Endoscopic Ultrasound Elastography in the Assessment of Rectal Tumors: How Well Does It Work in Clinical Practice?

Endorectal ultrasound applications in the evaluation of rectal tumors could be a useful tool in achieving proper staging of rectal cancer. The purpose of this study was to compare the efficacy of rectal tumor staging by flexible endoscopic ultrasound (EUS) with real-time elastography (RTE) using the gold standard post-surgery histological analysis of the resected tissue as the control. The second aim of our research was to establish cutoff values for the EUS-RTE strain ratio corresponding to stages by independently comparing the stiffness values obtained with histology and EUS-RTE staging in order to minimize observation bias. We evaluated the records of 130 patients with a rectal tumor confirmed by biopsy. EUS was used in 70 patients, EUS-RTE—in the other 60. We found no statistically significant differences in staging accuracy when comparing EUS to EUS-RTE. Through a correspondence method between staging assessment and the EUS-RTE stain ratio, we identified cutoff intervals for T2, T3, and T4 staging that were nonoverlapping and proved to be statistically significant in terms of EUS-RTE values (significantly different ascending values from one interval to the other). We found that EUS-RTE offers slightly better, although not statistically significant sensitivity and specificity for T and N stage predictions compared to 2D EUS. Our results showed that EUS-RTE offers slightly higher sensitivity and specificity compared to EUS. Reliable cutoff intervals were found for strain rate elastography, previously available only for shear wave elastography (SWE) which is currently unavailable on any EUS system. Thus, these commonly available EUS-RTE systems can serve as a complementary tool in the staging of rectal tumors.

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Prospective Evaluation of Semiquantitative Strain Ratio and Quantitative 2D Ultrasound Shear Wave Elastography (SWE) in Association with TIRADS Classification for Thyroid Nodule Characterization

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-0853-1821 ◽

2019 ◽

Vol 40 (04) ◽

pp. 495-503 ◽

Cited By ~ 13

Author(s):

Vito Cantisani ◽

Emanuele David ◽

Hektor Grazhdani ◽

Antonello Rubini ◽

Maija Radzina ◽

...

Keyword(s):

Thyroid Nodule ◽

Shear Wave ◽

Diagnostic Performance ◽

Thyroid Nodules ◽

Shear Wave Elastography ◽

Strain Ratio ◽

Ultrasound Elastography ◽

Prospective Evaluation ◽

2D Ultrasound

Abstract Purpose To evaluate the diagnostic performance of strain ratio elastography (SRE) and shear wave elastography (SWE) alone and in combination with Thyroid Imaging Reporting and Data System (TIRADS) classification parameters to improve differentiation between benign and malignant thyroid nodules. Materials and Methods In this prospective study benign (n = 191) and malignant (n = 52) thyroid nodules were examined with high-resolution ultrasound (US) features using the TIRADS lexicon and SRE semiquantitative and SWE quantitative findings using histology or cytology as the gold standard with a 12-month follow-up. Sensitivity (Se), specificity (Sp) and the area under the ROC curve (AUROC) were used to evaluate the diagnostic performance of each feature and combinations of the methods. Results TIRADS score showed a sensitivity of 59.6 %, a specificity of 83.8 % with an AUROC of 0.717, a PPV of 50.0 % and an NPV of 88.4 %. SRE yielded the highest performance with a sensitivity of 82.7 %, a specificity of 92.7 % with AUROC of 0.877, a PPV 75.4 % and an NPV of 95.2 %. SWE (kPa) had a sensitivity and specificity of 67.3 % and 82.7 %, respectively, with an AUROC of 0.750, a PPV of 51.5 % and an NPV of 90.3 %. Differences were significant for SRE only but not for SWE. Conclusion Ultrasound elastography may improve thyroid nodule discrimination. In particular, SRE has a better performance than TIRADS classification, while their combination improves sensitivity.

