scholarly journals High-performance sonographical multimodal imaging of non cystic thyroid lesions: Chances of the preoperative diagnostics in relation to histopathology

2021 ◽  
pp. 1-12
Author(s):  
M. Brandenstein ◽  
I. Wiesinger ◽  
F. Jung ◽  
C. Stroszczynski ◽  
E.M. Jung
Keyword(s):  
Shear Wave ◽  
Multimodal Imaging ◽  
High Performance ◽  
Power Doppler ◽  
Shear Wave Elastography ◽  
Arterial Phase ◽  
Multicenter Studies ◽  
Preoperative Diagnostics ◽  
High Resolution Power ◽  
Thyroid Lesions

AIM: To improve preoperative diagnostics of solid non-cystic thyroid lesions by using new high-performance ultrasound techniques: optimized B-mode morphology, elastography, Color-Coded Doppler-Sonography (CCDS) and contrast enhanced ultrasound (CEUS) MATERIALS AND METHODS: In 33 cases solid, non-cystic thyroid lesions were rated as TIRADS 3 and up from conventional B-mode examinations. Additional high resolution Power Doppler including HR- and Glazing-Flow as optimized macrovascularization techniques, shear wave elastography and CEUS were performed on these patients by one experienced examiner. For CEUS a bolus of 1–2.4 ml Sulfurhexafluorid microbubbles (SonoVue®, Bracco, Milan, Italy) was injected into a cubital vein and then the distribution kinetics of the contrast agent were documented from the early arterial phase (10 to 15 seconds after injection) to the late venous phase (5 minutes after injection). Postoperative histopathology was the diagnostic gold standard as it provides the most reliable proof. RESULTS: 33 patients (13 males, 20 females; age 29 –77 years; mean 55 years; SD 13 years) were included in this study. 28 of them had benign regressive thyroid nodules, 3 had adenomas and 4 were diagnosed with carcinomas (3 were histologically identified as papillary thyroid carcinomas, one as a medullary thyroid carcinoma). The volume of the thyroid gland ranged from 6.6 to 401.3 cm2 (mean 72.6±92.0 cm2). The adenomas diameters ranged from 9 to 40 mm (mean 22±16 mm) and the carcinoma diameters ranged from 19 to 33 mm (mean 26±6 mm). The 3 adenomas had different echogenicities: One was completely echofree, one was hypoechoic and one isoechoic. The 4 carcinomas however were equally characterized as hypoechoic and echofree. Two of three adenomas and all of the carcinomas showed an incomplete or diffuse margin. Micro-calcifications were found in one adenoma and in every carcinoma. However, no micro-calcifications were observed in cases of benign regressive nodules. Performing shear-wave elastography the adenomas showed lower values than the carcinomas: The tissue velocity of the adenomas ranged from 2.86 m/s to 3.85 m/s (mean 3.32±0.5 m/s) and in carcinomas from 3.89 m/s to 5.66 m/s (mean 4.18±0.3 m/s). Marginal hypervascularization was detected in two adenomas after applying CCDS. One adenoma was hypovascularized. The four carcinomas showed an irregular extreme hypervascularization along their margins as well as an irregular central normo- or hypervascularization in CCDS. The additional HR-Flow helped reducing artefacts. In CEUS the dynamic capillary microvascularization of all carcinomas was very irregular with early enhancement and followed by partial or complete wash-out. In CEUS two adenomas had no wash-out and the other one showed a partial wash-out. CONCLUSION: Using modern multimodal imaging offers new possibilities for the differentiation between benign and malignant thyroid lesions. It is a very important diagnostic tool in addition to the B-Mode TIRADS classification and eases the decision between TIRADS 3, 4 and 5. However, additional multicenter studies are required for more detailed evaluations.

scholarly journals Shear wave elastography detects novel imaging biomarkers of aromatase inhibitor–induced joint pain: a pilot study

2021 ◽  
Vol 21 (84) ◽  
pp. e1-e6
Author(s):  
Jessica A. Martinez ◽  
◽  
Mihra S. Taljanovic ◽  
Russell S. Witte ◽  
Andres A. Nuncio Zuniga ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Aromatase Inhibitor ◽  
Postmenopausal Women ◽  
Shear Wave ◽  
Joint Pain ◽  
Power Doppler ◽  
Shear Wave Elastography ◽  
Imaging Biomarkers ◽  
Tendon Stiffness ◽  
Extensor Compartment

