Quantitative Elastography of Rectal Lesions: The Value ofShear Wave Elastography in Identifying Benign and Malignant Rectal Lesions

Li, Tingting; Lu, Man; Li, Yuan; Li, Juan; Hu, Ziyue; Xu, Li; Cheng, Xueqing; Jiang, Jingzhen; Tan, Bo

doi:10.1016/j.ultrasmedbio.2018.09.008

Cited by 12 publications

(16 citation statements)

References 16 publications

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“…It was first used in GI diseases in 2013 by Dillman et al (10), who conducted a Crohn's disease animal model. Several studies have reported the value of using SWE, especially in inflammatory bowel disease (IBD) and rectal neoplasms (10)(11)(12)(13)(14)(15)(16)(17)(18)(19). For instance, it has proven effective in the differentiation of fibrotic from inflammatory strictures in Crohn's disease (14,18) and in assessing and staging rectal tumors (12,13,15).…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have reported the value of using SWE, especially in inflammatory bowel disease (IBD) and rectal neoplasms (10)(11)(12)(13)(14)(15)(16)(17)(18)(19). For instance, it has proven effective in the differentiation of fibrotic from inflammatory strictures in Crohn's disease (14,18) and in assessing and staging rectal tumors (12,13,15). However, there are only a few studies of SWE involving healthy subjects, especially trans-abdominally (20), and the normal elasticity values of the bowel wall measured by SWE remain uncertain (18,(21)(22)(23)(24)(25).…”

Section: Introductionmentioning

confidence: 99%

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Using shear wave elasticity in normal terminal ileum of a healthy southwest Chinese population: a pilot study of reference elasticity ranges

Zhao

Gao²,

Zhuang

et al. 2021

Quant Imaging Med Surg

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Background: Elastography has not been widely applied to the gastrointestinal tract. The bowel wall's normal elasticity values are still unknown and are necessary for studies of gastrointestinal diseases. This study explores the feasibility of using shear wave elastography (SWE) to measure the terminal ileum wall stiffness in healthy subjects and establish the corresponding normal ranges of elasticity values.Methods: This observational study recruited 139 healthy adult volunteers from April to July 2020.All examinations were performed in the anterior terminal ileum wall. Shear wave velocity (SWV) and Young's modulus (E) values were measured in the midline on longitudinal sections and replicated different operators' obtained data. Also, bowel wall thickness (BWT) and depth were recorded. Subgroups were classified according to the volunteers' gender, age, body mass index (BMI), BWT, and depth. The intra-class correlation coefficient was calculated to analyze inter-and intra-operator consistency, and independent t-tests and one-way analysis of variance were used to explore the differences in variables. Results:The inter-and intra-operator agreements were good to excellent by different operators and in the replicated measurements (intra-operator consistency: 0.963; inter-operator consistency: 0.842). In all volunteers, the mean SWV was 1.08±0.25 m/s, the mean E value was 3.84±1.84 kPa, and the median BWT was 2 mm. SWV and E did not show significant differences according to gender (P=0.589), age (P=0.738), BMI (P=0.678), depth (P=0.375), or BWT (P=0.410). BWT did not show significant differences according to age (P=0.142), BMI (P=0.863), or depth (P=0.368).Conclusions: SWE can be used in terminal ileum wall stiffness measurements with good reliability, and the SWE values do not appear to vary significantly according to different physiological factors. The corresponding elasticity ranges of the terminal ileum in normal adults were acquired.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using shear wave elasticity in normal terminal ileum of a healthy southwest Chinese population: a pilot study of reference elasticity ranges

Zhao

Gao²,

Zhuang

et al. 2021

Quant Imaging Med Surg

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“…Accurate staging of rectal cancer influences treatment decision, morbidity, and mortality [ 4 , 5 , 6 , 7 ]. Waage et al reported that strain ratio measurements in strain elastography were significantly different between adenomas and adenocarcinomas.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasound Elastography in the Assessment of Rectal Tumors: How Well Does It Work in Clinical Practice?

