Role Of Sonoelastography Research Articles

Role of Sonoelastography in Differentiating Benign and Malignant Breast Lesions: A Prospective Study Comparing Elasticity Contrast Index and Tsukuba Score

Introduction: Breast cancer is the most common cancer occurring in women globally which is potentially curable if detected early. Ultrasound elastography is a dynamic technique that estimates tissue stiffness to differentiate between benign and malignant masses. Our study aimed to determine and compare the diagnostic accuracy of B mode Sonography, Elasticity contrast index, and Tsukuba score in differentiating malignant and benign breast masses. Methods: This was a prospective cross-sectional study done including 110 lesions in 102 patients in the age group of 15-73 years. The solid breast lesions seen on sonography were categorized according to the American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS) and further evaluated with elastography using both Elasticity Contrast Index (ECI) and Tsukuba score with pathological diagnosis taken as the gold standard. The cut-off value of ECI was obtained. The diagnostic accuracy of B-mode sonography, ECI, and Tsukuba score was compared. Results: We found that B-mode sonography had a sensitivity of 85.7%, specificity of 100%, and accuracy of 96.9 %. The accuracy of Tsukuba scores for differentiating benign and malignant lesions was 81.2%. The cut-off value of ECI obtained was 2.8 and the accuracy was 81.8%. A statistically significant correlation (p < 0.05) existed between sonographic diagnosis, ECI, and Tsukuba score. Conclusions: B mode sonography had the highest diagnostic accuracy while ECI and Tsukuba scores were comparable. ECI can be used for breast masses using a cut-off of 2.8 to differentiate benign from malignant.

Role of Sonoelastography in Characterization of Solid Breast Lesions: Review Article

Role of Sonoelastography in Characterization of Solid Breast Lesions: Review Article

Role of Sonoelastography in Evaluation of Liver Fibrosis: Review Article

Role of Sonoelastography in Evaluation of Liver Fibrosis: Review Article

Sonoelastographic evaluation of plantar fascia in patients with plantar fasciitis: A case–control study

Background: Plantar fascitis causes heel pain and the thickened fascia has specific morphological features that can be utilized for early diagnosis through sonoelastographic evaluation. Aims and Objectives: This case–control study was conducted to find out the role of sonoelastography in the diagnosis of plantar fasciitis (PF). Materials and Methods: A case–control study was conducted in the department of radiodiagnosis in a teaching medical college. Thirtyclinically diagnosed PF patients and thirty controls were recruited based on selection criteria. Shear wave elastography (SWE) was done for all participants and the thickness of plantar fascia and strain ratio was compared between the groups. Plantar fascia thickness (mm) and elasticity (stain ratio) were considered as the primary outcome variable. coGuide software was used for data analysis. Results: The mean age of the cases was 46.73±16.92 years and controls was 47.5±16.1 years. There was no statistical difference observed between cases and controls in age, sex, and body mass index. There was a statistically significant difference in thickness of the plantar fascia (P<0.001) between cases (4.18±0.77 mm) and controls (3.33±0.71 mm). The difference in strain ratio between study groups was statistically significant (P<0.001). The strain ratio had excellent predictive validity with the area under the curve of 0.929 (P<0.001). Data were analyzed using co-Guide software, V.1.03. Conclusion: Ultrasound elastography can detect the thickening of the plantar fascia and strain ratio has excellent predictive validity in predicting PF.

Role of Sonoelastography Using 5-Point Scoring Method and Strain Ratio in Improving Diagnostic Performance of Conventional Ultrasound in Indeterminate BI-RADS 3 and 4 Breast Lesions

Role of Sonoelastography Using 5-Point Scoring Method and Strain Ratio in Improving Diagnostic Performance of Conventional Ultrasound in Indeterminate BI-RADS 3 and 4 Breast Lesions

Role of Sonoelastography in Differentiating Benign From Malignant Cervical Lymph Nodes and Correlating With Pathology.

