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Ioan Sporea - One of the best experts on this subject based on the ideXlab platform.
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Shear Wave Elastography versus Strain Elastography in Diagnosing Parathyroid Adenomas.
International Journal of Endocrinology, 2020Co-Authors: Laura Cotoi, Ioan Sporea, Daniela Amzar, Andreea Borlea, Dan Navolan, Flore Varcus, Dana StoianAbstract:Objectives. The aim of the study was to compare elastographic means in parathyroid adenomas, using shear wave Elastography and strain Elastography. Methods. This prospective study examined 20 consecutive patients diagnosed with primary hyperparathyroidism and parathyroid adenoma, confirmed by biochemical assay, technetium-99 sestamibi scintigraphy, and pathology report, after parathyroid surgery. All patients were examined on conventional 2B ultrasound, 2D shear wave Elastography, and strain Elastography. We determined using 2D shear wave Elastography (SWE) the elasticity index (EI) in parathyroid adenoma, thyroid parenchyma, and surrounding muscle and examined using strain Elastography the parathyroid adenoma, and determined the strain ratio with the thyroid tissue and muscle tissue. Results. All patients had positive sestamibi scintigraphy and underwent surgery, with confirmation of parathyroid adenoma in all cases. The mean parathormone (PTH) value before surgery was 153.29 pg/ml (36.5, 464.8) and serum calcium concentration was 10.5 mg/dl (9, 11.5). We compared using 2D-SWE and strain Elastography parathyroid adenoma with thyroid tissue and with surrounding muscle. The mean EI measured by SWE in parathyroid adenoma was 4.74 ± 2.74 kPa and in thyroid parenchyma was 11.718 ± 4.206 kPa (mean difference = 6.978 kPa, ), and the mean EI value in muscle tissue was 16.362 ± 3.829 kPa (mean difference = 11.622, ). Using ROC analysis, we found that an EI below 7 kPa correctly identifies parathyroid tissue. We evaluated parathyroid adenomas using strain Elastography by color mapping and strain ratio as a semiquantitative measurement; however, we could not find any statistical correlation comparing the strain ratio obtained from the parathyroid adenoma with the thyroid tissue ( ). Conclusion. Ultrasound Elastography is a helpful tool in identifying parathyroid adenomas. A cutoff value below 7 kPa can be used in 2D-SWE. Color maps in strain Elastography without adding strain ratio can be used, parathyroid adenoma being identified as score 1 in the Rago criteria.
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General advice in ultrasound based Elastography of pediatric patients
Medical Ultrasonography, 2019Co-Authors: Christoph F. Dietrich, Giovanna Ferraioli, Ioan Sporea, Alina Popescu, Roxana Sirli, Cristina Pienar, Christian Kunze, Heike Taut, Simone Schrading, Simona BotaAbstract:Ultrasound Elastography including transient Elastography (TE), point shear wave Elastography, (pSWE) and two (three)- dimensional shear wave Elastography (2D-SWE) have been introduced mainly for the evaluation of the liver. All the techniques are also feasible for the examination of spleen, whereas pSWE and 2D-SWE can be used for the assessment of the pancreas, kidney, gastrointestinal tract and other organs. Strain Elastography also plays a role for non-liver applications. The aim of the current report is to highlight unique features and techniques for the elastographic examinations in children and to report initial results in non-liver applications.
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Romanian national guidelines and practical recommendations on liver Elastography.
Medical Ultrasonography, 2014Co-Authors: Ioan Sporea, Simona Bota, Oana Grădinaru-tașcău, Alina Popescu, Monica Lupsor Platon, Carmen Fierbinţeanu-braticevici, Dan Ionuț Gheonea, Larisa Săndulescu, Radu BadeaAbstract:The use of liver Elastography has substantially developed in the past few years; the introduction of novel elastographic methods (Transient Elastography, point Shear Wave Elastography, Real Time Shear Wave Elastography, Strain Elastography) has changed the perspective in the evaluation of liver disease. The ongoing research in this area is mainly focused on diffuse liver diseases and for predicting liver cirrhosis complication. This guideline created under the auspice of Romanian Society of Ultrasound in Medicine and Biology is intended to accustomize the clinician with the current practical use of liver Elastography and has been issued to help in maximizing the clinical benefit for the patients with chronic liver diseases.
