Role Of Ultrasound Elastography Research Articles

Role of Ultrasound Elastography in Evaluating Suspicious Thyroid Nodules

Role of Ultrasound Elastography in Evaluating Suspicious Thyroid Nodules

Role of ultrasound elastography in improving the correlation between thyroid nodule TIRADS scoring and FNA bethesda categories in solitary thyroid nodules

Role of ultrasound elastography in improving the correlation between thyroid nodule TIRADS scoring and FNA bethesda categories in solitary thyroid nodules

Diagnostic Value of Ultrasound Elastography in the Differentiation of Breast Invasive Ductal Carcinoma and Ductal Carcinoma In situ.

Ultrasound elastography (US-E) has been shown superior to the conventional US in diagnosing benign and malignant breast lesions. In contrast, the role of US-E in the differentiation of breast invasive ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS) has been poorly described. This study was designed to examine the diagnostic value of US-E in the differentiation of IDC and DCIS. Medical records of all patients who underwent preoperative US-E evaluation and were diagnosed with IDC or DCIS at our hospital from April-December 2019 were retrieved and analyzed. Those who had prior surgical treatment, chemotherapy or radiotherapy were excluded. Twenty women with DCIS and 111 women with IDC were included in this study. There were no significant differences in age, maximum lesion diameter and tumor volume between the two groups. While shear wave velocity (SWV) inside the lesion and in the surrounding tissue, strain ratio and tumor area ratio were not substantially different between the two groups, SWV at the edge of the lesion was significantly higher in IDC cases, which had an AUC value of 0.66 with a sensitivity of 65.8% and a specificity of 60.0% for the differential diagnosis of IDC and DCIS. Edge SWV is significantly higher in IDC than that in DCIS, which had a moderate diagnostic value for the differentiation of IDC and DCIS, similar to the performance of diffusion-weighted magnetic resonance imaging as reported in the literature. In terms of cost-effectiveness, US-E could be very useful while waiting for further evaluations to determine whether US-E combined with other diagnostic modalities improves the diagnostic performance.

Role of Ultrasound Elastography and Diffusion Weighted Magnetic Resonance Imaging in Evaluation of Soft Tissue Masses

Role of Ultrasound Elastography and Diffusion Weighted Magnetic Resonance Imaging in Evaluation of Soft Tissue Masses

Role of ultrasound elastography in the evaluation of axillary lymph nodes in patients with breast cancer

Role of ultrasound elastography in the evaluation of axillary lymph nodes in patients with breast cancer

Role of Ultrasound Elastography in Patient Selection for Prostatic Artery Embolization

PurposeTo determine the effects of prostatic artery embolization (PAE) on prostate elasticity as assessed using ultrasound elastography (US-E) and to describe baseline US-E's potential role in patient selection. Materials and MethodsThis was a prospective investigation that included 20 patients undergoing PAE to treat lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH). US-E with measurement of the prostatic elastic modulus (EM) and shear wave velocity (SWV) was performed before PAE and at 1-month follow-up. Baseline, 3-month, and 1-year follow-up evaluations included prostate-specific antigen, uroflowmetry, pelvic magnetic resonance imaging, and clinical assessment using the International Prostate Symptom Score (IPSS) and quality of life (QoL) metrics. ResultsSeventeen patients entered statistical analysis. US-E showed a significant reduction in mean prostatic EM (34.4 kPa vs 46.3 kPa, −24.7%, P < .0001) and SWV (3.55 m/s vs 4.46 m/s, −20.0%, P < .0001) after PAE. There were moderate positive correlations between baseline EM and 1-year IPSS (R = 0.62, P = .007) and between baseline SWV and 1-year IPSS (R = 0.68, P = .002). Baseline SWV ≥ 5.59 m/s and baseline EM ≥ 50.14 kPa were associated with suboptimal IPSS and QoL outcomes after PAE with high degrees of sensitivity (100%) and specificity (69-100%). ConclusionsPAE led to a positive effect on the BPH dynamic component related to prostatic elasticity. There was a moderate positive correlation between baseline prostatic elastographic parameters and 12-month IPSS. Measurement of baseline elastographic characteristics may become useful for the evaluation and selection of patients for PAE.