Background and aimCombined use of ultrasonography and elastography improves diagnostic efficacy in differentiating benign from malignant cervical lymph nodes, thereby helping in treatment planning and reducing unnecessary fine needle aspiration cytology/ biopsy. This study aimed to correlate B-mode ultrasonography, color Doppler imaging, and elastography findings with pathological findings and to calculate sensitivity, specificity, and diagnostic accuracy of ultrasonography and elastography.Material and methodsPatients underwent ultrasonography (B-mode and color Doppler imaging) followed by elastography. Lymph node morphology on B-mode was assessed based on short axis diameter, short-to-long axis ratio, fatty hilum, echogenicity, and margin. Vascularity of lymph nodes on color Doppler imaging was divided into three patterns. On elastography, lymph nodes were defined based on elastography pattern and strain index.ResultsAmong all ultrasonography parameters, fatty hilum was found to have the highest diagnostic accuracy (73%), followed by vascularity pattern (70%). Combined use of all ultrasonography parameters yielded better sensitivity (90%), specificity (88%), and diagnostic accuracy (89%) than individual parameters. Five-scale elastography pattern had 83% sensitivity, 97% specificity, and 89% diagnostic accuracy. In the current study, the use of strain index cut-off of two showed sensitivity of 93%, specificity of 96%, and diagnostic accuracy of 94%. Together, ultrasonography and elastography achieved sensitivity of 96%, specificity of 94%, and diagnostic accuracy of 95%.ConclusionElastography can be a useful adjunct to ultrasonography for the accurate diagnosis of cervical lymphadenopathy. Elastography pattern and cut-off strain index of two can effectively differentiate benign from malignant cervical lymph nodes.

Evaluation of the plantar fascia in patients with diabetes mellitus: the role of sonoelastography.

PurposeIt has been postulated that hyperglycaemic non-enzymatic glycation of proteins with subsequent accumulation of glycosylated end-products in tissues like the plantar fascia (PF) contributes to the development of foot ulcers in diabetics. The present study evaluates the spectrum of sonoelastographic findings in the plantar fascia in patients with type 2 diabetes mellitus (DM).Material and methodsA total of 81 patients and 32 healthy volunteers were included in the study. PF thickness was registered 1 cm distal to the attachment at the calcaneus. Greyscale ultrasonographic examination was followed by strain elastography of the PF based on which PF were qualitatively categorized into 3 grades (hard, intermediate, soft) depending on their predominant colour.ResultsPatients were found to have thicker PF than healthy volunteers (p < 0.0001). Grade 2 (intermediate elasticity) PF was the most common type seen in both groups (48.44% of healthy volunteers and 57.25% of patients). However, a greater number of patients (36.64%) had grade 3, i.e. soft PF as compared to healthy volunteers (9.38%).ConclusionsTo conclude, there is thickening and softening of the PF in patients with type 2 DM, supporting the hypo-thesis that diabetes-induced changes occur in the tissues of the foot.

The Role of Sonoelastography in Diagnosis and Grading of Patients with Carpal Tunnel Syndrome

The Role of Sonoelastography in Diagnosis and Grading of Patients with Carpal Tunnel Syndrome

The role of sonoelastography in the evaluation of hepatic fibrosis in pediatric patients

The role of sonoelastography in the evaluation of hepatic fibrosis in pediatric patients

