scholarly journals 2D-shear wave elastography: number of acquisitions can be reduced according to clinical setting

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Marco Dioguardi Burgio ◽  
Jules Grégory ◽  
Maxime Ronot ◽  
Riccardo Sartoris ◽  
Gilles Chatellier ◽  
...  
Keyword(s):  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Mean Value ◽  
Factors Affecting ◽  
Absolute Value ◽  
Factors Associated ◽  
Supersonic Shear Imaging ◽  
The Mean ◽  
The Difference

Abstract Background The factors affecting intra-operator variability of two-dimensional shear wave elastography (2D-SWE) have not been clearly established. We evaluated 2D-SWE variability according to the number of measurements, clinical and laboratory features, and liver stiffness measurements (LSM). Methods At least three LSM were performed in 452 patients who underwent LSM by 2D-SWE (supersonic shear imaging) out of an initial database of 1650 patients. The mean value of the three LSM was our best measurement method. Bland–Altman plots were used to evaluate intra-operator variability when considering only one, or the first two measurements. Variability was assessed by taking the absolute value of the difference between the first LSM and the mean of the three LSM. Logistic regression was used to assess the factors associated with the highest tertile of variability. Results The limit of agreement was narrower with the mean of the first and second measurements than with each measurement taken separately (− 2.83 to 2.99 kPa vs. − 5.86 to 6.21 kPa and − 5.77 to 5.73 kPa for the first and second measurement, respectively). A BMI ≥ 25 kg/m2 and a first LSM by 2D-SWE ≥ 7.1 kPa increased the odds of higher variability by 3.4 and 3.9, respectively. Adding a second LSM didn’t change the variability in patients with BMI < 25 and a first LSM by 2D-SWE < 7.1 kPa. Conclusions Intra-operator variability of LSM by 2D-SWE increases with both a high BMI and high LSM value. In patients with BMI < 25 kg/m2 and a first LSM < 7.1 kPa we recommend performing only one LSM.

scholarly journals Evaluation of Inter-System Variability in Liver Stiffness Measurements

2018 ◽  
Vol 40 (01) ◽  
pp. 64-75 ◽  
Author(s):  
Giovanna Ferraioli ◽  
Annalisa De Silvestri ◽  
Raffaella Lissandrin ◽  
Laura Maiocchi ◽  
Carmine Tinelli ◽  
...  
Keyword(s):  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Mean Difference ◽  
Observer Agreement ◽  
Concordance Correlation ◽  
Limits Of Agreement ◽  
Inter Observer Variability ◽  
System Variability ◽  
The Mean

Abstract Aim The primary aim of this study was to determine the inter-system variability of liver stiffness measurements (LSMs) in patients with varying degrees of liver stiffness. The secondary aim was to determine the inter-observer variability of measurements. Materials and Methods 21 individuals affected by chronic hepatitis C and 5 healthy individuals were prospectively enrolled. The assessment of LSMs was performed using six ultrasound (US) systems, four of which with point shear wave elastography (p-SWE) and two with 2 D shear wave elastography (2D-SWE) systems. The Fibroscan (Echosens, France) was used as the reference standard. Four observers performed the measurements in pairs (A-B, C-D). The agreement between different observers or methods was calculated using Lin’s concordance correlation coefficient. The Bland-Altman limits of agreement (LOA) were calculated as well. Results There was agreement above 0.80 for all pairs of systems. The mean difference between the values of the systems with 2D-SWE technique was 1.54 kPa, whereas the maximum mean difference between the values of three out of four systems with the pSWE technique was 0.79 kPa. The intra-patient concordance for all systems was 0.89 (95 % CI: 0.83 – 0.94). Inter-observer agreement was 0.96 (95 % CI: 0.94 – 0.98) for the pair of observers A-B and 0.93 (95 % CI: 0.89 – 0.96) for the pair of observers C-D. Conclusion The results of this study show that the agreement between LSMs performed with different US systems is good to excellent and the overall inter-observer agreement in “ideal conditions” is above 0.90 in expert hands.

scholarly journals The Usefulness of Noninvasive Liver Stiffness Assessment Using Shear-Wave Elastography for Predicting Liver Fibrosis in Children

2020 ◽  
Author(s):  
Seunghyun Lee ◽  
Young Hun Choi ◽  
Yeon Jin Cho ◽  
Seul Bi Lee ◽  
Jung-Eun Cheon ◽  
...  
Keyword(s):  
Liver Disease ◽  
Shear Wave ◽  
Diagnostic Performance ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Fibrosis Stage ◽  
Receiver Operating Curve ◽  
Affecting Factors ◽  
Cutoff Value ◽  
Factors Affecting