The Role of Ultrasound Elastography in Evaluation for Axillary Lymph Nodes of Patients with Breast Cancer

Abstract Background: Axillary lymph node status is the most reliable prognostic indicator for disease recurrence and patient survival in breast cancer. Axillary ultrasound is an important mean for detecting metastatic LNs, being non-invasive, avail-able & cheap. Aim of Study: To investigate the role of strain elastography combined with conventional ultrasound in the diagnosis of axillary lymph nodes in patients with breast cancer. Patients and Methods: 24 patients diagnosed with breast cancer with enlarged axillary lymph node were included in this study over the course of six months, they were examined bu B mode ultrasound and ultrasound elastography. Finally, findings of B-mode US and elastography were compared with pathological results (reference standard). ROC analysis was constructed to obtain best cutoff values for B-mode criteria, alasticity score and strain ratio. Results: Elastography score and strain ratio had a higher specifcity (83.3% vs. 33.3%) and a lower sensitivity (88.9% vs. 100%) than gray-scale ultrasonography. Of all the 6 benign axillary lymph nodes analysed in the present study, 2 were determined to be metastatic by gray-scale ultrasonography, while these diagnoses were corrected by RTE. As regards the semi-quantitative assessment; strain ratio, in our study there was a significant increase in mean strain ratio in the malignant nodes (1-8.3) than the benign ones (0.7-3.4) (p=0.005), with the best cutoff value 2.5 which yielded sensitivity of 88.89, specificity of 83.33,accuracy of 90%, PPV 94.1%, NPV 71.4%. Conclusion: Ultrasound elastography by its qualitative (elasticity score) and quantitative (strain ratio) evaluation has proved to useful in differentiation between benign and malig-nant nodes as a complementary to conventional ultrasound. Using elasticity score/strain ratio; 11 out of 18 pathologically proved malignant nodes, were diagnosed as malignant, 5 out of 6 benign nodes were diagnosed as benign.

Role of gray-scale ultrasound, Doppler, and ultrasound elastography in the evaluation of nodular goiter

Background Thyroid nodules are very common. Most nodules are benign, with less than 5% of them being malignant. High-resolution ultrasound (US) is sensitive in detection of thyroid nodules, enabling differentiation of solid and cystic lesions. Conventional US does not provide information regarding hardness of the nodule and this is often the role of Ultra Sound Elastography (USE). US elastography was developed to work out tissue stiffness and strain information noninvasively. Aim The aim was to judge of the accuracy of gray-scale US, Doppler, and US elastography in the diagnosing of nodular thyroid diseases. Patients and methods The study included 20 consecutive patients with a clinically diagnosed multinodular goiter presented to Otorhinolaryngology OutPatient Clinic. All patients have been subjected to detailed history taking, complete Oto Rhino Laryngology (ORL) head and neck examination, complete general examination, and routine investigations for general anesthesia. Radiological imaging using conventional US and real- time US, Doppler study of the whole thyroid gland by the same probe, and elastography. Suspicious nodules were subject to Fine Needle Aspiration Cytology (FNAC) and surgery was done by ORL surgeon in the ENT department. Results In this study, 20 cases were included from which 19 cases were benign and only one case was malignant. There was a high statistical significance in-between the US classification and elasticity score with P less than 0.001, and high statistical significance in-between Doppler signs and elasticity score with P less than 0.001. Conclusion US elastography may be a promising technique that combined with other US modalities is straightforward and rapid to perform and might help to spot thyroid nodules that are likely to be malignant.

The role of ultrasound elastography and virtual touch tissue imaging in the personalized prediction of lymph node metastasis of breast cancer.

This study examined the effects of different ultrasound imaging technologies in the identification and prediction of axillary lymph node metastasis of breast cancer. It also investigated the relationship between human papilloma virus (HPV) infection and axillary lymph node metastasis. Eighty-five female patients diagnosed with breast masses participated in this study. Each patient underwent a conventional ultrasound, ultrasonic elastography, and virtual touch tissue imaging quantification (VTIQ). The differential diagnosis efficiency of a conventional ultrasound, ultrasound elastography, VTIQ, and ultrasound elastography combined with VTIQ technology was compared with a pathological diagnosis, which represents the gold standard. 85 axillary lymph node tissues and 25 normal breast tissues were used to detect HPV positive infection rate differences in different tissues. The results showed that metastatic lymph nodes and reactive lymph node hyperplasia accounted for 54.12% and 45.88% of the 85 axillary lymph nodes of breast cancer, respectively. The conventional ultrasound, ultrasound elastography, and VTIQ scores of metastatic lymph nodes were significantly higher than those of reactive lymph node hyperplasia (P<0.05). The diagnostic sensitivity (Se) (91.30%), specificity (Sp) (92.31%), accuracy (Ac) (91.76%), positive predictive value (PPV) (93.33%), and negative predictive value (NPV) (90.00%) of ultrasound elastography combined with VTIQ technology were the highest among the diagnostic efficiency test results of different computer ultrasound imaging technologies. The positive infection rate of HPV in metastatic lymph node tissues was significantly higher than that in reactive lymph node hyperplasia and normal breast tissues (P<0.05). Combining ultrasound elastography with VTIQ technology has high value in the differential diagnosis of axillary lymph nodes of breast cancer. Further, it appears that HPV infection may have an etiological role in lymph node metastasis in breast cancer patients.

