Abstract
PurposeThis study was conducted in order to assess the intra- and interoperator reproducibility of shear-wave speed (SWS) measurement on elasticity phantoms and healthy volunteers using ultrasound-based point shear-wave elastography.Materials and methodsThis study was approved by the institutional review board. Two operators measured the SWS of five elasticity phantoms and seven organs (thyroid, lymph node, muscle, spleen, kidney, pancreas, and liver) of 30 healthy volunteers with 1.0–4.5 MHz convex (4C1) and 4.0–9.0 MHz linear (9L4) transducers. The phantom measurements were repeated ten times, while the volunteer measurements were performed five times each. Intra- and interoperator reproducibility was assessed. Interoperator reproducibility was also evaluated with the 95% Bland–Altman limits of agreement (LOA).ResultsIn phantoms, all intraclass correlation coefficients (ICCs) were above 0.90 and the 95% LOA between the two operators were less than ± 18%. In volunteers, intraoperator ICCs were > 0.75 for all regions except the pancreas. Interoperator ICC was above 0.75 for the right lobe of the liver (depth 4 cm) and the kidney, but the 95% LOA was less than ± 25% only for the liver.ConclusionAlthough excellent in phantoms, interoperator reproducibility was insufficient for all regions in the volunteers other than the right hepatic lobe at a depth of 4 cm. Clinicians should be aware of the 95% LOA when using SWS in patients.Key Points• Our phantom study indicated a high reproducibility for shear-wave speed (SWS) measurements with point shear-wave elastography (pSWE).• In volunteers, intraoperator reproducibility was generally high, but the interoperator reproducibility was not high enough except for the right hepatic lobe at 4 cm depth.• To evaluate interoperator reproducibility, the 95% limits of agreement (LOA) between operators should be considered in addition to the intraclass correlation coefficient (ICC).
Highlights
PhantomsUltrasound (US) elastography has been widely used to evaluate liver fibrosis or to differentiate between benign and malignant lesions in breast, thyroid, and prostate [1,2,3,4]
In volunteers, intraoperator reproducibility was generally high, but the interoperator reproducibility was not high enough except for the right hepatic lobe at 4 cm depth
To evaluate interoperator reproducibility, the 95% limits of agreement (LOA) between operators should be considered in addition to the intraclass correlation coefficient (ICC)
Summary
Ultrasound (US) elastography has been widely used to evaluate liver fibrosis or to differentiate between benign and malignant lesions in breast, thyroid, and prostate [1,2,3,4]. Measurements of shear-wave speed (SWS) provide quantitative information about organ stiffness, which is a potential noninvasive biomarker [5]. Many studies have evaluated the accuracy of SWS measurement as a biomarker for staging liver fibrosis or differentiating a malignant lesion from a benign one [8, 9, 11, 14,15,16, 18, 20].
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