The Role of Sonoelastography in the Diagnosis of Supraspinatus Tendinosis

Purpose: The aim of the study was to evaluate the sensitivity and specificity of compressive elastosonography (“Strain Elastography”), integrated with the B-mode ultrasound examination, in supraspinatus tendinosis, using magnetic resonance imaging as the gold standard for diagnosis. We also verified the intra-observer reproducibility of this elastosonographic method. Materials and Methods: The supraspinatus tendons of 30 patients with shoulder pain and positive magnetic resonance imaging for tendinosis were examined with B-Mode ultrasound and compressive elastosonography in the absence of full-thickness tendon ruptures. At the same time, 30 control individuals, asymptomatic for shoulder pain and with a negative history of previous diseases affecting the rotator cuff, were examined with B-Mode ultrasound and compressive elastosonography. The MRI exam was used as a gold standard reference exam for the diagnosis of tendinosis. At the “Strain” elastosonography the images were evaluated qualitatively with the color elastogram and quantitatively with the percentages of deformation of the supraspinatus tendon (Strain T), of the deltoid muscle used as reference tissue (Strain R) and of the SR/ST ratio (Ratio). Results and Conclusions: The comparison between the group of individuals with tendinosis and the control group shows a statistically significant difference (p&lt;0.05) for the Ratio values (SR/ST), respectively: 4.7 ± 0.14 vs 5.3 ± 0.19. The different Ratio values indicate that the supraspinatus tendon, when compared with the deltoid muscle, is softer in patients with tendinosis than in the control group. As indicated by the statistical analysis of the ROC curve, the Ratio value of 4.8 represents the best sensitivity and specificity data (70% and 61% respectively). Elastosonography can therefore provide added value, compared to the conventional ultrasound examination only, to confirm the diagnosis of supraspinatus tendinosis. The analysis showed a low variance of results, due to its excellent intra-observer reproducibility (intraclass correlation coefficient = 0.86). Future studies could aim to describe any changes in Stain T, Strain R and Ratio values in a cohort of individuals stratified by gender, age and BMI.

Role of Sonoelastography in Predicting Positive Sperm Retrieving in Patients with Non-Obstructive Azoospermia

Background: Infertility is an important public health problem , almost 10-30 % is due to azoospermia.Elastography is a new ultrasound modality which simply could evaluate the internal elasticity of the testis &amp;finally give an idea about the presence or absence of sperms.Objective: To evaluate the validity of sonoelastography in predicting positive sperm retrieving in patientwith azoospermia.Patients and Methods: A cross sectional study performed in Al-Sader Teaching Hospital / fertility center&amp; radiology department during the period from 1st September 2017 to 1st September 2018, included 98patients /196 testes) with azoospermia by B-mode U/S, Doppler study (RI) &amp; Elastography (strain ratio) ,then biopsies obtained for all patientsResults: Only (136) testes were subjected to biopsy. Testicular volume &amp; strain ratio were the most importantfactors which suggest that the testis will give a positive or negative sperm retrieving. Low volume + highstrain NSR (bad prognosis) while high volume + low strain PSR (good prognosis).These findings of SR were 75.7% sensitive, 93% specific, with 78% and 92% positive and negativepredictive values, respectively and an accuracy of 89%.Conclusion: Strain Elastography results have been validated and were differed significantly betweenpatients with abnormal sperms count than those without. This Technique provides a promising way to getmore accurate diagnostic results.

Role of sonoelastography and thyroid imaging reporting and data system in assessment of thyroid nodules

Background Thyroid nodules are very common and may be observed at ultrasound (US) in 50% of adult population. US elastography is a noninvasive technique for evaluating thyroid nodules to decrease the number of tissue biopsies. Thyroid imaging reporting and data system (TIRADS) is the assessment of risk stratification of thyroid nodules using a score. Patients and methods This cross-sectional study was carried out on 100 patients with 146 thyroid nodules. The study was conducted in the period from October 2018 to October 2020 at the Radiology Department and approved by the Ethics Committee, and all patients gave their informed consent before inclusion in the study. Results were collected and then analyzed using a specialized computer statistical program. Results We found 124 (84.9%) benign nodules and 22 (15.1%) malignant nodules. The accuracy of elastography color score in detection of malignancy was found to be 95.1%, 89.7% for strain ratio, and 88.4% for TIRADS. Conclusion Adding elastography examination and TIRADS score to the routine thyroid US will be of high diagnostic value in detection of malignancy.

