What does liver elastography measure? Technical aspects and methodology.

Published on May 1, 2021in Minerva gastroenterologica e dietologica3.072
· DOI :10.23736/S2724-5985.20.02787-7
Christoph F. Dietrich76
Estimated H-index: 76
,
Long Shi2
Estimated H-index: 2
+ 5 AuthorsGiovanna Ferraioli34
Estimated H-index: 34
(UNIPV: University of Pavia)
Sources
Abstract
Elastography can be thought as an extension of the ancient technique of palpation. After giving a short introduction to the history of elastography, the different technologies that are nowadays available and the physics behind them, the article focuses on the assessment of liver stiffness in patients with diffuse liver disease using shear wave elastography (SWE). Practical advices on how to perform the SWE techniques and on the factors that should be taken into account for a correct interpretation of the results are given. This paper aims to provide a practical guide for beginners and advanced clinical users to better understand technical aspects, methodologies and terminology.
References136
Newest
#1Mauro Giuffrè (UniTS: University of Trieste)H-Index: 10
#2Sofia Fouraki (UniTS: University of Trieste)H-Index: 2
Last. Lory Saveria Crocè (UniTS: University of Trieste)H-Index: 24
view all 12 authors...
BACKGROUND: Spleen stiffness (SS) has gained a lot of interest in the context of liver cirrhosis and portal hypertension stratification. However, there is a paucity of data on confounding factors that may alter SS values. METHODS: Between January 2018 and October 2019, we enrolled 120 healthy subjects and 117 patients with hepatitis C virus (HCV) infection who did not have significant liver fibrosis (i.e., F0-1). Abdominal ultrasound evaluation was performed on each individual to measure portal ...
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#1Giovanna Ferraioli (UNIPV: University of Pavia)H-Index: 34
#2Laura MaiocchiH-Index: 15
Last. Carlo Filice (UNIPV: University of Pavia)H-Index: 32
view all 6 authors...
OBJECTIVES: To assess performance and cutoffs of the 2-dimensional shear wave elastography technique available on the Aplio i800 ultrasound system (Canon Medical Systems, Japan), using transient elastography as reference standard, and to assess the correlation of shear-wave-speed dispersion with liver fibrosis or steatosis. METHODS: This was a single-center cross-sectional study. The correlations between values obtained with transient elastography and 2-dimensional-shear wave elastography, and b...
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#1Jee Hyeon Lee (Sacred Heart Hospital)H-Index: 1
#2Sang Min Lee (Sacred Heart Hospital)H-Index: 18
Last. Jeong Min Lee (Seoul National University Hospital)H-Index: 85
view all 9 authors...
PURPOSE: This study quantified the impact of respiratory motion on liver stiffness measurements according to different shear wave elastography (SWE) techniques and region of interest (ROI) methods, using liver fibrosis phantoms. METHODS: Three operators measured stiffness values in four phantoms with different stiffness on a moving platform with two SWE techniques (point-SWE [pSWE] and 2-dimensional SWE [2D-SWE]), three types of motion (static mode and moving mode at low and high speeds), and fo...
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#1Mauro Giuffrè (UniTS: University of Trieste)H-Index: 10
#2Michela GiuricinH-Index: 10
Last. Lory Saveria Crocè (UniTS: University of Trieste)H-Index: 24
view all 13 authors...
Background: Obesity is a primary limiting factor in liver stiffness measurement (LSM). The impact of obesity has always been evaluated in terms of body mass index (BMI), without studying the effects of skin-to-liver distance (SLD) on LSM. We studied the impact of SLD on LSM in a cohort of obese patients undergoing bariatric surgery and intra-operatory liver biopsy. Materials and Methods: 299 patients underwent LSM by point-shear wave elastography (ElastPQ protocol), with two different ultrasound...
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#1Richard G. BarrH-Index: 43
#2Stephanie R. WilsonH-Index: 50
Last. Giovanna FerraioliH-Index: 34
view all 5 authors...