THE ROLE OF ULTRASOUND ELASTOGRAPHY IN THE DIAGNOSIS OF PATHOLOGIC CONDITIONS OF TESTICLES AND SCROTUM.

SUMMARYSeveral years ago, elastography emerged as a potentially very useful ultrasound technique that is currently used in diagnostic workup of the breast, liver and some other organ systems, whereas for other ones it is still mainly in the phase of research. The aim of the study was to compare elasticity index (EI) of testicles using strain elastography in healthy subjects and those with pathologic changes of testicles/scrotum. A total of 117 patients were included in the study. Measurements were performed on a Logiq E9 ultrasound system using strain elastography. In healthy subjects, the mean EI value was 1.34±0.35 for right testis and 1.49±0.47 for left testis. Increased mean EI values were found in the following six conditions: patients with varicocele, infertile patients, solitary testis after orchidectomy of the other testicle because of tumor, patients with testicular tumors, patients after orchidopexy of undescended testicle, and patients with congenitally smaller testicle. There is a paucity of literature data on the use of elastography in testes, as well as on normal elastography values in testicular tissue. Strain elastography was demonstrated to be a valuable method to acquire additional information in patients with pathologic changes in testicles/scrotum. These data provide reference values for further research in a larger sample of subjects.

556 Poster - Role of Ultrasound Elastography in characterization of breast lesions: Does it really count?

Background: To compare the diagnostic performance of Ultrasound Elastography, Ultrasonography (Greyscale & Colour Doppler) and Digital Mammography in the characterisation of breast lesions using Pathological diagnosis as Gold standard.

Role of ultrasound elastography in the evaluation of focal liver lesions

Background: Ultrasound Elastography is a new imaging technique developed to non-invasive assessment of mechanical properties of the lesion. Focal liver lesions are cystic masses seen in the abnormal part of the liver. Ultrasound Elastography is non-invasive, non-contrast enhanced, easy to perform and is efficient in the characterization of focal liver lesion. This study was designed to evaluate and characterize the focal liver lesions by ultrasound Elastography. Materials and methods: A total of 100 cases with focal lesions referred for image-guided biopsy or planned for surgical resection, between age group 25-70 years were recruited. Cases with multiple lesions, the larger lesion was considered for index lesion. Liver stiffness was measured in the peripheral area of bigger lesion and in the liver greater than 2 cm from the lesion periphery. Data of stiffness value, stiffness ratio and shear wave velocity (m/s) were recorded 5 times for each group. Results: The mean values of elastographic parameters between malignant and benign FLL show statistically significant difference in stiffness ratio, shear wave velocity, stiffness value and strain ratio (P

Effects of Prostatic Artery Embolization on the Dynamic Component of Benign Prostate Hyperplasia as Assessed by Ultrasound Elastography: A Pilot Series.

To determine the effects of prostatic artery embolization (PAE) on prostaticelasticity as assessed by Ultrasound Elastography (US-E), as well as to describe the feasibility and role of US-E as a novel tool in both pre- and post-PAE evaluation. This is a prospective, single-center investigation that included eight patients undergoing PAE for treatment of lower urinary tract symptoms (LUTS) attributed to benign prostate hyperplasia (BPH). Baseline and 3-month follow-up evaluations were performed and included prostate-specific antigen (PSA), uroflowmetry, pelvic magnetic resonance imaging and clinical assessment using the International Prostate Symptom Score (IPSS) questionnaire and the IPSS-Quality of life (QoL) item. US-E with measurement of the prostatic Elastic Modulus (EM) was performed before PAE and at 1-month follow-up. After PAE, US-E showed a significant reduction of prostatic EM as assessed in kPa (33.14 vs. 47.24, - 29.8%, p = 0.002) and in m/s (3.75 vs. 4.63, - 19.0%, p < 0.001). Also, the transitional/peripheral zone ratio was significantly reduced by 45.36% (0.53 vs. 0.97, p < 0.05). All eight patients presented with significant LUTS improvement after PAE (p < 0.05 for IPSS, QoL, prostate volume, peak urinary flow rate and PSA). Findings described in this study suggest that PAE significantly reduces prostaticEM, leading to a positive effect on BPH dynamic component related to prostatic elasticity. Also, it features US-E as an additional tool for pre- and post-PAE evaluation, describing a novel indication for this technology.