Assessing Low Skeletal Mass in Patients Undergoing Hip Surgery: The Role of Sonoelastography

PurposeTo analyze the utility of sonoelastography—a radiation-free procedure to characterize muscle properties—as an instrument to qualitatively and quantitatively assess the rectus femoris muscle.Materials and MethodsFifty-one consecutive patients who underwent a pelvic computed tomography (CT) exam were enrolled prospectively. The final analysis was conducted using data from 39 patients after 12 were removed due to exclusion criteria (muscle strength could not be measured due to poor cognition [n=11]; too young [n=1]). The potential correlation between average Hounsfield unit (HFU) at the rectus femoris muscle (measured by CT) and muscle quality grade (determined by sonoelastography) was assessed along with a retrospective analysis of the relationship between hand grip strength, knee extensor power, history of intensive care unit stay, length of hospital day and sonoelastographic grade.ResultsThere was a significant correlation between sonoelastographic grade and the average HFU (P<0.001). Furthermore, hand grip strength (P<0.001) and knee extensor power (P<0.001) decreased significantly as the sonoelastographic grade increased. The likelihood of an intensive care unit stay and prevalence of low skeletal mass increased significantly with an increase in sonoelastography grade (P=0.037, P<0.001, respectively). The sensitivity, specificity, and accuracy of sonoelastographic images for predicting low skeletal mass were 77.3%, 100%, and 87.5%, respectively.ConclusionSonoelastography advantages, including the lack of radiation and greater accessibility, may make it a valuable alternative to qualitatively and quantitatively identify sarcopenia and low skeletal mass.

Role of ultrasonography and elastography of palpable breast masses in pregnancy and lactation with clinical correlation

Introduction: Pregnancy and lactation represent unique physiologic states that induce notable changes in the mammary glands. Early detection and diagnosis of breast pathologies by noninvasive modalities is of great demand. In this prospective cross-sectional clinical study conducted among 62 pregnant and lactating patients, we focused on role of sonoelastography in diagnosing clinically suspected breast pathologies among these patient groups. Results: In our study, we concluded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ultrasound strain elastography for differentiating benign and malignant breast masses were calculated to be 92.6%, 90%, 86.6%, 91.4%, and 93.5%, respectively, which is more than the conventional sonography alone which had sensitivity, specificity, PPV, NPV, and accuracy as 86.21%, 83.5%, 88.6%, 85.3%, and 86.2%, respectively. This finding is found to be matching with the finding of literature studies. Conclusion: Sonoelastography can be used as an imaging modality of choice in diagnosing breast lesions during pregnancy and lactation.

Role of sonoelastography in assessment of axillary lymph nodes in breast cancer: a systematic review and meta-analysis

To evaluate the effectiveness of shear-wave elastography (SWE) and strain elastography (SE) for axillary lymph nodes (ALNs). PubMed, Embase, and Cochrane Library databases were searched until September 2018. Weighted mean difference was calculated for continuous variables. The accuracy of sonoelastography was assessed by calculating pooled sensitivity, specificity, area under the curve (AUC), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). All data were analysed using Stata 12.0. Ten studies with 1,038 ALNs were included in the meta-analysis. Five studies evaluated the use of SE, and the other five evaluated the SWE. The SWE stiffness values of malignant ALNs were significantly higher than those of benign nodes. Both SE and SWE have relatively high specificity and sensitivity. The max stiffness in SWE showed the highest specificity (0.94; 95% confidence interval [CI], 0.81-0.98), PLR (12.1; 95% CI, 4-36.5), NLR (0.29; 95% CI, 0.12-0.69), AUC (0.94; 95% CI, 0.91-0.96), and DOR (42; 95% CI, 12-154); in contrast, the mean stiffness showed the highest sensitivity (0.80; 95% CI, 0.61-0.91). Sonoelastography demonstrated high sensitivity and specificity for differentiating between malignant and benign ALNs. The max and mean stiffness on SWE appeared to exhibit the highest accuracy. Thus, SWE is an effective accompaniment to sentinel node biopsy, and is appropriate for preoperative assessment of ALNs in the post-Z0011 era.

Role of Sonoelastography in Differentiating Benign and Malignant Thyroid Nodules

Role of Sonoelastography in Differentiating Benign and Malignant Thyroid Nodules

The Role of Sonoelastography in Breast Lesions

There is a large body of published material that supports the use of elastography, both strain and shear wave, for characterization of breast lesions. To a lesser extent, elastography can be used in the detection of breast abnormalities. This article reviews the principles of elastography regarding breast imaging, reviews the techniques to perform both strain and shear wave elastography, and reviews the literature and discusses how elastography can be used to improve the characterization of breast lesions to allow for decrease in the number of short-term follow-up examinations and benign biopsies.

