Shear-wave elastography in breast ultrasonography: the state of the art

Youk, Ji Hyun; Gweon, Hye Mi; Son, Eun Ju

doi:10.14366/usg.17024

Cited by 150 publications

(128 citation statements)

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“…29 Ultrasound (US) imaging is extensively used to assess the elastic properties of tissues. [30][31][32][33][34] Its low cost and relative easy access when compared with magnetic resonance imaging (MRI) could explain its application in different fields of medicine, for example hepatology 30 and mastology. 33 A recent review has specifically addressed the use of US imaging to quantify masseter muscle hardness.…”

Section: A Ss E Ss Ment Of Muscle Hardne Ssmentioning

confidence: 99%

Muscle hardness and masticatory myofascial pain: Assessment and clinical relevance

Costa

Ariji

Ferreira

et al. 2018

J of Oral Rehabilitation

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The impression of increased muscle hardness in painful muscles is commonly reported in the clinical practice but may be difficult to assess. Therefore, the aim of this review was to present and discuss relevant aspects regarding the assessment of muscle hardness and its association with myofascial temporomandibular disorder (TMD) pain. A non-systematic search for studies of muscle hardness assessment in patients with pain-related TMDs was carried out in PubMed, Cochrane Library, Embase and Google Scholar. Mechanical devices and ultrasound imaging (strain and shear wave elastography) have been consistently used to measure masticatory muscle hardness, although an undisputable reference standard is yet to be determined. Strain elastography has identified greater masseter hardness of the symptomatic side in patients with unilateral myofascial TMD pain when compared to the contralateral side and healthy controls (HC). Likewise, shear wave elastography has shown greater masseter elasticity modulus in patients with myofascial TMD pain when compared to HC, which may be an indication of muscle hardness. Although assessment bias could partly explain these preliminary findings, future randomised controlled trials are encouraged to investigate this relationship. This qualitative review indicates that the muscle hardness of masticatory muscles is still a rather unexplored field of investigation with a good potential to improve the assessment and potentially also the management of myofascial TMD pain. Nonetheless, the current evidence in favour of increased hardness in masticatory muscles in patients with myofascial TMD pain is weak, and the pathophysiological importance and clinical usefulness of such information remain unclear.

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Section: A Ss E Ss Ment Of Muscle Hardne Ssmentioning

confidence: 99%

Muscle hardness and masticatory myofascial pain: Assessment and clinical relevance

Costa

Ariji

Ferreira

et al. 2018

J of Oral Rehabilitation

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Section: We Can Distinguish Two Types Of Elastographymentioning

confidence: 99%

“…When lesions are harder like cancers, the stiffness area which sorrounds the mass on SWE corresponds in most cases to the echogenic halo identified on B-mode [18,37,38]. When it is too hard to propagate the shear wave the central area of the lesion and appears without a color code [17,37].…”

Section: E Score 5 (E5)mentioning

confidence: 99%

“…Also very fibrous breasts with absence of adipose tissue arround can complicate the results. However, sometimes the compression applied can be excessive and we can see an artificial or artefactual stiffness is seen codified into yellow or red color, generally radiating from the skin surface [18].For the accomplishment of this article I have reviewed several studies that I believe have been determinant for the validation of this ultrasound technique. With SWE, a quantitative measure of the lesion stiffness is obtained either in an FOV or pixel by pixel using a color map.…”

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confidence: 99%

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Breast Elastography: Present and Future

