Diagnostic Performance of Point Shear Wave Elastography (pSWE) Using Acoustic Radiation Force Impulse (ARFI) Technology in Mesenteric Masses: A Feasibility Study

Alhyari, Amjad; Görg, Christian; Dietrich, Christoph F.; Kawohl, Svenja; Zadeh, Ehsan Safai

doi:10.3390/diagnostics12020523

Cited by 3 publications

(5 citation statements)

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“…These observations are contrary to neoplastic lesions in other organs, where the stiffness of malignant lesions is often higher than that of benign lesions and the surrounding parenchyma [13,[17][18][19]. It is unclear why, in the spleen, as shown in the current study, the stiffness of the FSLs was lower than that of the surrounding NSP.…”

Section: Discussioncontrasting

confidence: 86%

“…US elastography represents a good, non-invasive method for characterizing tissue stiffness with various applications in many organs, including the liver, thyroid, pancreas, kidney, breast, lymph nodes, and prostate [13]. In previous studies, we have shown the feasibility and diagnostic performance of ARFI elastography in differentiating benign from malignant pathologies in the mesentery [17], omentum [18], and lung [19]. There are guidelines regarding the implementation of spleen elastography in patients with liver disease to assess for liver fibrosis, clinically relevant portal hypertension, and the presence of esophageal varices [13].…”

Section: Discussionmentioning

confidence: 99%

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Acoustic Radiation Force Impulse (ARFI) Elastography of Focal Splenic Lesions: Feasibility and Diagnostic Potential

Alhyari,

Görg,

Tahat

et al. 2023

Cancers

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Purpose: Nontraumatic focal splenic lesions (FSL) are rare, and the need for tissue diagnosis must be weighed against the very high risk of bleeding after a splenic biopsy. The aim of this study was to explore the feasibility and diagnostic potential of acoustic radiation force impulse (ARFI) elastography as a noninvasive method for different benign and malignant FSLs. No human studies on the elastographic characteristics of FSL exist. Methods: This was a retrospective analysis of 34 patients with FSLs, who underwent abdominal B-mode ultrasound (B-US), contrast-enhanced ultrasound (CEUS), and standardized ARFI examinations between October 2021 and December 2022 at our university hospital. The inclusion criteria were: (i) FSL size ≥ 1 cm; (ii) 10 valid ARFI measurements of the FSL, as well as of the normal splenic parenchyma (NSP) as an in vivo reference; and (iii) diagnostic confirmation of FSL etiology based on histological examination (8/34; 23.5%) or clinical evaluation, which included a clinical and sonographic follow-up (FU), CEUS morphology, and/or morphology on cross-sectional imaging (26/34; 76.5%). CEUS was performed on all patients and the FSLs were classified according to the current guidelines; cross-sectional imaging was available for 29/34 (85.3%). The mean FU duration was 25.8 ± 30.5 months. The mean ARFI velocity (MAV) of the FSL (MAVL), the NSP (MAVP), and the ratio of the MAVL to the MAVP (MAVL/P) were calculated and compared. Results: Of the 34 FSLs, 13 (38.2%) were malignant (mFSL) and 21 (61.8%) were benign (bFSL). The MAVL of all 34 FSLs (2.74 ± 0.71 m/s) was lower than the MAVP (3.20 ± 0.59 m/s), p = 0.009, with a mean MAVL/P ratio of 0.90 ± 0.34. No significant differences in the MAVL were observed between the mFSL (2.66 ± 0.67 m/s) and bFSL (2.79 ± 0.75 m/s). There were also no significant differences between the MAVP in patients with mFSL (3.24 ± 0.68 m/s) as compared to that in the patients with bFSL (3.18 ± 0.55 m/s). Likewise, the MAV L/P ratio did not differ between the mFSL (0.90 ± 0.41 m/s) and bFSL (0.90 ± 0.30 m/s) groups. Conclusion: ARFI elastography is feasible in evaluating the stiffness of FSLs. The lesions’ stiffness was lower than that of the NSP, regardless of the FSL etiology. However, differentiation between benign and malignant FSL with the help of this elastographic method does not appear possible. Larger prospective studies are needed to validate these findings.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Acoustic Radiation Force Impulse (ARFI) Elastography of Focal Splenic Lesions: Feasibility and Diagnostic Potential

Alhyari,

Görg,

Tahat

et al. 2023

Cancers

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“…If the lesion moved while being measured, this single reading “shot” was considered invalid and was repeated. A total of 11 valid measurements were obtained for each ARFI study 14 15 18. ARFI study was considered valid only if the success rate to obtain 11 measurements was >60%.…”

