Strain Elastography Evaluation of Rectal Tumors: Inter- and Intraobserver Reproducibility

Waage, Jo Erling Riise; Rafaelsen, Søren Rafael; Borley, Neil; Havre, Roald Flesland; Gubberud, Espen; Leh, Sabine; Kolbro, Thomas; Hagen, K. K.; Eide, Geir Egil; Pfeffer, F.

doi:10.1055/s-0034-1398985

Cited by 19 publications

(19 citation statements)

References 10 publications

(11 reference statements)

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“…Amended versions of this visual score have been proposed for other organs, such as for the pancreas and lymph nodes by EUS elastography. Both the continuous visual analog scale (VAS) score and categorical visual scores for endoscopic assessment of rectal tumors has shown comparable results with SR measurements [23]. In a comparative study of SR and the five-point visual elastography breast scale, SR was more accurate.…”

Section: Discussionmentioning

confidence: 98%

Strain Ratio as a Quantification Tool in Strain Imaging

et al. 2018

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Ultrasound-based strain imaging is available in several ultrasound (US) scanners. Strain ratio (SR) can be used to quantify the strain recorded simultaneously in two different user-selected areas, ideally exposed to the same amount of stress. The aim of this study was to evaluate SR variability when assessed in an in-vitro setup with a tissue-mimicking phantom on resected tissue samples and in live tissue scanning with endoscopic applications. We performed an in vivo retrospective analysis of SR variability used for quantification of elastic contrasts in a tissue-mimicking phantom containing four homogenous inclusion in 38 resected bowel wall lesions and 48 focal pancreatic lesions. Median SR and the inter-quartile range (IQR) were calculated for all external and endoscopic ultrasound (EUS) applications. The IQR and median provide a measure of SR variability focusing on the two percentiles of the data closest to the median value. The overall SR variability was lowest in a tissue-mimicking phantom (mean QR/median SR: 0.07). In resected bowel wall lesions representing adenomas, adenocarcinomas, or Crohn lesions, the variability increased (mean IQR/Median: 0.62). During an in vivo endoscopic examination of focal pancreatic lesions, the variability increased further (mean IQR/Median: 2.04). SR variability increased when assessed for different targets with growing heterogeneity and biological variability from homogeneous media to live tissues and endoscopic application. This may indicate a limitation for the accuracy of SR evaluation in some clinical applications.

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Section: Discussionmentioning

confidence: 98%

Strain Ratio as a Quantification Tool in Strain Imaging

et al. 2018

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“…Also, we did not perform an interobserver and intraobserver study of the patients. However, Waage et al 25 have recently reported that rectal elastography is highly reproducible. At present, endorectal shear wave measurement is only available from one vendor, and with ERUS ARFI technique, it would also be possible to measure the elasticity of tumours .10 cm above the anal verge.…”

Section: Study Limitationsmentioning

confidence: 99%

Elastography and diffusion-weighted MRI in patients with rectal cancer

Rafaelsen¹,

Vagn-Hansen²,

Sørensen³

et al. 2015

BJR

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Objective: The current literature has described the usefulness of elastography and diffusion-weighted MRI in patients with cancer, but to the best of our knowledge so far none of them has compared the two new methods. The tumour cell density is related to the MRI-measured apparent diffusion-weighted coefficient (ADC). The purpose of the present study was to compare quantitative elastography based on ultrasound shear wave measurements with MRI ADC. Methods: We prospectively examined 52 patients with histopathologically proven rectal cancer. The mean age was 67 years (range 42-90 years). Males: 39, females: 13. Tumour elasticity was measured transgluteally using the acoustic radiation force impulse (ARFI) to generate information on the mechanical properties of the tissue. The objective quantitative elastography shear wave velocity was blindly compared with the ADC measurements using a 1.5-T MRI system. Results: The mean tumour elasticity was 3.05 m s

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“…Regarding endorectal elastography, there are still not enough studies to make firm statements. For now, the results are very promising in this regard [49].…”

Section: Gray Scale Us (2d 3d)mentioning

confidence: 87%

Endoscopic ultrasound for the characterization and staging of rectal cancer. Current state of the method. Technological advances and perspectives.

et al. 2015

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Endoscopic ultrasound is the most accurate type of examination for the assessment of rectal tumors. Over the years, the method has advanced from gray-scale examination to intravenous contrast media administration and to different types of elastography. The multimodal approach of tumors (transrectal, transvaginal) is adapted to each case. 3D ultrasound is useful for spatial representation and precise measurement of tumor formations, using CT/MR image reconstruction; color elastography is useful for tumor characterization and staging; endoscopic ultrasound using intravenous contrast agents can help study the amount of contrast agent targeted at the level of the tumor formations and contrast wash-in/wash-out time, based on the curves displayed on the device. The transvaginal approach often allows better visualization of the tumor than the transrectal approach. Performing the procedure with the rectal ampulla distended with contrast agent may be seen as an optimization of the examination methodology. All these aspects are additional methods for gray-scale endoscopic ultrasound, capable of increasing diagnostic accuracy. This paper aims at reviewing the progress of transrectal and transvaginal ultrasound, generically called endoscopic ultrasound, for rectal tumor diagnosis and staging, with emphasis on the current state of the method and its development trends.

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Strain Elastography Evaluation of Rectal Tumors: Inter- and Intraobserver Reproducibility

Abstract: Visual evaluation of elastography loops is highly reproducible in an offline setting with blinded observers, and correlates significantly with pT-stages. Strain elastography performs better than ERUS and might consequently improve staging.

Cited by 19 publications

References 10 publications

Strain Ratio as a Quantification Tool in Strain Imaging

Strain Ratio as a Quantification Tool in Strain Imaging

Elastography and diffusion-weighted MRI in patients with rectal cancer

Endoscopic ultrasound for the characterization and staging of rectal cancer. Current state of the method. Technological advances and perspectives.

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