Usefulness of acoustic radiation force impulse elastography in the differential diagnosis of benign and malignant solid pancreatic lesions

Park, Min Kyoung; Jo, Jeong-Hyun; Kwon, Heejin; Cho, Jin Han; Oh, Jong Keon; Noh, Myung Hwan; Nam, Kyung Jin

doi:10.14366/usg.13017

Cited by 56 publications

(46 citation statements)

References 27 publications

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“…A study reported the usefulness of VTQ for differential diagnosis between malignant and benign pancreatic tumors [41] , and another reported the usefulness of VTQ for diagnosis of acute pancreatitis [42] . There is also a study reporting the possibility of discriminating serous cyst fluid from mucinous one [43] .…”

Section: Us-elastography -Shear Wave Elastograhymentioning

confidence: 99%

Elastography for the pancreas: Current status and future perspective

Kawada¹,

Tanaka²

2016

WJG

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Elastography for the pancreas can be performed by either ultrasound or endoscopic ultrasound (EUS). There are two types of pancreatic elastographies based on different principles, which are strain elastography and shear wave elastography. The stiffness of tissue is estimated by measuring the grade of strain generated by external pressure in the former, whereas it is estimated by measuring propagation speed of shear wave, the transverse wave, generated by acoustic radiation impulse (ARFI) in the latter. Strain elastography is difficult to perform when the probe, the pancreas and the aorta are not located in line. Accordingly, a fine elastogram can be easily obtained in the pancreatic body but not in the pancreatic head and tail. In contrast, shear wave elastography can be easily performed in the entire pancreas because ARFI can be emitted to wherever desired. However, shear wave elastography cannot be performed by EUS to date. Recently, clinical guidelines for elastography specialized in the pancreas were published from Japanese Society of Medical Ultrasonics. The guidelines show us technical knacks of performing elastography for the pancreas. Core tip: Elastography for the pancreas had been considered to be difficult to perform with adequate accuracy and reproducibility because the pancreas is a small organ located deep in center of the human body. This review introduces the recent innovation of elastography for the pancreas, and makes recommendations on how to use various elastographic modalities for the pancreas. The review also shows us what we can know by performing elastography for the pancreas. Elastography may be a promising imaging modality for differential diagnosis between malignant and benign pancreatic tumors, for early diagnosis of chronic pancreatitis, and for identifying high-risk patients for pancreatic cancer. TOPIC HIGHLIGHTKawada N, Tanaka S. Elastography for the pancreas: Current status and future perspective.

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Section: Us-elastography -Shear Wave Elastograhymentioning

confidence: 99%

Elastography for the pancreas: Current status and future perspective

Kawada¹,

Tanaka²

2016

WJG

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“…Currently, ARFI and SWEI methods have been implemented on Siemens Acuson ultrasound scanner as Virtual Touch Tissue Imaging and Virtual Touch Tissue Quantification, respectively [8]. Both techniques have been demonstrated useful for diagnosing pancreatic tumor, pancreatic fibrosis, and pancreatitis [14]–[17]. Although non-invasive, making these two methods appropriate for screening asymptomatic patients, their successful application in the abdominal organs faces a unique challenge: they are sensitive to physiologic motion [14].…”

Section: Introductionmentioning

confidence: 99%

Harmonic motion imaging for abdominal tumor detection and high-intensity focused ultrasound ablation monitoring: an in vivo feasibility study in a transgenic mouse model of pancreatic cancer

Chen

Hou

Han

et al. 2015

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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Harmonic motion imaging (HMI) is a radiation force-based elasticity imaging technique that tracks oscillatory tissue displacements induced by sinusoidal ultrasonic radiation force to assess relative tissue stiffness. The objective of this study was to evaluate the feasibility of HMI in pancreatic tumor detection and high-intensity focused ultrasound (HIFU) treatment monitoring. The HMI system consisted of a focused ultrasound transducer, which generated sinusoidal radiation force to induce oscillatory tissue motion at 50 Hz, and a diagnostic ultrasound transducer, which detected the axial tissue displacements based on acquired radiofrequency signals using a 1D cross-correlation algorithm. For pancreatic tumor detection, HMI images were generated for pancreatic tumors in transgenic mice and normal pancreases in wild-type mice. The obtained HMI images showed a high contrast between normal and malignant pancreases with an average peak-to-peak HMI displacement ratio of 3.2. Histological analysis showed that no tissue damage was associated with HMI when it was used for the sole purpose of elasticity imaging. For pancreatic tumor ablation monitoring, the focused ultrasound transducer was operated with a higher acoustic power and longer pulse length than that used in tumor detection to simultaneously induce HIFU thermal ablation and oscillatory tissue displacements, allowing HMI monitoring without interrupting tumor ablation. HMI monitoring of HIFU ablation found significant decreases in the peak-to-peak HMI displacements before and after HIFU ablation with a reduction rate ranging from 15.8% to 57.0%. The formation of thermal lesions after HIFU exposure was confirmed by histological analysis. This study demonstrated the feasibility of HMI in abdominal tumor detection and HIFU ablation monitoring.

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“…The lesion detection rate and diagnostic rate could be improved to over 90% by the combined use of B-mode and elastographic images, compared to using b-mode images alone (Uchida et al, 2009;Park et al, 2014). This technique has been reported to be useful in characterizing and differentiating normal pancreas, chronic pancreatitis and acute pancreatitis.…”

Section: Primary Applications Of Elastographymentioning

confidence: 99%

“…Higher ARFI values in acute pancreatitis are due to increased fluid content in the inflamed organ making the tissue hard (Mateen et al, 2012). Another study (Janssen et al, 2007) concluded that chronic pancreatitis and hard tumors cannot be distinguished by elastography, probably because of their similar fibrous structure and calcification, leading to high ARFI values (Janssen et al, 2007;Park et al, 2014).…”

Section: Primary Applications Of Elastographymentioning

confidence: 99%

Elastography: Principles and considerations for clinical research in veterinary medicine cibele

Figueira¹,

Thassila²,

Maria³

2015

J. Vet. Med. Anim. Health

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Since the beginning of medicine, palpation has been the primary semiologic method used to detect abnormalities during clinical examination. The mechanical properties of soft tissues are usually related to changes in stiffness. However, changes in stiffness and echogenicity of soft tissues are not always correlated. Elastography has emerged in the last decade as a new method that, when used in association with ultrasonography, can provide information about the acoustic properties (echogenicity and texture) and mechanical attributes (stiffness) of a region of interest in a specific tissue. The objective of this article is to review the literature on the physical principles of elastography and to describe several features of the elastographic imaging process to provide a better understanding of this new technique and its potential utilization in the veterinary field.

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Usefulness of acoustic radiation force impulse elastography in the differential diagnosis of benign and malignant solid pancreatic lesions

Cited by 56 publications

References 27 publications

Elastography for the pancreas: Current status and future perspective

Elastography for the pancreas: Current status and future perspective

Harmonic motion imaging for abdominal tumor detection and high-intensity focused ultrasound ablation monitoring: an in vivo feasibility study in a transgenic mouse model of pancreatic cancer

Elastography: Principles and considerations for clinical research in veterinary medicine cibele

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