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Liver Elastography - An Update
Medical Ultrasonography, 2013Co-Authors: Ioan Sporea, Simona Bota, Roxana Sirli, Odd Helge Gilja, Alina PopescuAbstract:Liver fibrosis evaluation is very important for treatment and prognosis in patients with chronic liver disease. The “goldstandard” method for liver fibrosis assessment is still considered to be the liver biopsy, but in the last years non-invasive methods have increasingly been used, especially ultrasound based elastographic ones. The oldest and the only validated elastographic method for non-invasive liver fibrosis evaluation is Transient Elastography (TE). In the last 2-3 years, similar results to TE for liver fibrosis assessment were obtained by using Acoustic Radiation Force Impulse (ARFI) Elastography. More recently, Real Time Shear Wave Elastography (SWE) was developed and promising results were obtained by this technique. Strain Elastography is less used in clinical practice for non-invasive liver fibrosis assessment. TE is also useful for predicting liver cirrhosis complications, especially portal hypertension. ARFI Elastography seems to be inferior to TE in this field.
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value of acoustic radiation force impulse imaging Elastography for non invasive evaluation of patients with nonalcoholic fatty liver disease
Ultrasound in Medicine and Biology, 2013Co-Authors: Carmen Fierbinteanu Braticevici, Ioan Sporea, Eugenia Panaitescu, Laura TribusAbstract:Abstract The goals of the work described here were to evaluate the clinical utility of acoustic radiation force impulse (ARFI) Elastography in differentiating non-alcoholic fatty liver disease (NAFLD) histologic subtypes and to determine if ARFI Elastography measurements correlate with the severity of liver fibrosis. We compared ARFI Elastography measurements with clinical, biologic and histologic features (simple steatosis or steatohepatitis) in 64 patients with histologically proven NAFLD. ARFI Elastography is suitable for distinguishing patients with non-alcoholic steatohepatitis from those with simple steatosis, with an area under the receiver operating characteristic curve (AUROC) of 0.867 (95% confidence interval = 0.782–0.953). There was a highly significant correlation ( r = 0.843) between ARFI Elastography measurements and fibrosis ( p F ≥ 2) had an AUROC of 0.944. ARFI Elastography better predicted F = 4 fibrosis (AUROC = 0.984). In conclusion, ARFI Elastography is a promising method for differentiating patients with non-alcoholic steatohepatitis from patients with simple steatosis and can also predict significant fibrosis in these patients.
J G Albert - One of the best experts on this subject based on the ideXlab platform.
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assessment of liver fibrosis with 2 d shear wave Elastography in comparison to transient Elastography and acoustic radiation force impulse imaging in patients with chronic liver disease
Ultrasound in Medicine and Biology, 2015Co-Authors: L Gerber, Daniela Kasper, D Fitting, V Knop, A Vermehren, K Sprinzl, Martin L Hansmann, Eva Herrmann, Joerg Bojunga, J G AlbertAbstract:Abstract Two-dimensional shear wave Elastography (2-D SWE) is an ultrasound-based Elastography method integrated into a conventional ultrasound machine. It can evaluate larger regions of interest and, therefore, might be better at determining the overall fibrosis distribution. The aim of this prospective study was to compare 2-D SWE with the two best evaluated liver Elastography methods, transient Elastography and acoustic radiation force impulse (point SWE using acoustic radiation force impulse) imaging, in the same population group. The study included 132 patients with chronic hepatopathies, in which liver stiffness was evaluated using transient Elastography, acoustic radiation force impulse imaging and 2-D SWE. The reference methods were liver biopsy for the assessment of liver fibrosis (n = 101) and magnetic resonance imaging/computed tomography for the diagnosis of liver cirrhosis (n = 31). No significant difference in diagnostic accuracy, assessed as the area under the receiver operating characteristic curve (AUROC), was found between the three Elastography methods (2-D SWE, transient Elastography, acoustic radiation force impulse imaging) for the diagnosis of significant and advanced fibrosis and liver cirrhosis in the “per protocol” (AUROCs for fibrosis stages ≥2: 0.90, 0.95 and 0.91; for fibrosis stage [F] ≥3: 0.93, 0.95 and 0.94; for F = 4: 0.92, 0.96 and 0.92) and “intention to diagnose” cohort (AUROCs for F ≥2: 0.87, 0.92 and 0.91; for F ≥3: 0.91, 0.93 and 0.94; for F = 4: 0.88, 0.90 and 0.89). Therefore, 2-D SWE, ARFI imaging and transient Elastography seem to be comparably good methods for non-invasive assessment of liver fibrosis.
