Stiffness and Anisotropy Effect on Shear Wave Elastography: A Phantom and in Vivo Renal Study

Leong, Sook Sam; Wong, Jeannie Hsiu Ding; Shah, Mohammad Nazri Md; Vijayananthan, Anushya; Jalalonmuhali, Maisarah; Sharif, Nur Hidayati Mohd; Abas, Nurul Khairyah; Ng, Kwan Hoong

doi:10.1016/j.ultrasmedbio.2019.08.011

Cited by 32 publications

(17 citation statements)

References 34 publications

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“…Our cut‐off stiffness value was lower compared to the value suggested by Koc and Sumbul (7.92 kPa) 32 . This discrepancy might be attributable to the difference in transducer position to anisotropic renal structures 20 . Based on the figures displayed in the study conducted by Koc and Sumbul, the ROI box was not fixed at the mid‐region of the renal cortex (shear wave propagated perpendicular to the pyramid axis), and therefore, could be the cause of the discrepancy in the cut‐off stiffness value compared to our results 32 …”

Section: Discussioncontrasting

confidence: 84%

“…Although Hu et al recruited a large sample size in their study (n = 163), the location of ROI during SWE acquisition was not mentioned 14 . Based on our previous research, slight changes in ROI location during SWE acquisition could impact measured stiffness values, due to tissue anisotropy effect 20 …”

Section: Discussionmentioning

confidence: 93%

“…A region of interest (ROI) with a fixed size of 0.5 × 0.8 × 0.02 cm 3 was positioned at the mid-region of the outer renal cortex, ensuring that the shear waves were perpendicular to the main ultrasound beam, vasa recta and loops of Henle. 20 The SWE stiffness values were quantified in kPa and were measured five times at the mid-region of the biopsied kidney. The mean kPa of each kidney was recorded ( Figure 1).…”

Section: Renal Biopsy and Histological Evaluationmentioning

confidence: 99%

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Shear wave elastography accurately detects chronic changes in renal histopathology

et al. 2020

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Aim: Renal biopsy is the gold standard for the histological characterization of chronic kidney disease (CKD), of which renal fibrosis is a dominant component, affecting its stiffness. The aim of this study was to investigate the correlation between kidney stiffness obtained by shear wave elastography (SWE) and renal histological fibrosis. Methods: Shear wave elastography assessments were performed in 75 CKD patients who underwent renal biopsy. The SWE-derived estimates of the tissue Young's modulus (YM), given as kilopascals (kPa), were measured. YM was correlated to patients' renal histological scores, broadly categorized into glomerular, tubulointerstitial and vascular scores. Results: Young's modulus correlates significantly with tubulointerstitial score (ρ = 0.442, P < .001) and glomerular score (ρ = 0.375, P = .001). Patients with no glomerular sclerosis showed lower mean YM measurements compared to those with glomerular sclerosis. The mean YM increased as the percentage of interstitial fibrosis and tubular atrophy increased. The area under the receiver operating characteristic curve (ROC) for SWE in differentiating between mildly and moderately impaired kidneys was 0.702. Conclusion: Shear wave elastography accurately detects chronic renal damage resulting from glomerular sclerosis, interstitial fibrosis and tubular atrophy, using the optimal cutoff YM value of ≥5.81 kPa.

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Section: Discussioncontrasting

confidence: 84%

Section: Discussionmentioning

confidence: 93%

Section: Renal Biopsy and Histological Evaluationmentioning

confidence: 99%

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Shear wave elastography accurately detects chronic changes in renal histopathology

et al. 2020

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“…In SWE of the kidney, anatomic anisotropy of the kidney parenchyma can affect shear waves propagation speed and result the inconsistent SWE values (Gennisson et al, 2012;Leong et al, 2020). In our study, SWE in the renal medulla was unreliable because of its heterogeneity in the color and propagation maps.…”

Section: Effects Of the Technical Factors On Sws Measurement In Abdomenmentioning

confidence: 66%

Two-Dimensional Shear Wave Elastography of Normal Soft Tissue Organs in Adult Beagle Dogs; Interobserver Agreement and Sources of Variability

Jung

Lee

et al. 2020

Front. Bioeng. Biotechnol.

