scholarly journals Changes in Muscle Hardness from Resting to Mid-Range Lengthened Positions Detected by Shear Wave Elastography (SWE) with a Novel Protocol of Ultrasound Probe Placement

2021 ◽  
Vol 11 (1) ◽  
pp. 452
Author(s):  
Long-Jun Ren ◽  
Connie Lok-Kan Cheng ◽  
Christina Zong-Hao Ma ◽  
Yong-Ping Zheng
Keyword(s):  
Shear Wave ◽  
Intraclass Correlation ◽  
Shear Wave Elastography ◽  
Rectus Femoris ◽  
Healthy Adults ◽  
Physiological Status ◽  
Ultrasound Probe ◽  
Muscle Hardness ◽  
Age Related ◽  
Probe Placement

Muscle hardness and its relationship with different muscle lengths/positions are important for understanding its underlying physiological status, and yet remained unclear. This study aimed to detect the local muscle hardness at different muscle lengths and identify the influence of muscle position on muscle hardness in healthy adults. A total of 26 healthy adults participated in this study. Shear wave elastography (SWE) was used to measure the muscle hardness of the Rectus Femoris (RF), Tibialis Anterior (TA) and Gastrocnemius Medialis (GM). Each muscle was tested at both resting (RST) and mid-range lengthened (MRL) positions. A novel ultrasound probe placing method was introduced, applied, and evaluated in this study. Moderate to excellent intra-/inter-rater reliability (Intraclass Correlation Coefficient, ICC ≥ 0.70) was found for muscle hardness measurements. The muscle hardness significantly increased from the RST to MRL position for all three muscles (p < 0.001). This study found that the muscle hardness increased at its mid-range lengthened position from the resting position. The mid-range lengthened muscle position of TA and GM could also be sensitive enough to reflect the age-related changes in local muscle hardness. This study also highlights the importance of placing the assessed extremities in an appropriate and consistent position when assessing muscle qualities by ultrasonics in clinical practice.

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.

Bidimensional shear wave elastography of the rectus femoris muscle in patients with cirrhosis

2020 ◽  
Vol 73 ◽  
pp. S696
Author(s):  
Chiara Becchetti ◽  
Giacomo Germani ◽  
Patrizia Burra ◽  
Jean-François Dufour ◽  
Annalisa Berzigotti
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Rectus Femoris ◽  
Rectus Femoris Muscle ◽  
Femoris Muscle

Normal Liver Stiffness in Healthy Adults Assessed By Real-Time Shear Wave Elastography and Factors That Influence This Method

2014 ◽  
Vol 40 (11) ◽  
pp. 2549-2555 ◽  
Author(s):  
Zeping Huang ◽  
Jian Zheng ◽  
Jie Zeng ◽  
Xiaoli Wang ◽  
Tao Wu ◽  
...  
Keyword(s):  
Real Time ◽  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Normal Liver ◽  
Healthy Adults

scholarly journals Reliability Criteria for Liver Stiffness Measurements with Real-Time 2D Shear Wave Elastography in Different Clinical Scenarios of Chronic Liver Disease

2016 ◽  
Vol 38 (06) ◽  
pp. 648-654 ◽  
Author(s):  
Maja Thiele ◽  
Bjørn Madsen ◽  
Bogdan Procopet ◽  
Janne Hansen ◽  
Linda Møller ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Standard Deviation ◽  
Real Time ◽  
Shear Wave ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Diagnostic Study ◽  
Clinical Scenarios

Abstract Purpose Liver stiffness measurement by real-time 2-dimensional shear wave elastography (2D-SWE) lacks universal reliability criteria. We sought to assess whether previously published 2D-SWE reliability criteria for portal hypertension were applicable for the evaluation of liver fibrosis and cirrhosis, and to look for criteria that minimize the risk of misclassification in this setting. Materials and Methods In a biopsy-controlled diagnostic study, we obtained five 2D-SWE measurements of optimal image quality. Correctly classified cases of fibrosis and cirrhosis were compared to misclassified cases. We compared reliability predictors (standard deviation (SD), SD/mean, size of region of interest (ROI) and difference between a single measurement and the patient’s median) with those obtained in a prior study on clinically significant portal hypertension. Results We obtained 678 2D-SWE measurements from 142 patients. Overall, the variability in liver stiffness within single 2D-SWE measurements was low (SD = 1.1 ± 1.5kPa; SD/mean = 12 ± 9 %). Intra-observer analysis showed almost perfect concordance (intraclass correlation coefficient = 0.95; 95 % CI 0.94 – 0.96; average difference from median = 0.4 ± 0.9kPa). For the diagnosis of cirrhosis, a smaller SD (optimally ≤ 1.75 kPa) and larger ROI size (optimally ≥ 18 mm) were associated with higher accuracy. Similarly, within the published cohort of patients assessed for portal hypertension, a low variability of measurements was associated with high reliability. Conclusion A high quality 2D-SWE elastogram ensures low variability and high reliability, regardless of indication. We recommend aiming for a combination of low standard deviation and large ROI.