Aim: To determine whether differences in joint and tendon stiffness as measured by ultrasound shear wave elastography are present in breast cancer patients with aromatase inhibitor- associated arthralgias compared to age-comparable healthy control women. Methods: Postmenopausal women with stage I–III breast cancer who were taking adjuvant aromatase inhibitors and complained of joint pain were enrolled (n = 6). Postmenopausal women with no history of breast cancer, hormone treatment, or joint pain served as controls (n = 7). All subjects had bilateral hands and wrists evaluated by gray-scale and power Doppler ultrasound, and shear wave elastography ultrasound. Results: Patients with AI-associated arthralgias had significantly stiffer tendons than controls in the 1st extensor compartment (long axis; p = 0.001), 4th extensor compartment (long axis; p = 0.014), 3rd metacarpophalangeal joint (p = 0.002), the pooled values of the extensor compartments, both long (p = 0.044) and short axes (p = 0.035), and the pooled values for the metacarpophalangeal joints (p = 0.002). On ultrasound, the patients (but not controls) presented with hyperemia and increased tenosynovial fluid in the flexor and extensor tendon sheaths, and the median nerves were symptomatic and bifid; however, these differences were not statistically significant. Conclusions: This is the first study to identify increased tendon stiffness as a putative physiological characteristic of aromatase inhibitor–associated arthralgias. Future studies should determine whether increased tendon stiffness is a risk factor for the development of aromatase inhibitor–associated arthralgias, or a result of aromatase inhibitor treatment.

Power Doppler Ultrasonography and Shear Wave Elastography as Complementary Imaging Methods for Suspected Local Breast Cancer Recurrence

2017 ◽  
Vol 37 (6) ◽  
pp. 1493-1501 ◽  
Author(s):  
Rodrigo Menezes Jales ◽  
Maira Teixeira Dória ◽  
Kátia Piton Serra ◽  
Mila Meneguelli Miranda ◽  
Carlos Alberto Menossi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Shear Wave ◽  
Doppler Ultrasonography ◽  
Power Doppler ◽  
Cancer Recurrence ◽  
Shear Wave Elastography ◽  
Breast Cancer Recurrence ◽  
Power Doppler Ultrasonography ◽  
Imaging Methods

scholarly journals The association between patellar tendon stiffness measured with shear-wave elastography and patellar tendinopathy—a case-control study

2020 ◽  
Vol 30 (11) ◽  
pp. 5942-5951 ◽  
Author(s):  
Stephan J. Breda ◽  
Arco van der Vlist ◽  
Robert-Jan de Vos ◽  
Gabriel P. Krestin ◽  
Edwin H. G. Oei
Keyword(s):  
Shear Wave ◽  
Patellar Tendon ◽  
Interobserver Reliability ◽  
Power Doppler ◽  
Shear Wave Elastography ◽  
Intraobserver Reliability ◽  
Patellar Tendinopathy ◽  
Altman Analysis ◽  
Tendon Stiffness ◽  
Bland Altman Analysis

Abstract Objectives (1) To determine the association between patellar tendon stiffness and the presence of patellar tendinopathy (PT). (2) To evaluate the reliability of shear-wave elastography (SWE). Methods Participants were consecutively enrolled between January 2017 and June 2019. PT was diagnosed clinically and confirmed by either grayscale US or power Doppler US, or both. Controls had no history of anterior knee pain and no clinical signs of PT. Patellar tendon stiffness (kilopascal, kPa) was assessed using SWE. Logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Reliability analyses included coefficients-of-variation (CV), coefficients-of-repeatability (CR), intraclass correlation coefficient (ICC) for intraobserver and interobserver reliability, and Bland-Altman analysis. Results In total, 76 participants with PT (58 men, mean age 24.4 ± 3.8 years) and 35 asymptomatic controls (16 men, mean age 21.5 ± 3.8 years) were included. Univariate analyses (OR 1.094, 95% CI 1.061–1.128, p < .001) and adjusted multivariate analyses (OR 1.294, 95% CI 1.044–1.605, p = .018) showed that athletes with PT had significantly increased patellar tendon stiffness. ICC for intraobserver reliability was 0.95 (95% CI 0.92–0.97), CR (CV) 12 kPa (10%) and 0.79 (95% CI 0.65–0.88), CR (CV) 18 kPa (21%) for interobserver reliability. Mean differences from Bland-Altman analysis were 5.6 kPa (95% CI 3.1–8.1, p < .001) for intraobserver reliability and 4.6 kPa (95% CI 1.9–7.2, p < .001) for interobserver reliability. Conclusions PT is associated with significantly higher patellar tendon stiffness. SWE measurements demonstrate excellent intraobserver reliability and good interobserver reliability. Therefore, SWE is a promising tool to implement in longitudinal studies and future studies should evaluate its prognostic value and utility as a monitoring tool in athletes with PT. Key Points • Patellar tendon stiffness measured with shear-wave elastography (SWE) is higher in athletes with patellar tendinopathy than in healthy controls, also after adjusting for potential confounders. • Excellent intraobserver reliability and good interobserver reliability were found for the quantitative assessment of patellar tendon stiffness using SWE.

