Acoustic radiation force impulse elastography for noninvasive assessment of chronic pancreatitis

Yashima, Yoko; Sasahira, Naoki; Isayama, Hiroyuki; Kogure, Hirofumi; Ikeda, Hitoshi; Hirano, Keisuke; Mizuno, Suguru; Yagioka, Hiroshi; Kawakubo, Kazumichi; Sasaki, Takashi; Tada, Minoru; Yoshida, Haruhiko; Omata, Masao; Koike, Kazuhiko

doi:10.1007/s00535-011-0491-x

Cited by 101 publications

(97 citation statements)

References 28 publications

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“…EUS-elastography, despite obtaining a high diagnostic accuracy using indirect quantification methods, is a dependent operator technique and has a relative degree of invasiveness. In 2012, Yashima et al (19) presented a study with 52 healthy subjects and 46 patients with CP using the ARFI technology. The cut-off values to differentiate healthy patients had a sensitivity, specificity, positive predictive value and negative predictive value of 75%, 72%, 69% and 78%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Reports on pancreatic elastography by ARFI technique have been increasing over the past 3 years (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22), having noted that currently it can only be used with a percutaneous ultrasound equipment and not by EUS. Yashima et al (19) presented the first study of diagnostic accuracy by ARFI between healthy volunteers and patients with chronic pancreatitis, taking standard magnetic resonance imaging (MRI), MR cholangiopancreatography (MRCP) and/or endoscopic retrograde cholangiopancreatography (ERCP) as a reference, and describing for SWV of 1.4 m/s sensitivity and specificity of 75% and 72%, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of percutaneous elastography by acoustic radiation force impulse for the non-invasive diagnosis of chronic pancreatitis

et al. 2016

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Objective: To determine the accuracy of the acoustic radiation force impulse (ARFI) technique for the diagnosis of chronic pancreatitis. Materials and methods:We present an observational, single-center study that included patients with suspected chronic pancreatitis in the period between October 2012 and September 2015 who underwent endoscopic ultrasound (EUS) and were classified according to the standard and Rosemont criteria. The same group of patients was assessed by the ARFI technology using ACUSON S2000™ equipment with Virtual Touch™ Quantification software for the assessment of pancreatic stiffness by obtaining the shear wave velocity (SWV) in the head, body and tail of the pancreas. Data were analyzed using ANOVA and nonparametric correlation methods. Diagnostic accuracy was obtained by analyzing receiver operating characteristic (ROC) curve.Results: A total of thirty-three patients were studied (45.5% women); mean age was 58.3 ± 11.8 years. Seventeen with a diagnosis of chronic pancreatitis and sixteen classified as normal according to standard criteria. A significant difference was detected between the means of SWV in pancreatic body of patients without (SWV: 1.27 m/s) and with chronic pancreatitis (SWV 1.57 m/s), p = 0.037. The area under the ROC curve was 71.3% (95% CI 0.532-0.895) and the accuracy of ARFI for diagnosing chronic pancreatitis was 69.7% for a SWV of 1.4 m/s in the pancreatic body. The SWV means in head (r = 0.421, p < 0.05) and body (r = 0.455, p < 0.05) of the pancreas showed a significant correlation with the number of EUS criteria for chronic pancreatitis.Conclusion: Quantification of pancreatic stiffness with ARFI elastography technique has proven to be useful for the non-invasive diagnosis of chronic pancreatitis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Usefulness of percutaneous elastography by acoustic radiation force impulse for the non-invasive diagnosis of chronic pancreatitis

et al. 2016

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“…In this case, X,XX m/s was always displayed on the screen during VTQ which indicated the tumor was not solid but cystic. Yashima et al [39] subjected 46 patients with chronic pancreatitis and 52 normal pancreas, and measured SWV at the head, the body and the tail of the pancreas for 10 times in each case. The success rates of > 60% for measuring SWV at the head, the body and the tail of the pancreas were 69%, 75%, and 42%, respectively.…”