Eva Herrmann - One of the best experts on this subject based on the ideXlab platform.
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assessment of liver fibrosis with 2 d shear wave Elastography in comparison to transient Elastography and acoustic radiation force impulse imaging in patients with chronic liver disease
Ultrasound in Medicine and Biology, 2015Co-Authors: L Gerber, Daniela Kasper, D Fitting, V Knop, A Vermehren, K Sprinzl, Martin L Hansmann, Eva Herrmann, Joerg Bojunga, J G AlbertAbstract:Abstract Two-dimensional shear wave Elastography (2-D SWE) is an ultrasound-based Elastography method integrated into a conventional ultrasound machine. It can evaluate larger regions of interest and, therefore, might be better at determining the overall fibrosis distribution. The aim of this prospective study was to compare 2-D SWE with the two best evaluated liver Elastography methods, transient Elastography and acoustic radiation force impulse (point SWE using acoustic radiation force impulse) imaging, in the same population group. The study included 132 patients with chronic hepatopathies, in which liver stiffness was evaluated using transient Elastography, acoustic radiation force impulse imaging and 2-D SWE. The reference methods were liver biopsy for the assessment of liver fibrosis (n = 101) and magnetic resonance imaging/computed tomography for the diagnosis of liver cirrhosis (n = 31). No significant difference in diagnostic accuracy, assessed as the area under the receiver operating characteristic curve (AUROC), was found between the three Elastography methods (2-D SWE, transient Elastography, acoustic radiation force impulse imaging) for the diagnosis of significant and advanced fibrosis and liver cirrhosis in the “per protocol” (AUROCs for fibrosis stages ≥2: 0.90, 0.95 and 0.91; for fibrosis stage [F] ≥3: 0.93, 0.95 and 0.94; for F = 4: 0.92, 0.96 and 0.92) and “intention to diagnose” cohort (AUROCs for F ≥2: 0.87, 0.92 and 0.91; for F ≥3: 0.91, 0.93 and 0.94; for F = 4: 0.88, 0.90 and 0.89). Therefore, 2-D SWE, ARFI imaging and transient Elastography seem to be comparably good methods for non-invasive assessment of liver fibrosis.
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acoustic radiation force impulse imaging for non invasive assessment of liver fibrosis in chronic hepatitis b
Journal of Viral Hepatitis, 2013Co-Authors: M Friedrichrust, Eva Herrmann, P Buggisch, R J De Knegt, V Dries, K Matschenz, M D Schneider, J Petersen, F Schulze, S ZeuzemAbstract:Summary Acoustic radiation force impulse (ARFI) imaging is a novel ultrasound-based Elastography method that is integrated in a conventional ultrasound machine. It might provide an alternative method to transient Elastography for the noninvasive assessment of liver fibrosis. While previous studies have shown comparable diagnostic accuracy of ARFI to transient Elastography in chronic hepatitis C, the aim of the present prospective multicenter study was to evaluate ARFI for the assessment of liver fibrosis in chronic hepatitis B. ARFI imaging involves the mechanical excitation of tissue using short-duration acoustic pulses to generate localized displacements in tissue. The displacements result in shear-wave propagation which is tracked using ultrasonic, correlation-based methods and recorded in m/s. In the present international prospective study, patients infected with chronic hepatitis B received ARFI imaging, blood tests and if available transient Elastography. The results were compared to liver biopsy as reference method analysed by a central pathologist. In 92 of 114 patients, a comparison of ARFI with transient Elastography was possible. ARFI imaging and transient Elastography correlated significantly with histological fibrosis stage. The diagnostic accuracy expressed as areas under ROC curves for ARFI imaging and transient Elastography was 0.75 and 0.83 for the diagnosis of significant fibrosis (F ≥ 2), 0.93 and 0.94 for the diagnosis of severe fibrosis (F ≥ 3), and 0.97 and 0.93 for the diagnosis of liver cirrhosis, respectively. No significant difference was found between ARFI and transient Elastography. ARFI imaging is a reliable ultrasound-based method for the assessment of advanced stages of liver fibrosis in chronic hepatitis B.
S Zeuzem - One of the best experts on this subject based on the ideXlab platform.