et al. 2021

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Endorectal ultrasound applications in the evaluation of rectal tumors could be a useful tool in achieving proper staging of rectal cancer. The purpose of this study was to compare the efficacy of rectal tumor staging by flexible endoscopic ultrasound (EUS) with real-time elastography (RTE) using the gold standard post-surgery histological analysis of the resected tissue as the control. The second aim of our research was to establish cutoff values for the EUS-RTE strain ratio corresponding to stages by independently comparing the stiffness values obtained with histology and EUS-RTE staging in order to minimize observation bias. We evaluated the records of 130 patients with a rectal tumor confirmed by biopsy. EUS was used in 70 patients, EUS-RTE—in the other 60. We found no statistically significant differences in staging accuracy when comparing EUS to EUS-RTE. Through a correspondence method between staging assessment and the EUS-RTE stain ratio, we identified cutoff intervals for T2, T3, and T4 staging that were nonoverlapping and proved to be statistically significant in terms of EUS-RTE values (significantly different ascending values from one interval to the other). We found that EUS-RTE offers slightly better, although not statistically significant sensitivity and specificity for T and N stage predictions compared to 2D EUS. Our results showed that EUS-RTE offers slightly higher sensitivity and specificity compared to EUS. Reliable cutoff intervals were found for strain rate elastography, previously available only for shear wave elastography (SWE) which is currently unavailable on any EUS system. Thus, these commonly available EUS-RTE systems can serve as a complementary tool in the staging of rectal tumors.

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“…One [22] used a pilot cohort to define a cut-off value for malignancy of ≥26.9 kPa and subsequently evaluated a validation cohort. The other study [21] defined lesions by color with predominantly red/yellow lesions considered to be an indication of malignancy and blue/green as benign.…”

Section: Study Characteristicsmentioning

confidence: 99%

Can Ultrasound Elastography Discriminate between Rectal Adenoma and Cancer? A Systematic Review

Loft

Pedersen

Rahr

et al. 2021

Cancers

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Background: Rectal cancer is a common malignancy. Since the introduction of bowel-screening programs, the number of patients with advanced adenomas and early rectal cancer has increased. Despite improved diagnostics, the discrimination between rectal adenomas and early rectal cancer (i.e., pT1–T2) remains challenging. The purpose of this systematic review was to evaluate the diagnostic performance of endorectal ultrasound (ERUS) elastography in discriminating rectal adenomas from cancer. Method: Using PRISMA guidelines, a systematic search was performed on PubMed, Embase, and MEDLINE databases. Studies evaluating the primary staging of rectal adenomas and cancer using ERUS elastography were included. Results: Six studies were identified; three evaluated the discrimination between adenomas and cancer; two evaluated adenomas and early rectal cancer (i.e., pT1–T2); one evaluated performance on different T categories. All studies reported increased diagnostic accuracy of ERUS elastography compared to ERUS. Sensitivity, specificity and accuracy ranged 0.93–1.00, 0.83–1.00 and 0.91–1.00, respectively, when discriminating adenomas from cancer. In the differentiation between adenomas and early rectal cancer, the sensitivity, specificity and accuracy were 0.82–1.00, 0.86–1.00 and 0.84–1.00, respectively. Conclusion: Elastography increases the accuracy of ERUS and may provide valuable information on malignant transformation of rectal lesions.

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Quantitative Elastography of Rectal Lesions: The Value ofShear Wave Elastography in Identifying Benign and Malignant Rectal Lesions

Cited by 12 publications

References 16 publications

Using shear wave elasticity in normal terminal ileum of a healthy southwest Chinese population: a pilot study of reference elasticity ranges

Using shear wave elasticity in normal terminal ileum of a healthy southwest Chinese population: a pilot study of reference elasticity ranges

Endoscopic Ultrasound Elastography in the Assessment of Rectal Tumors: How Well Does It Work in Clinical Practice?

Can Ultrasound Elastography Discriminate between Rectal Adenoma and Cancer? A Systematic Review

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