scholarly journals Interconversion of elasticity measurements between two-dimensional shear wave elastography and transient elastography

2018 ◽  
Vol 20 (2) ◽  
pp. 127 ◽  
Author(s):  
Yeun-Yoon Kim ◽  
Myung-Joon Kim ◽  
Hyun Joo Shin ◽  
Haesung Yoon ◽  
Ha Yan Kim ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Shear Wave ◽  
Transient Elastography ◽  
Intraclass Correlation ◽  
Shear Wave Elastography ◽  
Two Dimensional ◽  
Regression Analyses ◽  
Supersonic Shear Imaging ◽  
Probe Selection ◽  
Elasticity Measurements

Aims: To enable comparison and interconversion of elasticity measurements between two-dimensional (2D) shear wave elastography (SWE) and transient elastography (TE).Materials and methods: Elasticities of three phantoms were measured by 2D SWE (supersonic shear imaging) using four probes and TE using two probes. We performed regression analyses to evaluate correlation between the measurements and phantom elasticities, and make converting equations. In pediatric biliary atresia patients who had stiffness measurements by both 2D SWE and TE within 1-year interval, TE measurements were retrospectively converted into correlating 2D SWE values. We compared the calculated values with 2D SWE measurements by intraclass correlation coefficient.Results: Measurements in phantoms varied according to elastography method and probe selection. However, the measurement by both 2D SWE (R2, 0.974-0.985; p<0.001) and TE (R2, 0.996-0.999; p<0.001) showedsignificant linear correlation with phantom elasticity in all probe settings. From 67 biliary atresia patients (age, 2 months-20 years), agreements between the measured and calculated values were excellent in all 88 examinations within 1-year interval(ρ=0.828; p<0.001) and in 63 examinations within 2-month interval (ρ=0.863, p<0.001). Conclusions: The equations enabledinterconversion of elasticity values among different probes of 2D SWE and TE and provided reliable estimation of elasticityvalues for different probe settings in biliary atresia patients.

scholarly journals Shear Wave Elasticity by Tracing Total Nodule Showed High Reproducibility and Concordance with Fibrosis in Thyroid Cancer

2019 ◽  
Author(s):  
Myung Hi Yoo(New Corresponding Author) ◽  
Hye Jeong Kim(Former Corresponding Author) ◽  
In Ho Choi ◽  
Suyeon Park ◽  
Sang Jin Kim ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Clinical Practice ◽  
Shear Wave ◽  
Thyroid Nodules ◽  
Intraclass Correlation ◽  
Region Of Interest ◽  
Shear Wave Elastography ◽  
Circular Area ◽  
High Reproducibility ◽  
Wide Range

Abstract Background Although shear wave elastography (SWE) is reported to be useful in detecting malignant thyroid nodules, it shows a wide range of cut-off values of elasticity index (EI) in detecting malignant nodules. The cause of discrepancy remains unclear. Fibrosis of the tumors is known to increase the EI in SWE, and matching of SWE and surgical histopathology has not been fully illustrated in thyroid cancer. We aimed to evaluate the reproducibility of the new total nodular region of interest (ROI) method excluding the subjective features of focal circular ROI placement and to determine the lesion that causes the elevation of EI on SWE and on histopathology. Methods A total of 29 thyroid cancers from 28 patients were included. We evaluated the reproducibility of EI in the new total nodular ROI using Q-Box Trace program and compared the EI in focal nodular ROI using a 3-mm circular area. We analyzed the correlation between fibrosis and EI. Result The coefficient of variation (CV) of the intrarater assay was significantly lower in total nodular ROI than in focal nodular ROI within the image in rater 1 (1.7% vs. 13.4%, p<0.001) and in rater 2 (1.4% vs. 16.9%, p<0.001) and in different images in rater 1 (7.6% vs. 12.3%, p=0.040) and in rater 2 (7.5% vs. 19.8%, p=0.004). Moreover, CV of the interrater assay showed similar results (14.9% vs. 19%, p=0.030). Interrater intraclass correlation coefficient showed better agreement in total nodular ROI than in focal nodular ROI (0.863 vs. 0.783). The degree of fibrosis on histopathology showed significant correlations with EI (E Mean , p<0.001; E Max , p=0.027), and the location of fibrosis was concordant with the high EI area on SWE. Conclusion Our study revealed that the new total nodular ROI method showed higher reproducibility and better agreement in intra- and interrater assay than the focal nodular ROI method, suggesting a valuable and standardized method in clinical practice. Moreover, our results showed that fibrosis in the histopathology increased EI on SWE and might lead to the discrepancy of the cut-off values in detecting thyroid cancer.

scholarly journals Intra- and inter-observer variation and accuracy using different shear wave elastography methods to assess circumscribed objects – a phantom study.

