Quantification of elasticity changes in the myometrium during labor using Supersonic Shear Imaging: A feasibility study

Gennisson, Jean‐Luc; Müller, Marie; Gábor, P; Frydman, René; Musset, D.; Tanter, Mickaël; Ami, O.

doi:10.1016/j.ultras.2014.07.013

Cited by 22 publications

(20 citation statements)

References 30 publications

(35 reference statements)

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“…US elastography is increasingly used for the diagnosis of stiffness in numerous circumscribed tissues [1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17]. To date, there has been a lack of phantom studies which have systematically assessed the current US shear wave elastography techniques (pSWE with fixed ROI vs. 2D-SWE with variable ROI) in an effort to evaluate their suitability/test performance for this condition.…”

Section: Discussionmentioning

confidence: 99%

“…Elastic properties of circumscribed tissues and organs that are not accessible to physicians' hands (a), or which require measurements in a small, localized area (b) are of considerable clinical interest [1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Examples are: tendons/ligaments a/b , lymph nodes a/b , myometria a , prostates b , cervix uteri b , testicles b , anal sphincter muscles b , arterial plaques a/b , muscles a , intervertebral discs a/b , thyroid nodules a/b , and brain tumors a/b .…”

Section: Introductionmentioning

confidence: 99%

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Intra- and inter-observer variation and accuracy using different shear wave elastography methods to assess circumscribed objects – a phantom study.

Seliger

Chaoui

Kunze³

et al. 2017

Med Ultrason

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Aims: The elastic properties of circumscribed tissues (e.g., tendons, lymph nodes, prostates, brain tumors) are of considerable clinical interest. The purpose of this study was thus to compare the Intra-/Inter-observer variation and accuracy in vitro of point shear wave elastography (pSWE) with that of 2D-SWE and to assess 2D-SWE’s precision with variable ROI (vROI) incircumscribed objects.Material and methods: Round targets (Elasticity QA Phantom Model 049) were examined for varying degrees of stiffness (8, 14, 45, and 80 kPa) and diameters (20/10 mm). Three ultrasound systems and four probes were applied (pSWE: Acuson/S3000 9L4/4C1 and Epiq7 C51, 2D-SWE: Aplio/500 PVT375BT). Three different ROIs were used, namely fixed ROI (fROI) and variable ROI: rectangular-best-fitted ROI, and round-best-fitted ROI. Each measurement was performed twice by four observers.Results: A total of 3,604 measurements were conducted. The intra-observer variation of 2D-SWE measurements indicated better agreement (Intraclass Correlation Coefficient (ICC) = 0.971; 95% CI=[0.945; 0.985]), than for the pSWE measurements (ICC = 0.872; 95% CI=[0.794; 0.92]). With both methods, the shear wave elastography applied showed low inter-observer variation: ICC = 0.980; 95% CI=[0.970; 0.987]. However, a significant difference was observed between fROI (pSWE) and vROI (2D-SWE) on circumscribed objects in terms of accuracy. The lowest degree of observationerror was detected in situations where the ROI was not “best fitted”, but placed within the target of 3mm from the border (target diameter: 20mm; mean relative error = 0.15).Conclusions: When estimating the elastic properties of circumscribed tissues, the different measurement techniques performed by commercial shear wave elastography systems reveal a strong susceptibility for observational errors, depending upon the fixed vs. variable ROI of the pSWE vs. 2D-SWE technique.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intra- and inter-observer variation and accuracy using different shear wave elastography methods to assess circumscribed objects – a phantom study.