Section: Methodsmentioning

confidence: 99%

“…US elastography is a non-invasive imaging technique for the assessment of tissue stiffness with current established guidelines for hepatic and non-hepatic applications 12–15. Acoustic radiation force impulse (ARFI) is a type of point shear wave elastography (pSWE) which depends on the differences of acoustic wave propagation velocity in different tissues determined by measuring the degree of displacement within a 0.5–1.0 cm box on the US screen, known as ‘region of interest’ (ROI) 16…”

Section: Introductionmentioning

confidence: 99%

ARFI elastography of the omentum: feasibility and diagnostic performance in differentiating benign from malignant omental masses

Alhyari

Görg

Dietrich

et al. 2022

BMJ Open Gastroenterol

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ObjectiveTo evaluate the feasibility and diagnostic performance of acoustic radiation force impulse (ARFI) elastography in different omental masses (OM).DesignThis was a retrospective analysis of 106 patients with OM defined as omental thickness ≥1 cm, who underwent abdominal B-mode ultrasound (US) and standardised ARFI examinations of the OM between September 2018 and June 2021 at our university hospital. A cytohistological confirmation was available in 91/106 (85.8%) of all OM, including all 65/65 (100%) malignant OM (mOM) and 26/41 (63.4%) of benign OM (bOM). In 15/41 (36.6%) of bOM; cross-sectional imaging and or US follow-up with a mean duration of 19.8±3.1 months was performed. To examine the mean ARFI velocities (MAV) for potential cut-off values between bOM and mOM a receiver operating characteristic analysis was implemented.ResultsThe MAV in the mOM group (2.71±1.04 m/s) was significantly higher than that of bOM group (1.27±0.87 m/s) (p<0.001). Using 1.97 m/s as a cut-off yielded a sensitivity and specificity of 76.9% and 85.4%, respectively, in diagnosing mOM (area under the curve=0.851, 95% CI=0.774 to 0.928).ConclusionARFI elastography is feasible in the omentum and may represent a good non-invasive additional tool in differentiating bOM from mOM.

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“…Так, в многочисленных исследованиях было показано, что при случайно обнаруженных мезентериальных патологиях ARFI в сочетании с особенностями УЗИ в B-режиме (TUS) и паттернами изменения перфузии при CEUS может помочь в разработке диагностических алгоритмов. Однако при наличии злокачественного заболевания или клинического подозрения на злокачественное заболевание брыжейки КТ с контрастированием, ПЭТ-КТ и биопсия с гистологической верификацией продолжают оставаться методом визуализации с наивысшей диагностической эффективностью [88,89].…”

Section: инструментальная диагностикаunclassified

Sclerosing mesenteritis as a surgical problem: a review of the literature and own clinical observation

Bogachev,

Boldin,

Golosnitskiy

et al. 2024

Ambulatornaya khirurgiya

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The problem of studying the pathology of mesenteric fat of the small intestine in surgical practice has not yet received enough attention. A number of questions remain unresolved regarding the etiology and pathogenesis of mesenteric diseases, their possible connection with benign and malignant diseases, methods of their laboratory and instrumental diagnosis, possible options for conservative and surgical treatment, as well as systematization and structuring of the classification. One of the poorly studied representatives of diseases of the mesentery of the small intestine continues to be Sclerosing mesenteritis, characterized by various histological variants of damage to mesenteric fat and a varied nonspecific clinical picture. Taken together, this leads to certain difficulties in diagnosis, patients seeking access to doctors of various profiles, which ultimately negatively affects the results of treatment and can lead to social maladjustment and possible disability. Reports on the occurrence of this pathology in the medical literature are few and, as a rule, describe extremely rare clinical cases. However, in recent years, the frequency of detection of this pathology continues to grow steadily, which is associated with the progressive aging of the population, a high degree of surgical activity in relation to urgent diseases of the abdominal organs, and the improvement of instrumental diagnostic methods. Issues of etiology, pathogenesis, differential diagnosis of this disease and its possible connection with the paraneoplastic process currently continue to cause debate. Further accumulation of clinical experience, a better understanding of the pathogenesis of the disease, and improvement of imaging techniques will allow us to develop clearer diagnostic and clinical criteria, narrow the diagnostic search and, ultimately, improve and standardize treatment. The article provides a review of the literature on this rare surgical pathology, presents our own clinical observation, and discusses diagnostic issues and treatment options for this disease.

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Diagnostic Performance of Point Shear Wave Elastography (pSWE) Using Acoustic Radiation Force Impulse (ARFI) Technology in Mesenteric Masses: A Feasibility Study

Cited by 3 publications

References 43 publications

Acoustic Radiation Force Impulse (ARFI) Elastography of Focal Splenic Lesions: Feasibility and Diagnostic Potential

Acoustic Radiation Force Impulse (ARFI) Elastography of Focal Splenic Lesions: Feasibility and Diagnostic Potential

ARFI elastography of the omentum: feasibility and diagnostic performance in differentiating benign from malignant omental masses

Sclerosing mesenteritis as a surgical problem: a review of the literature and own clinical observation

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