2017 ◽  
Vol 19 (4) ◽  
pp. 357 ◽  
Author(s):  
Gregor Seliger ◽  
Katharina Chaoui ◽  
Christian Kunze ◽  
Yasmina Dridi ◽  
Klaus-Vitold Jenderka ◽  
...  
Keyword(s):  
Shear Wave ◽  
Elastic Properties ◽  
Measurement Techniques ◽  
Intraclass Correlation ◽  
Shear Wave Elastography ◽  
Observer Variation ◽  
Significant Difference ◽  
Clinical Interest ◽  
Observational Errors

Aims: The elastic properties of circumscribed tissues (e.g., tendons, lymph nodes, prostates, brain tumors) are of considerable clinical interest. The purpose of this study was thus to compare the Intra-/Inter-observer variation and accuracy in vitro of point shear wave elastography (pSWE) with that of 2D-SWE and to assess 2D-SWE’s precision with variable ROI (vROI) incircumscribed objects.Material and methods: Round targets (Elasticity QA Phantom Model 049) were examined for varying degrees of stiffness (8, 14, 45, and 80 kPa) and diameters (20/10 mm). Three ultrasound systems and four probes were applied (pSWE: Acuson/S3000 9L4/4C1 and Epiq7 C51, 2D-SWE: Aplio/500 PVT375BT). Three different ROIs were used, namely fixed ROI (fROI) and variable ROI: rectangular-best-fitted ROI, and round-best-fitted ROI. Each measurement was performed twice by four observers.Results: A total of 3,604 measurements were conducted. The intra-observer variation of 2D-SWE measurements indicated better agreement (Intraclass Correlation Coefficient (ICC) = 0.971; 95% CI=[0.945; 0.985]), than for the pSWE measurements (ICC = 0.872; 95% CI=[0.794; 0.92]). With both methods, the shear wave elastography applied showed low inter-observer variation: ICC = 0.980; 95% CI=[0.970; 0.987]. However, a significant difference was observed between fROI (pSWE) and vROI (2D-SWE) on circumscribed objects in terms of accuracy. The lowest degree of observationerror was detected in situations where the ROI was not “best fitted”, but placed within the target of 3mm from the border (target diameter: 20mm; mean relative error = 0.15).Conclusions: When estimating the elastic properties of circumscribed tissues, the different measurement techniques performed by commercial shear wave elastography systems reveal a strong susceptibility for observational errors, depending upon the fixed vs. variable ROI of the pSWE vs. 2D-SWE technique.

scholarly journals An investigation into the variability between different shear wave elastography systems in muscle

2017 ◽  
Vol 19 (4) ◽  
pp. 392 ◽  
Author(s):  
Abdulrahman M. Alfuraih ◽  
Philip O'Connor ◽  
Ai Lyn Tan ◽  
Elizabeth Hensor ◽  
Paul Emery ◽  
...  
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Rectus Femoris ◽  
Mean Velocity ◽  
Perfect Agreement ◽  
Intra Class Correlation ◽  
Longitudinal Orientation ◽  
Rectus Femoris Muscle ◽  
New System ◽  
Internal Agreement

Aims: The reliability and agreement between shear wave elastography (SWE) systems using different acquisition methods in muscles is not yet established. The objectives were to determine the reliability of a new SWE system on normal resting muscles using different acquisition methods and to compare its performance to an established state-of-the-art system.Material and methods: Small, medium and large ROI sizes in addition to longitudinal, oblique and transverse orientations over five different locations within the rectus femoris muscle were tested using the new system. Results were compared to the established system to test for inter-system reproducibility.Results: Lowest within-subject coefficient of variance (4.3%) andshear wave velocity (1.83 m/s) were associated with the medium ROI and longitudinal orientation from the lateral location. This combination resulted in a strong internal agreement of intra-class correlation of 0.76 (0.57–0.89) for the new system and an almost perfect agreement of 0.92 (0.82–0.97) for the established. Inter-system reproducibility for the best combination was 0.71 (0.48–1) with a mean velocity difference ±95% limits of agreement of 0.07±0.49 m/s.Conclusions: Altering SWE acquisition methods can produce variable results. The new system produced reliable results that are comparable with but not as reliable as the established.

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