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acoustic radiation force impulse imaging for non invasive assessment of liver fibrosis in chronic hepatitis b
Journal of Viral Hepatitis, 2013Co-Authors: M Friedrichrust, Eva Herrmann, P Buggisch, R J De Knegt, V Dries, K Matschenz, M D Schneider, J Petersen, F Schulze, S ZeuzemAbstract:Summary Acoustic radiation force impulse (ARFI) imaging is a novel ultrasound-based Elastography method that is integrated in a conventional ultrasound machine. It might provide an alternative method to transient Elastography for the noninvasive assessment of liver fibrosis. While previous studies have shown comparable diagnostic accuracy of ARFI to transient Elastography in chronic hepatitis C, the aim of the present prospective multicenter study was to evaluate ARFI for the assessment of liver fibrosis in chronic hepatitis B. ARFI imaging involves the mechanical excitation of tissue using short-duration acoustic pulses to generate localized displacements in tissue. The displacements result in shear-wave propagation which is tracked using ultrasonic, correlation-based methods and recorded in m/s. In the present international prospective study, patients infected with chronic hepatitis B received ARFI imaging, blood tests and if available transient Elastography. The results were compared to liver biopsy as reference method analysed by a central pathologist. In 92 of 114 patients, a comparison of ARFI with transient Elastography was possible. ARFI imaging and transient Elastography correlated significantly with histological fibrosis stage. The diagnostic accuracy expressed as areas under ROC curves for ARFI imaging and transient Elastography was 0.75 and 0.83 for the diagnosis of significant fibrosis (F ≥ 2), 0.93 and 0.94 for the diagnosis of severe fibrosis (F ≥ 3), and 0.97 and 0.93 for the diagnosis of liver cirrhosis, respectively. No significant difference was found between ARFI and transient Elastography. ARFI imaging is a reliable ultrasound-based method for the assessment of advanced stages of liver fibrosis in chronic hepatitis B.
Jung Min Chang - One of the best experts on this subject based on the ideXlab platform.
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practice guideline for the performance of breast ultrasound Elastography
Ultrasonography, 2013Co-Authors: Jung Min Chang, Ann Yi, Ji Hyun Youk, Seon Hyeong Choi, Shin Ho Kook, Jin Chung, Jeong Seon Park, Hae Kyoung Jung, Kyung Hee Ko, Hye Young ChoiAbstract:Ultrasound (US) Elastography is a valuable imaging technique for tissue characterization. Two main types of Elastography, strain and shear-wave, are commonly used to image breast tissue. The use of Elastography is expected to increase, particularly with the increased use of US for breast screening. Recently, the US elastographic features of breast masses have been incorporated into the 2nd edition of the Breast Imaging Reporting and Data System (BI-RADS) US lexicon as associated findings. This review suggests practical guidelines for breast US Elastography in consensus with the Korean Breast Elastography Study Group, which was formed in August 2013 to perform a multicenter prospective study on the use of Elastography for US breast screening. This article is focused on the role of Elastography in combination with B-mode US for the evaluation of breast masses. Practical tips for adequate data acquisition and the interpretation of Elastography results are also presented.
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comparison of shear wave and strain ultrasound Elastography in the differentiation of benign and malignant breast lesions
American Journal of Roentgenology, 2013Co-Authors: Jung Min Chang, Ann Yi, In Ae Park, Woo Kyung MoonAbstract:OBJECTIVE. The purpose of this article is to compare the diagnostic performances of shear-wave and strain Elastography for the differentiation of benign and malignant breast lesions. SUBJECTS AND METHODS. B-mode ultrasound and shear-wave and strain Elastography were performed in 150 breast lesions; 71 were malignant. BI-RADS final assessment, elasticity values in kilopascals, and elasticity scores on a 5-point scale were assessed before biopsy. The results were compared using the area under the receiver operating characteristic curve (AUC). RESULTS. The AUC for shear-wave Elastography was similar to that of strain Elastography (0.928 vs 0.943). The combined use of B-mode ultrasound and either Elastography technique improved diagnostic performance in the differentiation of benign and malignant breast lesions compared with the use of B-mode ultrasound alone (B-mode alone, AUC = 0.851; B-mode plus shear-wave Elastography, AUC = 0.964; B-mode plus strain Elastography, AUC = 0.965; p < 0.001). With the best cu...