http://www.ncbi.nlm.nih.gov/pubmed/23453381

Ultrasound Med Biol. 2013 Jun;39(6):935-40. doi: 10.1016/j.ultrasmedbio.2012.12.009. Epub 2013 Feb 27.

Quantitative shear wave elastography in the evaluation of metastatic cervical lymph nodes.

Choi YJ, Lee JH, Lim HK, Kim SY, Han MW, Cho KJ, Baek JH.

Source

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Abstract

Our aim was to compare the diagnostic performance of shear wave elastography (SWE) with that of gray-scale ultrasound (US) in differentiating metastatic from benign lymph nodes in patients with head and neck malignancies. Maximum shear elasticity modulus (maxSM) was measured on SWE. The reference standard was pathologic diagnosis after surgery. We examined 67 lymph nodes (34 metastatic, 33 benign) from 15 patients (8 men and 7 women; mean age, 54.2 years). The maxSM value was significantly higher for metastatic than benign lymph nodes (41.06 ± 36.34 kPa vs. 14.22 ± 4.19 kPa, p < 0.0001) at a cutoff level of 19.44 kPa. Accuracy, sensitivity and specificity were 94, 91 and 97%, respectively, for SWE, and 91, 88 and 94%, respectively, for gray-scale US. Multiple regression analysis showed that the maxSM value (r = 0.882) and gray-scale US criteria (r = 0.837) were independent variables. SWE may be a valuable quantitative reproducible method for characterizing cervical lymph nodes.

Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

PMID:

 

23453381

 

[PubMed - in process]

Eur J Radiol. 2012 Dec;81(12):3965-72. doi: 10.1016/j.ejrad.2012.09.002. Epub 2012 Sep 30.

A threshold value in Shear Wave elastography to rule out malignant thyroid nodules: a reality?

Veyrieres JB, Albarel F, Lombard JV, Berbis J, Sebag F, Oliver C, Petit P.

Source

Département d'imagerie médicale, Hôpital d'Instruction des Armées St Anne, Bd Saint Anne, BP 20545 Toulon cedex, France. jbveyrieres@hotmail.fr

Abstract

OBJECTIVES:

To evaluate the ability of a threshold value in ShearWave™ elastography to rule out malignant thyroid nodules while studying its pertinence in association with morphological signs. EQUIPMENT AND METHODS: 148 patients (110 women and 38 men; 52.5 y.o. 15.8) referred for surgery of thyroid nodules underwent standard ultrasound as well as elastography. Characteristics of the morphological signs and maximum elastographic index were calculated in relation to histology. Association of morphological signs alone and then of elastography was also evaluated. One hundred and fifty one nodules were studied on a double-blind basis.

RESULTS:

297 nodules were studied. Thirty-five cancers were detected (11.6%). Elastographic index was higher in malignant nodules (115 kPa 60.4) than in benign nodules (41 kPa 25.8) (p<0.001, Student's t-test). Cut off value of 66 kPa was the best to discriminate malignant nodules with a sensitivity of 80% (CI 95%, 62.5; 90.9) and a specificity of 90.5% (CI 95%, 86.1; 93.6) (p=0.0001). Association of elastography and morphological ultrasound signs presented a sensitivity of 97% (CI 95%, 83.3; 99.8) and a negative predictive value of 99.5% (CI 95%, 95.6; 99.9). Interobserver reproducibility proved to be excellent with an interclass correlation of 0.97 (CI 95%, 0.96; 0.98) (p<0.001).

CONCLUSION:

The 66 kPa threshold in Shear Wave elastography is the best ultrasound sign to rule out malignant thyroid nodules. The method is simple, quantitative, reproducible and usable in the study of nodules larger than 3 cm. Progress must still be made in the study of calcified nodules and follicular tumors.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Source : http://www.ncbi.nlm.nih.gov/pubmed/23031543

New guidance emerges on ultrasound for liver fibrosis

New guidance emerges on ultrasound for liver fibrosis

By AuntMinnieEurope.com staff writers

January 22, 2013 -- The Technology Assessment Centre (NTAC) of the U.K. National Health Service (NHS) has published a guide recommending that ultrasound elastography be performed instead of a biopsy for the diagnosis of liver fibrosis in a patient.

NTAC studied the implementation of ultrasound elastography within secondary care at three NHS trusts, or hospital groups. These included the King's College Hospital NHS Foundation Trust in London, the North West London Hospitals NHS Trust, and the East Cheshire NHS Trust.

The York Health Economic Consortium performed economic modeling based upon real life implementation costs. York estimated a gross savings of 520 pounds (618 euros) per diagnosis. When extrapolated across the NHS, this equates to an estimated savings of 14.3 million pounds (16.99 million euros) per annum.

FDA Clearance to Enhance ShearWave(TM) Elastography Imaging with a Real-Time Adjustable Numerical Scale (ANS)

FDA Clearance for ShearWave

a Gold Medal for Pr. Mathias Fink

The Ian Donald gold medal is awarded once a year to an individual who has made an outstanding scientific contribution to the field of Ultrasound in OB & GY.

This year, is awarded to Pr. Mathias Fink, one of SuperSonic Imagine's founders.

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.)