The Role of Sonoelastography in the Evaluation of Testes With Varicocele

To evaluate the role of elastosonography in the evaluation of testicular elasticity as a predictive sign of testicular damage in patients with varicocele. Between December 2010 and December 2014, we evaluated patients with varicocele by sonoelastography (SE) of the testes. We created 3 groups: group A included patients with untreated varicocele; group B, patients treated with the same technique; and group C, healthy age-matched patients without varicocele. All patients underwent SE for the evaluation of testicular stiffness and results were graded from 1 to 3 following the color scale grading. During the study period, 36 boys (9-16 years old) with untreated varicocele, 47 treated patients, and 24 age-matched healthy subjects underwent control visit for varicocele and SE. All right testes of all groups were scored as 1, whereas testes with varicocele were stiffer than normal; all hypotrophies were scored as 3, whereas not all testes that were scored 3 were associated with testicular hypotrophy. There was a significant and statistical recovery rate of the testicular volume and the sonoelastographic score after surgery. Testes with varicocele are significantly stiffer than normal ones. All testes with testicular hypotrophy had grade 3 sonoelastographic scores, but not all patients with a grade 3 score have testicular hypotrophy or continuous spermatic vein reflux. Our results show that sonoelasography can play a significant role in the evaluation of testicular elasticity as a predictive sign of testicular damage.

The role of sonoelastography in planning percutaneous biopsy of soft tissue tumours.

The aim of this study was to evaluate whether compression elastography has a useful role in the planning of percutaneous ultrasound-guided biopsies of soft tissue tumours. Consecutive patients were evaluated in the sarcoma clinic after their initial imaging work-up, involving ultrasound and MR. The multi-disciplinary team decided when percutaneous biopsy for histology was required, and this was performed in the multi-disciplinary clinic using ultrasound guidance. An experienced sarcoma radiologist performed the ultrasound with compression elastography in all cases. Grey scale imaging was used to predict the needle track for each biopsy and routinely, two passes were made into each lesion. In this study, the track for the second pass was predicted from the elastogram, aiming for a stiff (blue) area within the lesion. The samples were separately potted in formalin and sent to the sarcoma pathologist. Pathology reports for each sample were assessed to evaluate whether the elastographic blue targets yielded any specific diagnostic quality; 157 biopsies were performed in separate patients, including two passes per patient as per routine protocol; 107 (68.1%) were benign lesions and 50 (31.9%) were malignancies. In the benign group, 16 (14.9%) showed significant blue areas in the lesion. However, nine of these were thought to be artefactual, as they showed grey scale characteristics of complex cysts. Positive histology was recorded in all the blue areas, but in the benign lesions positivity was not seen solely in the blue areas; 14 (28%) in the malignant group showed blue areas in the lesion and five biopsies were positive in blue areas only. Overall, the blue target yielded the only positive tissue in 10% of the malignancies, equating to 3% of the whole study population. The p value was 0.008829 for positive histology for malignancy from blue areas only.

Impalpable Testicular Seminoma Identified on Sonoelastography

The role of sonoelastography in diagnosing cancerous masses has increased since the advent of elastography as an ultrasound modality. Its ability to display differences in the mechanical properties of cancerous masses compared to normal surrounding tissue has shown benefit in increasing the accuracy of diagnosing malignant breast and thyroid masses and has shown early potential in accomplishing better targeted prostate biopsies. To date, the literature is limited in the number of studies describing the use of sonoelastography for testicular masses. We describe a 34-year-old man who presented with an incidental finding of an impalpable hypoechoic testicular mass on grayscale ultrasound during an infertility work-up. Sonoelastography was performed displaying intermediate testicular elastic properties. Upon frozen section of the mass during surgical exploration, classic testicular seminoma was diagnosed and subsequent radical orchiectomy was performed. We would like to use this atypical presentation of testicular seminoma to review the potential role of elastography for diagnosing testicular cancer.