Role of Ultrasound Elastography in the Detection of Fibrotic Bowel Strictures in Patients with Crohn's Disease: Systematic Review and Meta-Analysis.

To perform a systematic review with meta-analysis to assess whether ultrasound elastography can have a diagnostic role in detecting fibrotic bowel strictures in patients with Crohn's disease. MEDLINE via the PubMed, Ovid Embase, Scopus and Cochrane Library databases, and abstracts of international conference proceedings were searched up to March 31, 2018. Studies were included if they assessed the performance of abdominal ultrasound elastography in detecting fibrotic bowel strictures in patients with Crohn's disease using histology or the need for surgery after medical treatment as a reference standard. The quality of the studies was assessed using Quality Assessment of Diagnostic Accuracy Studies. 6 studies including a total of 217 patients with Crohn's disease and 231 bowel segments, of which 76 were bowel segments with fibrotic stricture, were selected. Three studies used strain ratio and three studies used strain value as parameters of bowel stiffness. Both the pooled standardized mean strain ratio and the pooled standardized mean strain value were higher in bowel segments with fibrotic strictures than in those without fibrotic strictures with a standardized mean difference of 0.85 (95 % confidence level [CI]: 0 to 1.71; p = 0.05) and 1.0 (95 % CI: -0.11 to 2.10; p = 0.08), respectively. There was a high heterogeneity between studies. All studies were at "high risk" or "unclear risk" of bias. Ultrasound elastography could be able to detect fibrotic bowel strictures in patients with Crohn's disease. Well-designed high quality diagnostic studies with a large sample size are needed.

The Role of Ultrasound Elastography in Musculoskeletal Diseases

The Role of Ultrasound Elastography in Musculoskeletal Diseases

Role of Ultrasound Elastography in Characterization of Indeterminate Breast lesions (BIRADS 3&amp;4 lesions).

With the expanded role of screening breast ultrasonography and accumulating clinical experience, the American College of Radiology (ACR) has established the Breast Imaging Reporting and Data System (BI-RADS) ultrasonography lexicon to standardize terminology for description and management recommendations according to stratified risks. It has been established that probably benign (BI-RADS category 3) lesions having a malignancy rate of less than 2% require short-term imaging follow-up rather than immediate biopsy. The BI-RADS 4 category is assigned to suspicious lesions for which biopsy is recommended. Routine screening methods such as mammography and breast ultrasound are valuable methods for managing breast masses. Breast ultrasound is the preferable screening method as it provides high sensitivity for detecting breast cancer in women with dense breast tissue and can detect cancers not identified on mammography in asymptomatic women with dense breast tissue. In our study we included 46 patients with different breast lesions. All patients had a conventional B-mode ultrasound examination and were evaluated according to the BIRADS categories, then real time free-hand ultrasound elastography was performed in the same session and images were evaluated using both the Tsukuba elasticity score and the strain ratio method. Finally, the results were compared to the histopathologic results of those lesions. It was found that conventional B-mode ultrasound examination had a sensitivity of 72.73% and specificity of 83% While, elastography scoring alone turned out to have sensitivity of 65.5%, specificity of 83.4% using the Tsukuba score system. The additional of Strain ratio parameter for evaluating the elastography images showed the highest sensitivity 98.4% and specificity 85.68% at a best cutoff point of 3.47. So we have found that elastography is an easy procedure with high diagnostic performance which can be easily integrated with the B-mode ultrasound examination in the same session and improves its specificity. That has proven benefit in minimizing the number of unnecessary biopsies especially in the assessment of BIRADS 3 and 4 lesions

The role of ultrasound elastography as a tool for prediction of hepatocellular carcinoma in Egyptian patients with cirrhosis

