Elastography provides a noninvasive evaluation of the stiffness of a lesion. The technologies differ by the type of force applied, the visual representation of tissue elasticity and possibility to perform. Breast ultrasound elastography is a useful imaging modality resulting in increase specificity and sensitivity in diagnosing different breast lesions when combined with bmode ultrasound findings. Elastography was developed in the late 1980s to early 1990s to improve ultrasonic imaging lerner and parker 1987. Invasive breast cancer contains disordered fetal collagen which makes lesions poorly compressible. Evaluation ultrasound elasticitytissue strainhardening.
It is an efficacious and accurate diagnostic imaging modality that helps avoid invasive biopsies. The stiffness or softness of the imaged tissue derived from elastography provides accurate radiologic diagnosis for disease processes including cancer, inflammation, and fibrosis. Prior to positioning the patient turn on the active driver figure 3 found in the equipment room. If patient movement such as breathing, heartbeat, or external compression with rhythmic motion of the ultrasound transducer is used.
Shear wave elastography in the evaluation of liver. The elastography software then detects relative strain within the tissues in the field of view, and displays the resultant elastogram as a color overlay on the gray scale image or as a separate color or gray scale image shown side by side with the conventional ultrasound image. You can perform elastography at the same time as handheld ultrasound and view the images on a split screen, with the twodimensional ultrasound image on the left and the elastography image on the. More specifically, virtual imaging simulation of ultrasound elastography is referred to a process of elastographic system development, which involves computeraided engineering software i. Elastography is a noninvasive medical imaging technique that helps determine the stiffness of organs and other structures in your body. Greensboro imaging is pleased to announce that we have invested in new ultrasound equipment that contains revolutionary shear wave imaging technology. Mr imaging systems are equipped for mr elastography via installation of a device to generate shear waves in the body, a special mr imaging sequence to image the mechanical waves, and processing software to produce colorscaled quantitative images elastograms depicting tissue stiffness in units of kilopascals. Medical imaging is the technique and process of creating visual representations of the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues. Shear wave ultrasound liver assessment philips ultrasound. Ultrasound elastography and mr elastography for assessing. For example, cancerous tumours will often be harder than the surrounding tissue, and diseased livers are stiffer than healthy ones. Recent advances in magnetic resonance mr imaging mri have led to a growing interest in optimizing and applying functional mri to the assessment of liver disease. Mr elastography workflow elastography can be performed at the beginning or end of a routine liver examination, this is a site preference. Elastography techniques have been developed for both ultrasound and mr imaging.
Elastography is an imaging technology which measures tissue elastic properties. Diseased livers are stiffer and move more than healthy livers. Repeatability of shear wave elastography in liver fibrosis. The mr elastography package includes hardware and software. Experience has shown that conventional mr scanners can readily be upgraded with the hardware and software necessary to perform mr elastography. As part of the ongoing study, 179 patients underwent breast ultrasound and elastography. Elastography software modules are added to ultrasound systems. The primary objective is to perform a pilot trial evaluation of a novel prostate ultrasound imaging software utilizing tissue elasticity measurements to identify tumor foci among men who will undergo radical prostatectomy for localized prostate cancer.
Strain elastography is a noninvasive, realtime imaging technique that displays an overlay of stiffness information over a greyscale 2d image. The benefits of elastography in ultrasound providian medical. It used to assist diagnosis or treatment of different medical conditions. Qelaxto the shear waves are lateral waves, with a motion perpendicular to the direction of. Elastography may prove important in breast ultrasound. Elastography may reduce breast biopsies medpage today. The addition of elastography could potentially help decrease the need to perform a biopsy or could reduce the need for additional imaging, thus reducing the. A decade has passed since luminaries began generating promising clinical results using ultrasound elastography, which measures the elastic properties of tissue.
This stateoftheart hardware and software will not only allow for quicker scanning and higher quality. Now that companys experience with its eub logos 8500 and pioneering work with a modified siemens allegra suggest that efforts to push elastography. Breast elastography is a new sonographic imaging technique which provides information on breast lesions in addition to conventional ultrasonography us and mammography. Breast imaging software helps identify cancers reuters. As a result of this cooperation, a new mribased tool to help the physician noninvasively assess relative stiffness of liver tissue. About liver elastography center for diagnostic imaging cdi.
Ultrasound elastography reduces need for breast biopsy. Pdf a comparative study of medical imaging techniques. Two years ago, hitachi medical began commercializing this technology. Ultrasound elastography ue was the first technology to perform elastography and is widely studied in clinical diagnostic applications to assess the biomechanical properties of soft tissues.
It provides an additional way of interrogating tissues and is particularly useful when the grayscale and doppler or other imaging techniques are unhelpful or equivocal. The two main modalities of ultrasound elastography are acoustic radiation force imaging arfi or shear wave elastography swe. Magnetic resonance elastography mre is a technology that combines mri imaging with lowfrequency vibrations to create a visual map elastogram that shows stiffness of body tissues. You can perform elastography at the same time as handheld ultrasound and view the images on a split screen, with the twodimensional ultrasound image on the left and the elastography image on the right, dr. In this study, our goal was to assess the performance of swe in the staging of liver fibrosis in children with chronic liver disease. In clear terms, the ultrasound modalities do not measure the. How to perform strain elastography on philips epiq. Furthermore this represents a new approach of improved treatment decisions, especially for liver tissue. The main idea is that whether the tissue is hard or soft will give diagnostic information about the presence or status of disease. Medical imaging techniques mits are noninvasive methods for looking inside the body without opening up the body surgically.