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Shear wave elastography (SWE) induces lateral shear wave through acoustic pulses of the transducer and evaluates tissue stiffness quantitatively. This study was performed to evaluate feasibility and reproducibility of two-dimensional shear wave elastography (2D SWE) for evaluation of tissue stiffness and to examine technical factors that affect shear wave speed (SWS) measurements in adult dogs. Nine healthy, 2 yearold, adult beagles with the median weight of 9.8 kg were included. In this prospective, experimental, exploratory study, 2D SWE (Aplio 600) from the liver, spleen, kidneys, pancreas, prostate, lymph nodes (submandibular, retropharyngeal, axillary, medial iliac, and inguinal), submandibular salivary gland, and thyroid was performed in anesthetized beagles. Color map was drawn and SWS of each SWE were measured as Young's modulus (kPa) and shear wave velocity (m/s). The effect of measuring site, scan approach, depth, and anesthesia on SWE was assessed in abdominal organs by two observers independently. A total of 27 SWE examinations were performed in 12 organs by each observer. All SWS measurements were preformed successfully; however, SWE in the renal medulla could not be successfully conducted, and it was excluded from further analysis. Interobserver agreement of SWE was moderate to excellent in all organs, except for the left liver lobe at 10-15 mm depth with the intercostal scan. In the liver, there was no significant effect of the measuring site and scan approach on SWE. SWS of the liver and spleen tended to be higher with increasing the depth, but no significant difference. However, anesthesia significantly increased tissue stiffness in the spleen compared to awake dog regardless of the depth (P < 0.05). There was a significant difference in SWS according to the measuring site in the kidneys and pancreas (P < 0.001). 2D SWE was feasible and highly reproducible for the estimation of tissue stiffness in dogs. Measuring site and anesthesia are sources of variability affecting SWE in abdominal organs. Therefore, these factors should be considered during SWS measurement in 2D SWE. This study provides basic data for further studies on 2D SWE on pathological conditions that may increase tissue stiffness in dogs.

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“…The consequence of anisotropy of the renal structure is represented by the influence on the kidney stiffness measured using elastography [19]. The results are influenced Renal Elastography for the Assessment of Chronic Kidney Disease DOI: http://dx.doi.org/10.5772/intechopen.102076 by the relationship between the direction of the ultrasound main axis and the renal pyramid axis.…”

Section: Methods Descriptionmentioning

confidence: 99%

Renal Elastography for the Assessment of Chronic Kidney Disease

Bob¹

2022

Elastography - Applications in Clinical Medicine

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For the assessment of chronic kidney disease, point shear wave elastography (pSWE) and shear wave speed imaging (2D-SWE) are suitable, but the use of elastography in the assessment of the kidneys is more difficult compared to the use in other organs, because of the complex architecture of the kidneys, characterized by a high anisotropy and also by the limited size of the renal parenchyma, where the measurements are performed. Despite the difficulties of renal elastography, the reproducibility of the method is good. Kidney shear wave speed values are influenced mainly by age and gender, while in chronic kidney disease, renal stiffness is sometimes decreased in more advanced disease and is not influenced mainly by the progression of fibrosis. There are studies proving that a decreased renal blood flow is associated with a decrease in kidney shear wave speed, the fact that could explain why patients with CKD tend to have lower kidney stiffness. Elastography is a real-time imaging method that could be useful in the assessment of the kidneys, but more extensive studies and even some improvements of the processing algorithms of raw data of elastography machines seem to be needed to implement the use in clinical practice.

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Stiffness and Anisotropy Effect on Shear Wave Elastography: A Phantom and in Vivo Renal Study

Cited by 32 publications

References 34 publications

Shear wave elastography accurately detects chronic changes in renal histopathology

Shear wave elastography accurately detects chronic changes in renal histopathology

Two-Dimensional Shear Wave Elastography of Normal Soft Tissue Organs in Adult Beagle Dogs; Interobserver Agreement and Sources of Variability

Renal Elastography for the Assessment of Chronic Kidney Disease

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