervical lymph nodes (105.9 ± 5.2 kPa) was higher than that of benign (11.9 ± 4.4 kPa, p = 0.000). Conclusions: The shear wave elastography is an effective technique for the objectively and quantitatively diagnosis of cervical lymph node metastases of the oral carcinoma.

Download Full-text