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Proceedings ArticleDOI

Quantitative quasi-static ultrasound elastography using reference layer: Ex-vivo study

01 Jul 2019-Vol. 2019, pp 7107-7110
TL;DR: The results suggest that using this approach of reference layer of known stiffness yields Young’s modulus values within 10% error compared to the ground truth.
Abstract: It is well-documented in the literature that changes in tissue elasticity are generally correlated with disease condition. In the case of diffuse liver disease, the elasticity of the liver reduces progressively. However, this change does not clearly manifest in conventional ultrasound examinations. Although quasi-static elastography is popular in clinical applications where qualitative assessment of relative tissue stiffness is enough, its potential is relatively underutilized in liver imaging due to the need for quantitative stiffness value. Recently, it was demonstrated that using a reference layer of known stiffness, one could produce quantitative modulus elastograms of the target tissue using quasi-static elastography using simulations and phantom experiments. Here, we examined the performance of this approach on ex-vivo goat liver samples and compare the estimated modulus values to that obtained from indentation measurements. The results suggest that using this approach of reference layer yields Young’s modulus values within 10% error compared to the ground truth.
References
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Journal ArticleDOI
TL;DR: TE appears to be an excellent tool for early detection of cirrhosis and may have prognostic value in this setting and could be useful for monitoring fibrosis progression and regression in the individual case, but more data are awaited for this application.

1,235 citations


"Quantitative quasi-static ultrasoun..." refers background in this paper

  • ...Also, the liver disease staging correlates with Young’s modulus value [2, 3]....

    [...]

Journal ArticleDOI
TL;DR: In this article, a device and procedure for measuring elastic properties of gelatin for elasticity imaging (elastography) was described. And the measured compression forces were comparable to results obtained from finite element analysis when linear elastic media are assumed.
Abstract: Acoustic and mechanical properties are reported for gelatin materials used to construct tissue-like phantoms for elasticity imaging (elastography). A device and procedure for measuring elastic properties are described. The measured compression forces were comparable to results obtained from finite element analysis when linear elastic media are assumed. Also measured were the stress relaxation, temporal stability, and melting point of the materials. Aldehyde concentration was used to increase the stiffness of the gelatin by controlling the amount of collagen cross-linking. A broad range of tissue-like elastic properties was achieved with these materials, although gels continued to stiffen for several weeks. The precision for elastic modulus measurements ranged from less than 0.1% for 100 kPa samples to 8.9% for soft (<10 kPa), sticky samples.

511 citations


"Quantitative quasi-static ultrasoun..." refers background in this paper

  • ...Also, a small amount (1% volume/volume of N-propanol was added to get the speed of sound in phantoms to be matched with human tissue (1540 m/s) [12]....

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Journal ArticleDOI
TL;DR: LS is an excellent surrogate marker of advanced fibrosis (F3) and cirrhosis (F4) outscoring all previous noninvasive approaches to detect Cirrhosis and has helped to better understand the molecular mechanisms underlying liver fibrosis.
Abstract: The noninvasive quantitation of liver stiffness (LS) by ultrasound based transient elastography using FibroScan® has revolutionized the diagnosis of liver diseases, namely liver cirrhosis. Alternative techniques such as acoustic radiation impulse frequency imaging or magnetic resonance elastography are currently under investigation. LS is an excellent surrogate marker of advanced fibrosis (F3) and cirrhosis (F4) outscoring all previous noninvasive approaches to detect cirrhosis. LS values below 6 kPa are considered as normal and exclude ongoing liver disease. LS of 8 and 12.5 kPa represent generally accepted cut-off values for F3 and F4 fibrosis. LS highly correlates with portal pressure, and esophageal varices are likely at values >20 kPa. Many other factors may also increase LS such as hepatic infiltration with tumor cells, mast cells (mastocytosis), inflammatory cells (all forms of hepatitis) or amyloidosis. In addition, LS is directly correlated with the venous pressure (eg, during liver congestion) and is increased during mechanic cholestasis. Thus, LS should always be interpreted in the context of clinical, imaging and laboratory findings. Finally, LS has helped to better understand the molecular mechanisms underlying liver fibrosis. The novel pressure-stiffness-fibrosis sequence hypothesis is introduced.

309 citations


"Quantitative quasi-static ultrasoun..." refers background in this paper

  • ...Also, the liver disease staging correlates with Young’s modulus value [2, 3]....

    [...]

Journal ArticleDOI
TL;DR: Different hepatic ultrasound elastography techniques, their advantages and disadvantages, their diagnostic accuracy, their applications in clinical practice are reported on.
Abstract: Conventional imaging techniques cannot provide information about tissue mechanical properties. Many injuries can cause changes in tissue stiffness, especially tumors and fibrosis. In recent years, various non-invasive ultrasound methods have been developed to study tissue elasticity for a large number of applications (breast, thyroid, prostate, kidneys, blood vessels, liver…). For non-invasive assessment of liver diseases, several ultrasound elastography techniques have been investigated: Transient elastography (the most extensively used), Real Time Elastography (RTE), Acoustic Radiation Force Impulse Imaging (ARFI) and more recently Shear Wave Elastography (SWE). Even if evaluation of liver fibrosis in chronic liver disease remains the principal application, there are many others applications for liver: predicting cirrhosis-related complications; monitoring antiviral treatments in chronic viral liver disease; characterizing liver tumors; monitoring local treatments, etc. The aim of this article is to report on the different hepatic ultrasound elastography techniques, their advantages and disadvantages, their diagnostic accuracy, their applications in clinical practice.

165 citations


"Quantitative quasi-static ultrasoun..." refers background in this paper

  • ...The use of contrast transfer efficiency may be important for Young's modulus value estimation of liver as there appears to be a modulus rangescale that is correlated to the disease stage, and therefore, requires more accuracy [9]....

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Journal ArticleDOI
21 Sep 2012-PLOS ONE
TL;DR: The reliability and validity of the quantitative method for measuring absolute muscle hardness using ultrasound elastography was verified and the Young’s moduli of the medial gastrocnemius muscle obtained were within the range of values previously obtained using magnetic resonanceElastography.
Abstract: Muscle hardness is a mechanical property that represents transverse muscle stiffness. A quantitative method that uses ultrasound elastography for quantifying absolute human muscle hardness has been previously devised; however, its reliability and validity have not been completely verified. This study aimed to verify the reliability and validity of this quantitative method. The Young’s moduli of seven tissue-mimicking materials (in vitro; Young’s modulus range, 20–80 kPa; increments of 10 kPa) and the human medial gastrocnemius muscle (in vivo) were quantified using ultrasound elastography. On the basis of the strain/Young’s modulus ratio of two reference materials, one hard and one soft (Young’s moduli of 7 and 30 kPa, respectively), the Young’s moduli of the tissue-mimicking materials and medial gastrocnemius muscle were calculated. The intra- and inter-investigator reliability of the method was confirmed on the basis of acceptably low coefficient of variations (≤6.9%) and substantially high intraclass correlation coefficients (≥0.77) obtained from all measurements. The correlation coefficient between the Young’s moduli of the tissue-mimicking materials obtained using a mechanical method and ultrasound elastography was 0.996, which was equivalent to values previously obtained using magnetic resonance elastography. The Young’s moduli of the medial gastrocnemius muscle obtained using ultrasound elastography were within the range of values previously obtained using magnetic resonance elastography. The reliability and validity of the quantitative method for measuring absolute muscle hardness using ultrasound elastography were thus verified.

112 citations


"Quantitative quasi-static ultrasoun..." refers background in this paper

  • ...reference material which allows for calculating the approximate Young’s modulus value [6, 8]....

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