The exam captures the movement of the liver and can calculate the livers stiffness or elasticity. Furthermore, the bmode imaging capabilities of a diagnostic ultrasound system can be leveraged to provide image guidance of the exact location where shear wave elastography is performed, helping to ensure that a stiffness. Ultrasound elastography is a recently developed ultrasoundbased method which allows the qualitative or quantitative evaluation of the mechanical properties of tissue. Since then, new ultrasound modalities have been developed, such as doppler imaging, which provides new information for diagnosis.
In collaboration with mayo clinic, siemens is offering mr elastography for almost all magnetom scanner. Most conventional us machines today are equipped with the capability to perform elastography, especially with point shear wave techniques pswe. As a result of this cooperation, a new mribased biomarker for characterizing tissue noninvasively is provided. Addition of elastography could potentially help decrease the need to perform biopsy or reduce the need for additional imaging of benign lesions, destounis said. This equipment will allow us to perform ultrasound elastography studies on the liver. Dynamic elastography techniques, which rely on shear waves propagation, can produce quantitative and higher resolution youngs modulus map compared to quasistatic methods. Elastography aims to use the increased stiffness of malignant lesions compared with that of benign lesions to aid diagnosis. In pswe, an arfi pulse is used to generate shear waves in the liver in a small approximately 1 cm 3 roi.
Elastography minisite home lectures journal articles news stories press release white papers welcome to the sonoworld elastography minisite on ultrasound elastography principles, clinical applications, diagnosis and recent developments. Liver elastography is an ultrasound technique used in the detection and staging of liver diseases. The use of shear waves, however, requires a more complex system, able to generate the shear wave mechanical vibrator or ultrasound radiation pressure and to image the. Clinical pearls on how to accurately perform elastography and tips for avoiding falsepositive or falsenegative results.
Currently, mre is used to detect stiffening of the liver caused by fibrosis and inflammation in chronic liver disease. B mode imaging is used to monitor the displacement of liver tissue due to the shear waves. Elastography was developed in the 1990s to map tissue stiffness, and reproducesreplaces the palpation performed by clinicians. Elastography has consistently been shown to be accurate in staging chronic liver disease and has even been touted as a crystal ball that can help clinicians predict the outcomes of patients and help with therapeutic decisions. Elastography visualizes differences in the biomechanical properties of normal and diseased tissues sarvazyan et al. Furthermore this represents a new approach of improved treatment decisions, especially in the field of liver fibrosis. Although ultrasound elastography is easy to perform, appropriate knowledge regarding technical factors and interpretation of results is important for. Elastography elastography strain imaging is a method of assessing the stiffness of tissue. Elastography is a term referring to imaging techniques that aim. Research suggests that instead of a costly and painful biopsy procedure, an easy ultrasound exam could. As transient elastography cannot perform these functions it is complementary to conventional ultrasound in the evaluation of liver disease. Strain compression ultrasound elastography is the commonest technique performed by applying mild compression with the handheld transducer to create realtime strain distribution maps, which are colorcoded and superimposed on the bmode images. With treatment, the progression of liver disease can be slowed and may even be.
Building an opensource simulation platform of acoustic. The main elastography technologies can be divided into strain imaging, shear wave speed measurement and shear wave speed imaging 2dswe. Shear wave elastography relies on the generation of shear waves determined by the displacement of tissues induced by the force of a focused ultrasound beam or by an external push. Elastography is a novel imaging modality which depends on the same differences in mechanical properties between healthy and abnormal tissues but uses imaging to detect these differences at depths not reachable by manual palpation.
The cyclic motionencoding gradients necessary to image propagating shear waves can be incorporated into almost any type of mri pulse sequence, including gradient echo, spin echo, and echo planar methods. Cutoff values of 70%, 75%, 80%, and 90% of hard areas were applied for determining the. Elastography is a medical imaging modality that maps the elastic properties and stiffness of soft tissue. Performance of magnetic resonance elastography and.
Elastography is a technique of using ultrasound to visualize the elastic properties of tissues. Shear wave elastography is a more complex and advanced method because it uses a transducer that can perform a specific task when sending and receiving an ultrasonic signal, which allows it to measure a specific amount of stiffness. Theseare much slower than 3compressional waves 1 to 10 ms and propagate by creating a tangential sliding. This noninvasive, reproducible, and easily performed method of assessing liver tissue stiffness may help reduce, or even avoid, the need for conventional liver biopsies 1. Elastography was performed automatically on the best image with computeraided diagnosis cad software. Ultrasound elastography for imaging tendons and muscles. Elastography directs painless low frequency vibrations into the liver. The active driver goes into sleep mode after approximately one hour of inactivity. Research suggests that instead of a costly and painful biopsy procedure, an easy ultrasound exam could become routine for assessing liver disease status.
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