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Sa1447 ESTIMATING THE STIFFNESS OF THE PANCREATIC PARENCHYMA WITH A STRAIN RATIO USING ENDOSCOPIC ULTRASOUND ELASTOGRAPHY

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2020.03.1243 ◽

2020 ◽

Vol 91 (6) ◽

pp. AB195

Author(s):

Takamitsu Sato ◽

Kunihiro Hosono ◽

Sho Hasegawa ◽

Yuusuke Kurita ◽

Shingo Kato ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Strain Ratio ◽

Ultrasound Elastography ◽

Pancreatic Parenchyma

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Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions

World Journal of Gastroenterology ◽

10.3748/wjg.v23.i32.5962 ◽

2017 ◽

Vol 23 (32) ◽

pp. 5962 ◽

Cited By ~ 5

Author(s):

Hussein Okasha ◽

Shaimaa Elkholy ◽

Ramy El-Sayed ◽

Mohamed-Naguib Wifi ◽

Mohamed El-Nady ◽

...

Keyword(s):

Real Time ◽

Endoscopic Ultrasound ◽

Strain Ratio ◽

Ultrasound Elastography

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Ultrasonic Elastography in the Differential Diagnosis of Thyroid Nodular Patholog

Kuban Scientific Medical Bulletin ◽

10.25207/1608-6228-2019-26-4-45-55 ◽

2019 ◽

Vol 26 (4) ◽

pp. 45-55

Author(s):

L. A. Timofeeva ◽

M. G. Tukhbatullin ◽

A. N. Sencha

Keyword(s):

Differential Diagnosis ◽

Thyroid Cancer ◽

Shear Wave ◽

Density Ratio ◽

Shear Wave Elastography ◽

Strain Ratio ◽

Ultrasound Elastography ◽

Control Group ◽

Tissue Elasticity ◽

Patient Groups

Aim.In this study, we set out to determine the informative value of multi-parametric ultrasound examination using ultrasound elastography in the differential diagnosis of thyroid nodular neoplasms.Materialsand methods. We analysed 229 multi-parametric ultrasound examinations of patients in the preoperative period in order to assess the effectiveness of strain elastography (SE) and shear wave elastography (SWE) drawing on the example of ARFI and Strain Ratio. Two patient groups were formed. The fi rst group (N1=93) included patients with thyroid cancer, whereas the second one (N2=136) was composed of patients with benign thyroid nodules (thyroid adenoma and follicular or colloid goitre). The control group consisted of 174 patients with unchanged thyroid parenchyma. SE visualised tissue elasticity as a colour map. Shear wave elastography (SWE) — ARFI and Strain Ratio techniques — was performed using the following ultrasonic apparatuses: Acuson S-2000 (Siemens, Germany), Ultrasonix SP (Sonix, Canada) and Mindray DC-8 (Mindray, China).Results.According to the obtained data (SE technique), the parenchyma of the unchanged thyroid gland exhibited heterogeneous, uneven fi ne / moderately granular, symmetrical staining (96.6%). Thyroid cancer was characterised by a shear wave velocity (ARFI) of greater than 3.57 m/s, as well as a density ratio (elasticity modulus and Strain Ratio) of more than 1.56.Conclusion.The study revealed that the application of ultrasound elastography is highly informative in the comprehensive diagnosis of thyroid nodular neoplasms and should be used when thyroid cancer is suspected to ascertain the size of nodules, as well as the tumour invasion into surrounding tissues.

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Evaluation of Focal Breast Lesions Using Ultrasound Elastography with FNAC and / or Histopathological Correlation - A Prospective Observational Study in the Region of Katihar, Bihar

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/402 ◽

2021 ◽

Vol 8 (25) ◽

pp. 2143-2148

Author(s):

Raunak Sinha ◽

Zafar Ali ◽

Manish Jaiswal ◽

Anuggya Mimansa

Keyword(s):