Fernadez¹

2017

IJRRT

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Objective: Make a literature review of breast elastography, an imaging technique not so new today, for many still unknown in diagnostic ultrasound, which emerges in order to characterize complementarily tissues of the breast, contributing to differential diagnosis between benign and malignant lesions.Review: Today breast cancer is by far the most common cancer in women. Mammography and ultrasound has become an indispensable diagnostic tandem within the breast image, increasing the sensitivity of ultrasound mammography by 15% and both techniques are able to characterize most breast lesions. Using these techniques together we achieve a sensitivity of 85-100% and a specificity of 76-80%, specially in dense breasts where mammography is significantly limited [1]. Copyright: ©2017 Fernadez Keywords: We can distinguish two types of elastographyCompression elastography and "shear-wave" elastography (SWE).Compression elastography (strain) produces an image based on the displacement of the tissue from an external or patient source, and the movement of the tissue shows the direction of US beam propagation. This technique allows a qualitative assessment of the lesion. With real-time ultrasound elastography, the physical properties of soft tissue are revealed through characterization of the differences in stiffness between the region of interest and the surrounding tissue based on mechanically induced deformation (strain) of structures during B-mode scanning [8].Data acquisition and interpretation of elasticity images are largely dependent on the examiner´s experience, and significant interobserver variability has been found [3,4,13,14]. The real-time elastogram is displayed with a scale based on the relative strain of the tissues. The technique to obtain the optimal images varies with the algorithm used by the manufacturer of the ultrasound system. Monitoring of the B-mode image to confirm the lesion is only displaced in depth during scanning and otherwise moving in the field of view (FOV) will allow optimal images. With the displacement technique, one cannot be surveying the breast; scanning must be done in one stationary position.Modern US devices allow combined elasticity and 2D real time assessment of tissues or lesions, using the same probe as conventional ultrasound imaging [15]. Sonoelastography demonstrates the elasticity of a lesion related to the elasticity of the surrounding tissue [13], so the final result is based on the comparison between pre and postcompression data [10,15,16], however it´s difficult with this technique to amount of the stress during the compression process.In contrast to strain elastography, SWE uses an acoustic radiation force impulse created by a focused ultrasound beam, which allows measurement of the propagation speed of shear waves within the tissue to locally quantify its stiffness in kilopascals or m/s. Because the speed of sound through tissues is dependent on the "stiffness" of these tissues, a quantitative value of the stiffness can be obtained, shear wave velocity is propo...

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“…Among them, shear wave elastography (SWE) recently has become available on multiple systems and is attractive due to its 2D imaging capability and quantitative nature. Because of the unique tissue mechanical information provided, numerous clinical studies have demonstrated the clinical utility of ultrasound elastography, such as in liver, breast, prostate, kidney, pancreas, and musculoskeletal (MSK) applications 6, 7, 8, 9, 10, 11. For example, 2D SWE was shown to have high sensitivity in the assessment of liver fibrosis 12.…”

Section: Introductionmentioning

confidence: 99%

Clinical acceptance testing and scanner comparison of ultrasound shear wave elastography

Long

Tradup

Song

et al. 2018

J Applied Clin Med Phys

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Because of the rapidly growing use of ultrasound shear wave elastography (SWE) in clinical practices, there is a significant need for development of clinical physics performance assessment methods for this technology. This study aims to report two clinical medical physicists’ tasks: (a) acceptance testing (AT) of SWE function on ten commercial ultrasound systems for clinical liver application and (b) comparison of SWE measurements of targets across vendors for clinical musculoskeletal application. For AT, ten GE LOGIQ E9 XDclear 2.0 scanners with ten C1‐6‐D and ten 9L‐D transducers were studied using two commercial homogenous phantoms. Five measurements were acquired at two depths for each scanner/transducer pair by two operators. Additional tests were performed to access effects of different coupling media, phantom locations and operators. System deviations were less than 5% of group mean or three times standard deviation; therefore, all systems passed AT. A test protocol was provided based on results that no statistically significant difference was observed between using ultrasound gel and salt water for coupling, among different phantom locations, and that interoperator and intraoperator coefficient of variation was less than 3%. For SWE target measurements, two systems were compared — a Supersonic Aixplorer scanner with a SL10‐2 and a SL15‐4 transducer, and an abovementioned GE scanner with 9L‐D transducer. Two stepped cylinders with diameters of 4.05–10.40 mm were measured both longitudinally and transaxially. Target shear wave speed quantification was performed using an in‐house MATLAB program. Using the target shear wave speed deduced from phantom specs as a reference, SL15‐4 performed the best at the measured depth. However, it was challenging to reliably measure a 4.05 mm target for either system. The reported test methods and results could provide important information when dealing with SWE‐related tasks in the clinical environment.

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Shear-wave elastography in breast ultrasonography: the state of the art

Cited by 150 publications

References 61 publications

Muscle hardness and masticatory myofascial pain: Assessment and clinical relevance

Muscle hardness and masticatory myofascial pain: Assessment and clinical relevance

Breast Elastography: Present and Future

Clinical acceptance testing and scanner comparison of ultrasound shear wave elastography

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