ShearWave Elastography for Chronic Liver fibrosis & hepatitis

http://onlinelibrary.wiley.com/doi/10.1002/hep.25936/abstract

Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: A pilot study

.                 Giovanna Ferraioli M.D.^1,†,*, Carmine Tinelli M.D.², Barbara Dal Bello M.D.³, Mabel Zicchetti M.D.¹, Gaetano Filice M.D.⁴, Carlo Filice M.D.¹, on behalf of the Liver Fibrosis Study Group, Elisabetta Above M.D.¹, Giorgio Barbarini M.D.⁴, Enrico Brunetti M.D.⁴, Willy Calderon M.D.⁴, Marta Di Gregorio M.D.¹, Raffaella Lissandrin M.D.⁴, Serena Ludovisi⁴, Laura Maiocchi M.D.⁴, Antonello Malfitano M.D.⁴, Giuseppe Michelone M.D.⁴, Mario Mondelli M.D.⁴, Savino F.A. Patruno M.D.⁴, Alessandro F. Perretti M.D.⁴, Gianluigi Poma M.D.¹, Paolo Sacchi M.D.⁴, Marco Zaramella M.D.⁴

DOI: 10.1002/hep.25936

Copyright © 2012 American Association for the Study of Liver Diseases

Issue

Hepatology

Accepted Article. These manuscripts have been accepted, but have not been edited or formatted. They will be published at a future date.

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Abstract

Real-time shear wave elastography (SWE) is a novel, noninvasive method to assess liver fibrosis by measuring liver stiffness. This single center study was conducted to assess the accuracy of SWE in patients with chronic hepatitis C in comparison with transient elastography (TE) by using liver biopsy (LB) as the reference standard.

Consecutive patients with chronic hepatitis C scheduled for liver biopsy by referring physicians were studied. One hundred twenty-one patients met inclusion criteria. On the same day real-time SWE using the ultrasound system Aixplorer™ (SuperSonic Imagine S.A., Aix-en-Provence, France), TE using FibroScan™ (Echosens, Paris, France) and ultrasound-assisted LB were consecutively performed. Fibrosis was staged according to METAVIR scoring system. Analyses of receiver operating characteristic curve were performed to calculate optimal area under the curve (AUROC) for F0-F1 versus F2-F4, F0- F2 versus F3-F4, and F0-F3 versus F4 for both real-time SWE and TE.

Liver stiffness values increased in parallel with the degree of liver fibrosis both with SWE and TE. AUROCs were 0.92 (95%CI,0.85-0.96) for SWE and 0.84 (95%CI,0.76-0.90) for TE (p=0.002); 0.98(95%CI,0.94-1.00) for SWE and 0.96 (95%CI,0.90-0.99) for TE (p=0.14); 0.98(95%CI,0.93-1.00) for SWE and 0.96 (95%CI,0.91-0.99) for TE (p=0.48) when comparing F0-F1 versus F2- F4; F0- F2 versus F3-F4; and F0 -F3 versus F4 respectively.

Conclusion.

The results of this study show that real-time SWE is more accurate than TE in assessing significant fibrosis (F≥2). With respect to TE, SWE has the advantage of imaging liver stiffness in real-time, while guided by a B-mode image. Thus, the region of measurement can be guided with both anatomical and tissue stiffness information. (Hepatology 2012.)

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SuperSonic Imagine introduces UltraFast Doppler technology

SuperSonic Imagine, the ultrasound company that pioneered breakthrough ShearWave™ Elastography technology, today announced another major breakthrough in ultrasound imaging: UltraFast™ Doppler. The company, based in Aix-en-Provence, France, unveiled this revolutionary technology at the World Federation for Ultrasoundin Medicine and Biology, Euroson and Ultraschall Meeting.
Color Flow Imaging and Pulsed Wave Doppler are well-established ultrasound tools that analyze blood flow and are critical to cardiovascular disease assessment and cancer diagnosis.
On Aixplorer's fully patented UltraFast imaging platform, UltraFast Doppler unites Color Flow Imaging with Pulsed Wave Doppler. The result is never-seen-before ultra-high frame rate Color Flow clips that are up to ten times faster than conventional Color Doppler. Remarkably, the same technology also acquires fully quantifiable Doppler data throughout the Color box, enabling the generation of post-processed Pulsed Wave Doppler spectra from multiple locations in the same image.
These new advances in Doppler technology introduce a new era of flow imaging, workflow efficiency and diagnostic confidence.
Peter Burns, Professor of Medical Biophysics at the University of Toronto and Senior Scientist at Sunnybrook Health Sciences Centre, Toronto commented, "This technology promises to overcome two challenges faced by vascular sonographers every day when they use conventional duplex scanners. First, conventional color frame rates are too low to show real arterial hemodynamics, with pathology often masked by aliasing artifacts and second, the pulsed Doppler examination is a separate and time consuming process of searching for the optimal signal. UltraFast Doppler provides high frame rates, less aliasing and the ability to show spectra at every point in a stored color loop. It provides more accurate flow imaging and will enable more effective workflow in the vascular lab."

source : www.news-medical.net , Published on August 26, 2011 at 8:13 AM

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