Sensitivity And Specificity ◽

Strain Ratio ◽

Ultrasound Elastography ◽

Vascular Involvement ◽

Breast Lesions ◽

Breast Masses ◽

Medical College ◽

Histopathological Correlation ◽

Malignant Breast ◽

Contiguous Spread

BACKGROUND We wanted to evaluate the sensitivity and specificity of ultrasound elastography in the detection and characterization of various breast masses and study its role in differentiating benign vs malignant breast masses with fine needle aspirarion cytology (FNAC) and/or histopathological correlation of its findings. METHODS A total of 120 patients with breast lesions were prospectively evaluated using ultrasonography (USG) in the Department of Radiodiagnosis at Katihar Medical College, Katihar, Bihar. After procuring consent from the patients, B-mode and elastography examination of all the patients was carried out simultaneously, using the Philips EPIQ 5G ultrasound machine. The findings were noted in a proforma for observation and further comparisons. The usefulness of elastography, regarding prediction of the nature of the mass (benign/malignant), delineation of its exact extent, and correlation with clinical/cytological diagnosis was studied. RESULTS A sensitivity of 97.0% and specificity of 86.7% was observed when a cut off value of 3 was used for elasticity score. A specificity of 95.5% and a sensitivity of 93.3% was observed when a cut off of 3.8 was used for strain ratio (SR). In all cases, the extent of the pathology, the local or contiguous spread and vascular involvement, predicted by ultrasound elastography examination corroborated well with the cytological findings. The results of this study are in concordance with results of studies that have been conducted previously. CONCLUSIONS Ultrasound elastography is a simple and rapid method that can improve the sensitivity and specificity of ultrasonography of focal breast lesions and can decrease the rate of unnecessary biopsies. The diagnostic accuracy of combined ultrasound and elastography is quite high and thus improves the diagnostic confidence of the cases under evaluation. KEYWORDS Elastography, Ultrasound, Focal Breast Lesions

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Endoscopic ultrasound elastography in diagnosing chronic pancreatitis: has the strain ratio found its region of interest?

Endoscopy ◽

10.1055/s-0033-1344786 ◽

2013 ◽

Vol 45 (10) ◽

pp. 789-791 ◽

Cited By ~ 1

Author(s):

Pietro Fusaroli ◽

Mohamad Eloubeidi

Keyword(s):

Chronic Pancreatitis ◽

Endoscopic Ultrasound ◽

Region Of Interest ◽

Its Region ◽

Strain Ratio ◽

Ultrasound Elastography

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The Role of Elastography in Fibroadenoma of the Breast and Differentiating it from its Mimics

QJM ◽

10.1093/qjmed/hcab106.038 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Marina Essam Fares Massak ◽

Sahar M. El Fiky ◽

Asmaa M Salama

Keyword(s):

Sensitivity And Specificity ◽

Diagnostic Performance ◽

High Sensitivity ◽

Strain Ratio ◽

Cross Sectional Study ◽

Ultrasound Elastography ◽

University Hospitals ◽

Cross Sectional ◽

Strain Elastography ◽

Imaging Characteristics

Abstract Background Fibroadenomas are one of the most common benign diseases of the breast varying in number and size in all quadrants of the breast. Less than 2% of lesions with the typical ultrasound features of a fibroadenoma, are found to be malignant on biopsy. Aim of the Work To evaluate the diagnostic performance of combined ultrasonography and strain elastography and to compare the imaging characteristics of fibroadenomas with other benign and malignant mimics and assess the results by histopathological characteristics. Patients and Methods Type of Study: Cross-sectional study. Study Setting: The study was conducted at Ain Shams University Hospitals, Radiodiagnosis department. Study Period: 6 months (From March 2020 till September 2020). Study Population: Female Patients with breast lumps. Results Ultrasound elastography combined with B-mode ultrasonography had shown variable degrees of sensitivity and specificity. However, in our study it showed high sensitivity and specificity as compared to other studies. The most reliable tool in our study was the strain ratio having the highest sensitivity and specificity. Conclusion Strain elastography combined to B-mode sonography improves the diagnostic performance of differentiating benign from malignant well circumscribed breast lesions with an additional benefit of preventing unnecessary biopsies and speeding up the diagnosis of malignant lesions instead of follow up of the patient for early diagnosis of malignancies.

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