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Image-guided point-shear-wave elastography: a valid and reliable technique for liver fibrotic staging

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Abstract

Purpose

Despite progressive implementation of image-guided point-shear wave elastography (pSWE) in guidelines as an alternative to transient elastography for the staging of fibrotic liver disease, pSWE is not widely adopted in clinical workflow. More information on reliability and validity of pSWE systems is needed. Therefore, we performed a phantom study to evaluate the validity and reliability of pSWE with ultrasound systems.

Methods

Validity and reliability of pSWE measurements from three ultrasound systems were evaluated. Measurements were performed on an elasticity phantom with reference elasticities of 7 ± 1 (low) (median ± interquartile range (IQR)), 14 ± 2 (medium) and 26 ± 3 (high) kPa. Measurements were repeated in tenfold for each reference at 2, 3 and 4 cm depth. Results were considered valid when median elasticity ± IQR was between the uncertainty limits (IQR) for each reference elasticity value and reliable when IQR/median < 0.30.

Results

pSWE with the systems provided valid results for all reference elasticities and focal depths, except for overestimation of high reference elasticity at 2 and 4 cm depth for one system (41.5 ± 4.3 and 39.0 ± 1.2 kPa, respectively). Measurements were reliable with a maximum IQR/median of 0.13, well below the guideline of IQR/median < 0.30.

Discussion

The results support the use of pSWE as an alternative to invasive or non-image guided noninvasive techniques for liver fibrotic staging.

Conclusions

pSWE with ultrasound systems from different vendors is valid and reliable and can therefore be implemented to optimize clinical workflow by performing imaging and elastography simultaneously.

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Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

ARFI:

Acoustic radiation force impulse

IQR:

Interquartile range

pSWE:

Point-shear wave elastography

ROI:

Region of interest

TE:

Transient elastography

USE:

Ultrasound elastography

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Acknowledgements

The authors would like to thank the department of Radiology of St Jansdal Hospital, Harderwijk, The Netherlands for kindly providing the Siemens Acuson Sequoia ultrasound systems.

Funding

The authors declare that no funding, grants, or other support were received during the preparation of this manuscript.

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Author notes

  1. Sietske Bergsma and Margo van Gent should be considered joint first authors.

Authors and Affiliations

  1. Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands

    Sietske Bergsma, Margo van Gent, Alida J. Dam-Vervloet, Martine C. M. Lagerweij & Lieke Poot

  2. Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Margo van Gent

  3. Department of Gastroenterology and Hepatology, Isala Hospital, Zwolle, The Netherlands

    Egbert-Jan van der Wouden

  4. Department of Radiology, Isala Hospital, Zwolle, The Netherlands

    Ingrid M. Nijholt & Martijn F. Boomsma

  5. Department of Innovation & Science, Isala Hospital, Zwolle, The Netherlands

    Ingrid M. Nijholt

  6. Medical Center Leeuwarden, Department of Medical Physics, Leeuwarden, The Netherlands

    Margo van Gent

Authors
  1. Sietske Bergsma
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  2. Margo van Gent
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  3. Alida J. Dam-Vervloet
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  4. Martine C. M. Lagerweij
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  5. Egbert-Jan van der Wouden
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  6. Ingrid M. Nijholt
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  7. Martijn F. Boomsma
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  8. Lieke Poot
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Contributions

SB: investigation, writing—final draft; MG: conceptualization, methodology, validation, investigation, data curation, writing—first draft, visualization; AD & ML: methodology, writing—review & editing, supervision; IN: formal analysis, writing—review & editing; EW, MB & LP: writing—review & editing.

Corresponding author

Correspondence to Sietske Bergsma.

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Bergsma, S., van Gent, M., Dam-Vervloet, A.J. et al. Image-guided point-shear-wave elastography: a valid and reliable technique for liver fibrotic staging. J Ultrasound (2024). https://doi.org/10.1007/s40477-023-00854-9

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  • DOI: https://doi.org/10.1007/s40477-023-00854-9

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