T1947 Real-Time Elastography - a Pilot Study for Non-Invasive Detection of Small Hepatocellular Carcinoma in Cirrhotic Patients

Gheorghe, Liana; Iacob, Speranţa; Iacob, Răzvan; Becheanu, Gabriel; Dumbravă, Mona; Gheorghe, Cristian; Simionov, Iulia; Lupescu, Ioana Gabriela; Popescu, Irinel

doi:10.1016/s0016-5085(08)63869-x

Cited by 6 publications

(6 citation statements)

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“…11 Real time elastography provides color coded images (blue, green and red) which reflect the elasticity of the liver lesions; however, the absence of a standardized quantitative measurement limits its usefulness in the evaluation of liver lesions. 12 ARFI elastography is a technique which provides both 2D images and numerical measurements of tissue stiffness. 13 It is performed under direct visual guidance and is a suitable method for the quantification of stiffness of focal liver lesions.…”

Section: Introductionmentioning

confidence: 99%

Role of acoustic radiation force impulse elastography and triphasic computed tomography in the evaluation of focal liver lesions

Goel¹

2016

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Background: The purpose of this study was to determine the enhancement patterns of focal liver lesions on triphasic CT and to evaluate the role of Acoustic Radiation Force Impulse (ARFI) elastography in the differentiation of benign from malignant liver lesions. Methods: A total of 38 patients (15 male, 23 female with mean age of 49.4 years) with focal liver lesions underwent triphasic CT and the enhancement patterns of the lesions were recorded. The patients were also evaluated with ARFI elastography using Virtual Touch Tissue quantification (VTQ) technique and shear wave velocity (SWV) values were obtained for quantification of their stiffness. The area under the curve and cutoff value for SWV were obtained using a receiver operating characteristic curve analysis. The findings were correlated with fine needle aspiration cytology or histopathology results. Results:Triphasic CT correctly diagnosed 96.2% of the malignant lesions (n=26) and 100% of the benign lesions (n=12). On ARFI elastography, there was a significant difference (p< 0.0001) between the SWV of the benign (mean ± SD = 1.775 ± 0.488 m/s) and malignant (mean ± SD = 3.271 ± 0.561 m/s) liver lesions. With a cutoff value of 2.44 m/s for shear wave velocity, the sensitivity, specificity, and area under the receiver operating characteristic curve for malignancy were 92.3 %, 91.7%, and 0.968 respectively. Conclusions: ARFI elastography is a promising technique that can noninvasively provide information regarding the tissue stiffness which along with triphasic CT is helpful in differentiating benign and malignant focal liver lesions.

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Section: Introductionmentioning

confidence: 99%

Role of acoustic radiation force impulse elastography and triphasic computed tomography in the evaluation of focal liver lesions

Goel¹

2016

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“…HCC lesions are typically stiffer than normal liver but the difference may be less pronounced when compared to cirrhotic liver in which the tumors typically occur [127]. Preliminary studies are promising for the identification of HCC with A z values as high as 0.94 [126, 288]. Recent work has also suggested that HCC may be distinguished from other malignancies such as cholangiocarcinoma and metastatic disease with reasonable accuracy using elasticity estimates [289].…”

Section: Clinical Applicationsmentioning

confidence: 99%

An Overview of Elastography-An Emerging Branch of Medical Imaging

Sarvazyan¹,

Hall²,

Urban³

et al. 2011

CMIR

363

239

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From times immemorial manual palpation served as a source of information on the state of soft tissues and allowed detection of various diseases accompanied by changes in tissue elasticity. During the last two decades, the ancient art of palpation gained new life due to numerous emerging elasticity imaging (EI) methods. Areas of applications of EI in medical diagnostics and treatment monitoring are steadily expanding. Elasticity imaging methods are emerging as commercial applications, a true testament to the progress and importance of the field. In this paper we present a brief history and theoretical basis of EI, describe various techniques of EI and, analyze their advantages and limitations, and overview main clinical applications. We present a classification of elasticity measurement and imaging techniques based on the methods used for generating a stress in the tissue (external mechanical force, internal ultrasound radiation force, or an internal endogenous force), and measurement of the tissue response. The measurement method can be performed using differing physical principles including magnetic resonance imaging (MRI), ultrasound imaging, X-ray imaging, optical and acoustic signals. Until recently, EI was largely a research method used by a few select institutions having the special equipment needed to perform the studies. Since 2005 however, increasing numbers of mainstream manufacturers have added EI to their ultrasound systems so that today the majority of manufacturers offer some sort of Elastography or tissue stiffness imaging on their clinical systems. Now it is safe to say that some sort of elasticity imaging may be performed on virtually all types of focal and diffuse disease. Most of the new applications are still in the early stages of research, but a few are becoming common applications in clinical practice.

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“…When only solid FLLs were evaluated, color maps showed an accuracy of 92.7% in defining FLL as metastatic, whereas when all types of nodules, including necrotic nodules, were included, only SWV had a positive predictive value (PPV) of 80% (using 2.5 m/s as cut-off) to discriminate between metastatic and nonmetastatic FLLs [22,23]. Regarding FLLs occurring on cirrhosis, Gheorge et al [24] demonstrated the utility of RT elastography in the discrimination between regenerative nodules and small HCC lesions by quantifying the resulting color map. However, in general, it is necessary to remark the influence of a cirrhotic background during elastography.…”

Section: Characterizationmentioning

confidence: 99%

Clinical Impact of Ultrasound-Related Techniques on the Diagnosis of Focal Liver Lesions

Salvatore

Bolondi

2012

Liver Cancer

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Since its introduction in clinical practice, ultrasound technology has greatly impacted patient management, particularly in the case of liver diseases, where hepatologists usually perform ultrasound examinations. Clinicians are increasingly aware of the great potential of ultrasound waves and of the recent innovations that exploit the mechanical properties of ultrasound waves. Thus, at present, not only B-mode ultrasound but also contrast-enhanced ultrasound and, more recently, elastosonography are used worldwide in various settings. This review aims to describe why clinicians should be aware of ultrasound-based techniques, how they should use these techniques for assessing focal liver lesions, and how these techniques impact patient management. We will review the clinical potential of ultrasound-related techniques, starting from lesion detection, moving to characterization, and concluding with their utility in guiding treatments and analyzing their effects.

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T1947 Real-Time Elastography - a Pilot Study for Non-Invasive Detection of Small Hepatocellular Carcinoma in Cirrhotic Patients

Cited by 6 publications

References 0 publications

Role of acoustic radiation force impulse elastography and triphasic computed tomography in the evaluation of focal liver lesions

Role of acoustic radiation force impulse elastography and triphasic computed tomography in the evaluation of focal liver lesions

An Overview of Elastography-An Emerging Branch of Medical Imaging

Clinical Impact of Ultrasound-Related Techniques on the Diagnosis of Focal Liver Lesions

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