Objective The aim of the work was to study the role of ultrasound elastography as a tool for prediction of hepatocellular carcinoma (HCC) in patients with cirrhosis. Background Fibroscan is a novel, noninvasive, ultrasound technique–based technology that allows measuring liver stiffness. It is a noninvasive method for prediction of HCC. Patients and methods A total of 60 patients with cirrhosis were included in a case–control study from January 2014 to January 2015. Patients with obesity and ascites were excluded from the study. Patients underwent clinical examination, laboratory investigations, abdominal ultrasonography, triphasic computed tomography, liver biopsy, and fibroscan. They were divided into group I (patients with cirrhosis with no HCC) and group II (patients with cirrhosis with HCC). Results Stiffness range was 2.90–39.80 kPa among patients without HCC with a mean of 8.95 ± 7.27 kPa, whereas among patients with HCC, it was 8.40–75.00 kPa, with a mean of 31.10 ± 16.05 kPa. Fibroscan showed a high sensitivity (100%) and specificity (80%) for detecting HCC at the cut-off level of more than 12 kPa with a positive predictive value of 100 and a negative predictive value of 79%, and the area under the curve was 100%. Conclusion Transient elastography can predict HCC in patients with cirrhosis.

Strain Elastosonography of Thyroid Nodules: A New Tool for Malignancy Prediction? Overview of Literature

Ultrasound (US) elastography is a new non-invasive technique that uses ultrasounds to provide quantitative information about tissue stiffness. Two kinds of elastography (strain and shear wave elastography) are currently used in clinical practice. Although fine needle aspiration (FNA) is the most important procedure for the management of thyroid nodules, several studies have used US elastography as an adjunctive tool to conventional US, to differentiate malignant from benign nodules. In these studies malignant nodules are often associated with a greater elasticity scoring compared to benign. The conventional US plays an important role in defining which nodules are suitable for the US elastography because calcified and cystic nodules could be responsible for false positive and negative results respectively. On the other hand, follicular carcinoma gross anatomy and cellular pattern may resemble those of benign follicular adenoma. The histologic examination is often necessary to discover capsular or vascular invasion. Moreover, in contemporary literature there is disagreement about the role of US elastography in thyroid nodules with indeterminate or non-diagnostic cytology.

Role of ultrasound elastography in the differentiation of breast lesions

Background: Breast biopsy remains the gold standard for diagnosis of breast lesions; however, most of the breast specimens reveal benign results. Therefore, in order to avoid unnecessary breast biopsies, noninvasive diagnostic tools have been developed. Ultrasound elastography (USE) is a noninvasive technique which helps in reducing the frequency of breast biopsies. Aims: The aim of the study was to study the role of ultrasound elastography in differentiation of breast lesions which will ultimately help in better patient diagnosis. Materials and Methods: In this study, 54 patients with 66 breast lesions were first assessed with sonography and then with USE after obtaining informed patient consent. The examination was carried out in Department of Onco Imaging, Delhi State Cancer Institute, Delhi, India. from July 2011 to February 2012. Statistical Analysis: Statistical analysis was performed using SPSS software (version 20.0). Results and Conclusion: The lesions were classified on elastography using scoring system described by Itoh et al., 2006 with elasticity score of 1,2,3 as benign and score of 4 and 5 as malignant. The sensitivity of USE was found to be 88.57% with specificity of 90.32% and positive predictive value of 91.18%. Thus, we conclude that in the present scenario, USE can be used in early diagnosis and differentiation of breast masses into benign and malagnant and henceforth, can be influential in reducing the number of breast biopsies.

Role of Ultrasound Elastography in Prediction of Malignancy in Thyroid Nodules

Background. Ultrasonography is considered useful to distinguish between solid and cystic thyroid nodules and to stratify a nodule’s risk of cancer as low, medium, or high. Ultrasound (US) elastography has been applied to study the hardness/elasticity of nodules to differentiate malignant from benign lesions. Elastography possibly can solve the dilemma in reaching an accurate diagnosis for the cytologically known as indeterminate nodules. Aim. To evaluate the sensitivity and specificity of US elastography in the diagnosis of thyroid cancer. Patients and methods. This prospective study included 40 patients. The total number of nodules was 46, they were all euthyroid. Laboratory investigations were done including FT3, FT4, and TSH to exclude hot nodules. Neck US, US elastography, and fine-needle aspiration were done to all patients, and US elastography scoring system from 1 to 4 was used. Results. Four out of the 46 studied nodules were malignant. The ROC curve for elastography score (E-score) showed high sensitivity, specificity for the diagnosis of malignant thyroid nodules with a cut-off value of E-score 4 and high significance (p < 0.001), the area under curve was 0.92. The sensitivity was 75.0% and specificity was 100%. For E-score more than 2, the sensitivity was 100% and specificity was 85.37%. Conclusion. US elastography can be used to increase both the sensitivity and the specificity of US for the detection of malignant thyroid nodules, and so it seems to have great potential as a new tool for the diagnosis of thyroid cancer.