Abstract Background: Pediatric patients with liver disease require noninvasive monitoring for the likelihood of fibrosis progression. The purpose of this study is to evaluate the significant factors affecting liver stiffness values from two-dimensional-shear wave elastography (2D-SWE), and whether liver stiffness can predict the fibrosis stage of various childhood liver diseases.Methods: This study comprised 30 children (22 boys and 8 girls; mean age, 5.1 ± 6.1 years; range, 7 days–17.9 years) who had undergone biochemical evaluation, 2D-SWE examination, and histopathologic analysis with fibrosis grade (F0 to F3), necroinflammatory activity, and steatosis grade between August 2016 and March 2020. The liver stiffness from 2D-SWE were compared between fibrosis stages using the Kruskal-Wallis analysis. The significant affecting factors to liver stiffness were evaluated using univariate and multivariate linear regression analyses. The diagnostic performance was determined from the area under the receiver operating curve (AUC) values of the 2D-SWE liver stiffness.Results: Liver stiffness at the F0-1, F2, and F3 stages were 7.9, 13.2, and 21.7 kPa (P < 0.001). Both of fibrosis stage and necroinflammatory grade were factors significantly associated with liver stiffness (P < 0.001 and P = 0.021). Liver stiffness value could distinguish significant fibrosis (≥F2) with an AUC of 0.950 (cutoff value, 11.3 kPa) and the severe fibrosis (F3 stage) with an AUC of 0.924 (cutoff value, 18.1 kPa). Conclusion: The liver stiffness values from 2D-SWE can be effected through both fibrosis and necroinflammatory grade and can provide excellent diagnostic performance in evaluating the fibrosis stage, even in various liver disease.

scholarly journals Shear wave elastography as a new, non-invasive diagnostic modality for the diagnosis of penile elasticity: a prospective multicenter study

2021 ◽  
Vol 13 ◽  
pp. 175628722110079
Author(s):  
Ester Illiano ◽  
Francesco Trama ◽  
Antonio Ruffo ◽  
Giuseppe Romeo ◽  
Filippo Riccardo ◽  
...  
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Diagnostic Modality ◽  
Erectile Tissue ◽  
Corpora Cavernosa ◽  
Hardness Scale ◽  
Cavernous Tissue ◽  
Male Patients ◽  
The Mean ◽  
The Difference

Objective: Shear wave elastosonography (SWE) could be used to evaluate the elasticity of penile tissue. Few studies in the literature, however, have investigated its use in patients with erectile dysfunction (ED) or have attempted to correlate findings with International Index of Erectile Function (IIEF-5) scores. The primary aim of this study was to evaluate the characteristics of erectile tissue using SWE and to determine possible relationships with IIEF-5 and Erection Hardness Scale (EHS) scores. The secondary aim was to establish a cut-off SWE examination value over which cavernous tissue stiffness could contribute to a subsequent organic alteration. Methods: This prospective study included male patients 18−80 years of age who attended two general andrology clinics and underwent SWE. Subjects were divided into groups according to IIEF-5 score, and correlations between SWE and IIEF-5 and EHS questionnaire scores were explored. Results: A total of 270 subjects (mean age 46.7 ± 16.9 years) were included. ED was reflected by low IIEF-5 and EHS scores and a decrease in the mean elasticity of the corpora cavernosa according to SWE, although the difference between the left and right corpora cavernosa was not statistically significant. No statistically significant correlation was found between measurements of the corpora cavernosa (in kPa) and age. The optimal cut-off identified was 24.75 kPa. Conclusion: Results demonstrated that the mean elasticity of the corpora cavernosa according to SWE was correlated with IIEF-5 score and EHS score.

Placental elastography in second trimester preeclampsia prediction: A prospective study

Ultrasound ◽  
2021 ◽  
pp. 1742271X2110405
Author(s):  
Rajkumar Meena ◽  
Amita Malik ◽  
Swarna Jain ◽  
Achla Batra
Keyword(s):  
Shear Modulus ◽  
Shear Wave ◽  
Predictive Value ◽  
Shear Wave Elastography ◽  
Mean Value ◽  
Diagnostic Potential ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Objective The aim of the study was to evaluate the diagnostic potential of placental shear wave elastography in predicting preeclampsia at 16 to 20 weeks of gestation. Materials and methods A total of 230 pregnant women between 16 and 20 weeks of gestation were observed for the study. These women underwent shear wave elastography ElastPQ (Philips Healthcare, Bothell, Washington, USA) of the placenta. The mean value of placental shear modulus was obtained for each participant. These participants were followed up for the development of preeclampsia and were divided into two groups; group A included those who developed preeclampsia and group B included those who remained normotensive until delivery. The elasticity values of the two groups were compared, and the ROC curve was drawn to obtain the best cut-off value that would predict the onset of preeclampsia. Results Placental shear modulus varied from 1.03 kPa to 7.4 kPa at 16 to 20 weeks of gestation with an average of 2.74 ± 0.87 kPa. There was a statistically significant difference in the mean value of elasticity between two groups, being 4.61 kPa in group A and 2.51 kPa in group B. Maximum diagnostic accuracy was obtained at 2.9667 kPa with area under the curve 0.970, sensitivity 92%, specificity 91.71%, positive predictive value 57.5% and negative predictive value 98.9%. Conclusion Stiffness of placenta, quantitatively measured by SWE at 16 to 20 weeks of gestation, is higher in the women who develop preeclampsia and hence may be used for predicting preeclampsia.