Seliger

Chaoui

Kunze³

et al. 2017

Med Ultrason

View full text Add to dashboard Cite

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“…In a recent study, Gennisson at al. [26] assessed the elasticity changes in the myometrium during labor using the same technique. The sensitivity of the technique in cervical tissue was already reported in a previous study performed in animals [16].…”

Section: Discussionmentioning

confidence: 99%

Transient Elastography to Assess the Cervical Ripening during Pregnancy: A Preliminary Study

et al. 2015

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To explore the feasibility of transient elastography (TE) to quantify cervical stiffness changes during normal pregnancy and its spatial variability. TE was used to quantify the cervical stiffness in four anatomical regions. 42 women between 17 and 43 years of age and at 6 - 41 weeks of gestation were studied. The stiffness was related to gestational age at the time of examination, interval from ultrasound examination to delivery and cervical length to evaluate the potential of TE to assess cervical ripening. In addition, a sensitivity analysis based on Cronbach's alpha coefficient was carried out to assess the concordance between inter/intra-operator measurements. There were significant correlations between cervical stiffness measured in the four regions with gestational age and the remaining time for delivery. Results confirm stiffness variability within the cervix. No significant association was found between cervical length and stiffness in the four ROIs. Associations between gestational age and remaining time for delivery with cervical length present weaker correlations than with cervical stiffness. The external part of the cervix was significantly softer than the internal one, and these stiffness values vary significantly in the anterior compared to the posterior cervix. The measurements taken by the same and by two different observers for different regions in the cervix were reliable and reproducible. It is feasible to objectively quantify the decrease of cervical stiffness correlated to gestational age. Transient elastography is a valuable promising tool to provide additional information on the process of cervical effacement to that obtained from digital examination and conventional ultrasound. Further studies are needed to assess the feasibility of the technique in obstetric clinical applications, such as prediction of preterm birth or success in labor induction.

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“…It has been used in the examination of breast, thyroid and liver masses and for measuring cervix elasticity, placental insufficiency and in studying the myometrium during labor [27–29]. SWE uses acoustic radiation to generate a shear wave which is a cone-shaped force that is measured using high velocity ultrasound at around 5000 to 20,000 KHz [28].…”

Section: Discussionmentioning

confidence: 99%

“…The placenta has been examined as well to examine the elastic modulus of the placenta in comparison to other established measures of placental perfusion and is found to have potential for measurement of placental function [27]. Of note, a similar study on the myometrium using SWE to measure uterine contractions during labor used an elastogram window of 18 by 15 mm squared [29]. In another study, the resolution of ultrasound elastography has been reported to be as low as hundreds of microns, though it is not clear if this is possible in vivo [30].…”

Section: Discussionmentioning

confidence: 99%

Fetal membrane imaging and the prediction of preterm birth: a systematic review, current issues, and future directions

Nunes

Cross

Speich

et al. 2016

BMC Pregnancy Childbirth

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BackgroundPreterm premature rupture of membranes (PPROM) is the largest identifiable cause of preterm birth. There is currently no good screening test for PPROM in low-risk asymptomatic patients. Our goal was to identify how imaging methods can be utilized for examining the risks for PPROM in asymptomatic patients.MethodsThis paper is a systematic review of the literature on fetal membrane thickness and its use for the prediction of PPROM. Four key studies are identified and reviewed; two in vitro studies and two in vivo ultrasound studies each using differing methodologies. Additionally reviewed is a study using Optical Coherence Tomography, an emerging technique using near-infrared technology to produce high-resolution images.ResultsThere is currently insufficient data to determine the association between fetal membrane thickness and PPROM by ultrasound.ConclusionsFetal membrane thickness could have relevant clinical ramifications for the prediction of PPROM. Suggested improvements in study methodology and design will lead to progress in this area of research, as well as the use of newer technologies. Larger sample sizes, histological comparison, uniform methodologies for data collection, longitudinal study design and expanding data analysis beyond fetal membrane thickness to other properties would expand our knowledge in this field. In addition, transvaginal ultrasound should be utilized to improve resolution, as well as emerging methodologies such as MRI fusion imaging using ultrasound and Shear Wave Elastography.

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Quantification of elasticity changes in the myometrium during labor using Supersonic Shear Imaging: A feasibility study

Cited by 22 publications

References 30 publications

Intra- and inter-observer variation and accuracy using different shear wave elastography methods to assess circumscribed objects – a phantom study.

Intra- and inter-observer variation and accuracy using different shear wave elastography methods to assess circumscribed objects – a phantom study.

Transient Elastography to Assess the Cervical Ripening during Pregnancy: A Preliminary Study

Fetal membrane imaging and the prediction of preterm birth: a systematic review, current issues, and future directions

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