scholarly journals Muscle shear wave elastography, conventional B mode and power doppler ultrasonography in healthy adults and patients with autoimmune inflammatory myopathies: a pilot cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shereen Paramalingam ◽  
Merrilee Needham ◽  
Warren Raymond ◽  
Frank Mastaglia ◽  
Daniel Lightowler ◽  
...  
Keyword(s):  
Shear Wave ◽  
Inclusion Body Myositis ◽  
Normative Data ◽  
Power Doppler ◽  
Shear Wave Elastography ◽  
Flexor Digitorum Profundus ◽  
Healthy Controls ◽  
Inflammatory Myopathies ◽  
Autoimmune Myopathy ◽  
Flexor Digitorum

Abstract Background Before the role of shear wave elastography (SWE) and B mode ultrasound (US) in the diagnosis of different forms of idiopathic inflammatory myopathies (IIM) can be investigated, normative data is required. This study aimed to describe and then compare normative SWE and B mode ultrasound metrics of muscles in healthy controls and patients with IIM. Methods Twenty nine healthy adult controls and 10 IIM patients (5 with inclusion body myositis and 5 with necrotising autoimmune myopathy) underwent a full clinical examination, laboratory investigations, SWE and US measurements of selected proximal and distal limb muscles. Shear wave speed (SWS) and multiple US domains [echogenicity, fascial thickness, muscle bulk and power Doppler (PD)] were measured in both groups. Results In healthy controls (n = 29; mean age 46.60 ± 16.10; 44.8 % female), age was inversely correlated with SWS at the deltoid (stretch) (Rs. -0.40, p = 0.030) and PD score at the deltoid (rest) (Rs. -0.40, P = 0.032). Those ≥ 50 years old had a lower SWS at the deltoid (stretch) compared to the < 50 year group (2.92 m/s vs. 2.40 m/s, P = 0.032). Age correlated with increased echogenicity in the flexor digitorum profundus (Rs. 0.38, P = 0.045). Females had a smaller muscle bulk in the deltoid (P = 0.022). Body mass index (BMI) was inversely associated with SWS in the deltoid (stretch) (Rs – 0.45, P = 0.026), and positively correlated with echogenicity in the deltoid (Rs. 0.69, P = 0.026). In patients ≥50 years of age, patients with IIM (mean age 61.00 ± 8.18; females 20.0 %) had a higher proportion of abnormal echogenicity scores at the flexor digitorum profundus (FDP) (40.00 % vs. 14.30 %, P = 0.022) and tibialis anterior (TA) (80.00 % vs. 28.60 %, P = 0.004). Fascial thickness was lower in the FDP (0.63mm vs. 0.50mm, p = 0.012) and TA (0.58mm vs. 0.45mm, P = 0.001). Conclusions Our findings suggest there is scope for US techniques to be useful for diagnostic screening of affected muscles in patients with IIM, especially in those with suspected inclusion body myositis or necrotising autoimmune myopathy. We provide normative data for future studies into SWE and US techniques in skeletal muscle. The differences between IIM patients and controls warrant further study in a broader IIM patient cohort.

Correlation between Quantitative Shear Wave Elastography and Pathologic Structures of Thyroid Lesions

2015 ◽  
Vol 41 (9) ◽  
pp. 2326-2332 ◽  
Author(s):  
Takahiro Fukuhara ◽  
Eriko Matsuda ◽  
Yukari Endo ◽  
Masao Takenobu ◽  
Shoichiro Izawa ◽  
...  
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Thyroid Lesions
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