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.

Noninvasive Assessment of Liver Diseases using 2D Shear Wave Elastography

2016 ◽  
Vol 25 (4) ◽  
pp. 525-532 ◽  
Author(s):  
Monica Lupșor-Platon ◽  
Radu Badea ◽  
Mirela Gersak ◽  
Anca Maniu ◽  
Ioana Rusu ◽  
...  
Keyword(s):  
Shear Wave ◽  
Predictive Value ◽  
Liver Diseases ◽  
Venous Pressure ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Two Dimensional ◽  
Non Invasive ◽  
Examination Technique

There has been great interest in the development of non-invasive techniques for the diagnosis of liver fibrosis in chronic liver diseases, including ultrasound elastographic methods. Some of these methods have already been adequately studied for the non-invasive assessment of diffuse liver diseases. Others, however, such as two-dimensional Shear Wave Elastography (SWE), of more recent appearance, have yet to be validated and some aspects are for the moment incompletely elucidated. This review discusses some of the aspects related to two-dimensional SWE: the examination technique, the examination performance indicators, intra and interobserver agreement and clinical applications. Recommendations for a high-quality examination technique are formulated. Key words:  –  –  – Two-dimensional Shear Wave Elastography. Abbreviations: 2D- SWE: Two-dimensional Shear Wave Elastography; 3D- SWE: Three-dimensional Shear Wave Elastography; AUROC: area under the receiver operating characteristic curves; ARFI Acoustic Radiation Force Impulse Elastography; EFSUMB: European Federation of Societies for Ultrasound in Medicine and Biology; HVPG: hepatic venous pressure gradient; LS: liver stiffness; LR: likelihood ratio; NPV: negative predictive value; PPV: positive predictive value; ROI: region of interest; RT-E: Real Time-Elastography; Se: sensitivity; Sp: specificity; TE: Transient Elastography; US: ultrasound; VM: valid measurement; E: Young’s modulus

Seasonal trends in the stable isotopic composition of snow and meltwater runoff in a subarctic catchment at Okstindan, Norway

2004 ◽  
Vol 35 (2) ◽  
pp. 119-137 ◽  
Author(s):  
S.D. Gurney ◽  
D.S.L. Lawrence
Keyword(s):  
Isotopic Composition ◽  
Mean Value ◽  
Mean Values ◽  
Stable Isotopic Composition ◽  
Meltwater Runoff ◽  
Stable Isotopic ◽  
The Mean ◽  
The Difference ◽  
Δ18o And Δd

Seasonal variations in the stable isotopic composition of snow and meltwater were investigated in a sub-arctic, mountainous, but non-glacial, catchment at Okstindan in northern Norway based on analyses of δ18O and δD. Samples were collected during four field periods (August 1998; April 1999; June 1999 and August 1999) at three sites lying on an altitudinal transect (740–970 m a.s.l.). Snowpack data display an increase in the mean values of δ18O (increasing from a mean value of −13.51 to −11.49‰ between April and August), as well as a decrease in variability through the melt period. Comparison with a regional meteoric water line indicates that the slope of the δ18O–δD line for the snowpacks decreases over the same period, dropping from 7.49 to approximately 6.2.This change points to the role of evaporation in snowpack ablation and is confirmed by the vertical profile of deuterium excess. Snowpack seepage data, although limited, also suggest reduced values of δD, as might be associated with local evaporation during meltwater generation. In general, meltwaters were depleted in δ18O relative to the source snowpack at the peak of the melt (June), but later in the year (August) the difference between the two was not statistically significant. The diurnal pattern of isotopic composition indicates that the most depleted meltwaters coincide with the peak in temperature and, hence, meltwater production.

Prospective assessment of liver stiffness by shear wave elastography in childhood obesity: a pilot study

Endocrine ◽  
2021 ◽  
Author(s):  
Domenico Corica ◽  
Antonio Bottari ◽  
Tommaso Aversa ◽  
Letteria Anna Morabito ◽  
Selenia Curatola ◽  
...  
Keyword(s):  
Childhood Obesity ◽  
Pilot Study ◽  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Prospective Assessment
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