Section: Us-elastography -Shear Wave Elastograhymentioning

confidence: 99%

Elastography for the pancreas: Current status and future perspective

Kawada¹,

Tanaka²

2016

WJG

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Elastography for the pancreas can be performed by either ultrasound or endoscopic ultrasound (EUS). There are two types of pancreatic elastographies based on different principles, which are strain elastography and shear wave elastography. The stiffness of tissue is estimated by measuring the grade of strain generated by external pressure in the former, whereas it is estimated by measuring propagation speed of shear wave, the transverse wave, generated by acoustic radiation impulse (ARFI) in the latter. Strain elastography is difficult to perform when the probe, the pancreas and the aorta are not located in line. Accordingly, a fine elastogram can be easily obtained in the pancreatic body but not in the pancreatic head and tail. In contrast, shear wave elastography can be easily performed in the entire pancreas because ARFI can be emitted to wherever desired. However, shear wave elastography cannot be performed by EUS to date. Recently, clinical guidelines for elastography specialized in the pancreas were published from Japanese Society of Medical Ultrasonics. The guidelines show us technical knacks of performing elastography for the pancreas. Core tip: Elastography for the pancreas had been considered to be difficult to perform with adequate accuracy and reproducibility because the pancreas is a small organ located deep in center of the human body. This review introduces the recent innovation of elastography for the pancreas, and makes recommendations on how to use various elastographic modalities for the pancreas. The review also shows us what we can know by performing elastography for the pancreas. Elastography may be a promising imaging modality for differential diagnosis between malignant and benign pancreatic tumors, for early diagnosis of chronic pancreatitis, and for identifying high-risk patients for pancreatic cancer. TOPIC HIGHLIGHTKawada N, Tanaka S. Elastography for the pancreas: Current status and future perspective.

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“…Additionally, the characterization and/or differentiation of pathological tissues by US elastography have increasingly been evaluated by numerous up-to-date studies that aimed to reveal the diagnostic efficacy of US elastography in differentiating benign or malignant conditions. Although the visceral organs, such as the liver [8], kidney [9], spleen [10], pancreas [11], uterus [12], and prostate [13], were the main subjects in these studies, the utility of US in assessing pathologies of the thyroid glands [14][15][16] and breast tissue [17][18][19] have also been evaluated by a substantial number of researchers. In comparison, only a limited number of studies in the literature have reported the validity of using US elastography in clinical practice for patients with musculoskeletal issues.…”

Section: Introductionmentioning

confidence: 99%

Acoustic Radiation Force Impulse (ARFI) elastography quantification of muscle stiffness over a course of gradual isometric contractions: a preliminary study.

et al. 2015

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Aims: To evaluate the feasibility of quantitative analysis of muscle stiffness by Acoustic Radiation Forced Impulse (ARFI) elastography over a course of graduate isometric voluntary contractions. Material and methods: The stiffness of the bilateral biceps muscle of 13 healthy volunteers was measured in real time by ARFI elastography, while the forearm was in neutralextended position, 90 degree self-flexed positions and 90 degree self-flexed position, with altered weights ranging from 1 to 8 kg placed on flattened palmar surfaces consecutively. The determined increases in biceps muscle stiffness were measured for both arms and correlated with the loadings weights adopted at progressive trial stages. Results: The mean shear wave velocity (SWV) values of biceps muscles in a neutral position, in 90 degree flex position and 90 degree flex position with 1 to 8 kg weights on palmar surfaces were 2.162±0.302 m/sec, 3.382±0.581 m/sec, and 3.897±0.585 to 5.562±0.587 m/sec, respectively. Significant correlations between the muscle SWV values and related palmar weights and between the SWV values of right and left sides at different trial stages were identified (r=0.951 and r=0.954, respectively). A mutual propagation path of deep regions to entire areas was described to account for the distribution of increase in stiffness with increases in palmar weights. The confidence of method regarding inter-observer difference was confirmed by the correlation analyses of the results (r=0.998). Conclusions: ARFI elastography is a feasible imaging modality for quantifying the stiffness of isometrically voluntarily contracting muscles.Keywords: Acoustic Radiation Force Impulse, elastography, muscle stiffness Acoustic Radiation Force Impulse (ARFI) elastography quantification of muscle stiffness over a course of gradual isometric contractions: a preliminary study.

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Acoustic radiation force impulse elastography for noninvasive assessment of chronic pancreatitis

Abstract: ARFI elastography of the pancreas showed high elasticity in chronic pancreatitis compared to findings in the normal pancreas. This modality is feasible to use for the diagnosis of chronic pancreatitis.

Cited by 101 publications

References 28 publications

Usefulness of percutaneous elastography by acoustic radiation force impulse for the non-invasive diagnosis of chronic pancreatitis

Usefulness of percutaneous elastography by acoustic radiation force impulse for the non-invasive diagnosis of chronic pancreatitis

Elastography for the pancreas: Current status and future perspective

Acoustic Radiation Force Impulse (ARFI) elastography quantification of muscle stiffness over a course of gradual isometric contractions: a preliminary study.

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