To follow-up patients, the consensus suggests using the delta changes of liver stiffness over time instead of the absolute values, using as a baseline value in case of viral hepatitis that obtained...
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#1Meng Jiang (HUST: Huazhong University of Science and Technology)H-Index: 6
#2Changli LiH-Index: 3
Last. Christoph F. DietrichH-Index: 76
view all 9 authors...
Abstract Background Accurate preoperative prediction of cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC) provide a basis for surgical decision making and the e...
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#1Huipeng Wang (PRC: China Medical University (PRC))H-Index: 1
#2Pengchao Zheng (PRC: China Medical University (PRC))H-Index: 1
Last. Xue-Mei Wang (PRC: China Medical University (PRC))H-Index: 7
view all 4 authors...
OBJECTIVES: The purpose of this research was to evaluate whether operator experience and the quantitative analysis system (Q-Box; SuperSonic Imagine, Aix-en-Provence, France) diameter affect the repeatability of liver stiffness measurements. METHODS: We enrolled 417 outpatients. All measurements were performed by 2 operators, including an expert and a novice. Each patient was continuously measured 3 times by the 2 operators. The Q-Box diameter was adjusted to 10, 20, and 30 mm each time, and the...
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: In patients with solid pancreatic lesions (SPLs), the differential diagnosis must be evaluated to determine whether radical surgery, pancreatic parenchyma-saving strategies, or follow-up is indicated. Contrast-enhanced (endoscopic) ultrasonography and elastography facilitate the further characterization of SPLs. The majority of cases of pancreatic ductal adenocarcinoma exhibit hypoenhancement with contrast-enhanced ultrasonography. Elastographically soft SPLs are benign with very few exception...
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#2Irina M. Cazacu (University of Texas MD Anderson Cancer Center)H-Index: 9
Last. Adrian SaftoiuH-Index: 57
view all 14 authors...
Background: Recent advances in EUS techniques (real-time EUS elastography and contrast-enhanced EUS) have allowed a better characterization of focal pancreatic masses. Mean strain histograms (SHs) are considered a good parameter for the semi-quantitative evaluation of focal pancreatic masses, alongside complementary contrast-enhanced EUS parameters which can be quantified during both the early arterial and late venous phase. Materials and Methods: The study design was prospective, blinded, and m...
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#1Mauro Giuffrè (UniTS: University of Trieste)H-Index: 10
#2Sofia Fouraki (UniTS: University of Trieste)H-Index: 2
Last. Lory Saveria Crocè (UniTS: University of Trieste)H-Index: 24
view all 5 authors...
Background: Liver stiffness measurement (LSM) is crucial for appropriate fibrosis staging in patients with ongoing hepatitis C virus (HCV) infection. However, there is still an ongoing debate on the impact of serum transaminases (aspartate-aminotransferase, AST; alanine-aminotransferase, ALT) on LSM. Methods: We selected 110 patients undergoing HCV eradication therapy with LSM compatible with significant liver fibrosis. LSM was evaluated prior to therapy and one year after HCV eradication. Resul...
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Cited By2
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#8Yi Dong (Fudan University)H-Index: 21
Ultrasonography is a ubiquitous and indispensable diagnostic and therapeutic tool in medicine. Due to modern equipment and automatic image optimization, nowadays the introduction of ultrasound imaging requires only little technical and physical knowledge. However, profound knowledge of the device function repertoire and underlying mechanisms are essential foroptimal image adjustment and documentation. From a medical as well as an aesthetic point of view, the goal should always be to achieve the ...
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We recently introduced a series of papers describing how to do certain techniques. This article is the first part of a review of shear wave elastography (SWE). It reports the principles and interpretation of the technique and describes how to optimize it. Normal values, pitfalls and artefacts for the examination of liver, breast. thyroid and salivary gland with shear wave elastography are presented. The manuscript provides specific tips for applying SWE as part of a diagnostic US examination.
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