Advances in Clinical and Experimental Medicine
2014, vol. 23, nr 4, July-August, p. 645–655
Publication type: review article
Language: English
Ultrasound Elastography – Review of Techniques and its Clinical Applications
1 Department of Radiology, Wroclaw Medical University, Poland
Abstract
Sonoelastography is a modern ultrasound method, which enables the representation of tissues and organs with the evaluation of their elasticity, “stiffness”. The principle of elastography is to use repeated, slight pressure on the examined organ with the ultrasound transducer. Changes in elasticity and deformation of tissues arising whilst the compression is processed and presented in real time with color-coded maps, is called elastograms. The method is applicable mainly in diagnosing malignant lesions. Tumor tissues have different elasticity and undergo different deformations under pressure than healthy tissues. As a result of computer analysis, images in various colors are generated. Based on the nature of areas of normal and increased stiffness classifications of the images in point scales have been developed. Ultrasound devices equipped with sonoelastography option enable more accurate imaging and evaluation of the nature of lesions situated at small depth, e.g. breast, thyroid, testicles, prostate, some groups of lymph nodes. They increase the accuracy of ultrasound in diagnostics and the evaluation of the stage of malignant lesions. This also helps to indicate more precisely the areas that require the biopsy.
Key words
sonoelastography, ultrasound, diagnostic imaging.
References (40)
- Ophir J, Alam SK, Garra BS, Kallel F, Konofagou EE, Krouskop T, Merritt ChRB, Righetti R, Souchon R, Srinivasan S, Varghese T: Elastography: Imaging the elastic properties of soft tissue with ultrasound. J Med Ultrasonics 2002, 29 (Winter), 155–171.
- Parker KJ, Taylor, LS, Gracewski, S, & Rubens, DJ: A unified view of imaging the elastic properties of tissue. The Journal of the Acoustical Society of America 2005, 117, 2705.
- Bamber J: EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall Med 2013 Apr, 34, 169–184.
- Cosgrove D: EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: Clinical applications. Ultraschall Med 2013, 34, 238–253.
- Itoh A, Ueno E, Tohno E, Kamma H, Takahashi H, Shiina T, Yamakawa M, Matsumura T: Clinical application of US elastography for diagnosis. Radiology 2006, 239, 341–350.
- Vorländer Ch, Wolff J, Saalabian S, Lienenlüke RH, Wahl RA: Real-time ultrasound elastography – a noninvasive diagnostic procedure for evaluating dominant thyroid nodules. Langenbecks Arch Surg 2010, 395, 865–871.
- Sarvazyan A, Hall TJ, Urban MW, Fatemi M, Aglyamov SR, Garra BS: An overview of elastography – an emerging branch of medical imaging. Curr Med Imaging Rev 2011, 7, 255–282.
- Lerner RM, Parker KJ, Holen J, Gramiak R, Waag RC: Sono-elasticity: Medical elasticity images derived from ultrasound signals in mechanically vibrated targets. In Acoustical imaging. Springer US 1989, 317–327.
- Aguilo MA, Aquino W, Brigham JC, Fatemi M: An inverse problem approach for elasticity imaging through vibroacoustics. IEEE Trans Med Imaging 2010, 29, 1012–1021.
- Sandrin L, Fourquet B, Hasquenoph JM, Yon S, Fournier C, Mal F, Christidis C, Ziol M, Poulet B, Kazemi F, Beaugrand M, Palau R: Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol 2003, 29, 1705–1713.
- Das D, Gupta M, Kaur H, Kalucha A: Elastography: the next step. J Oral Sci. 2011 Jun, 53, 137–141.
- Xu W, Shi J, Zeng X, Li X, Xie WF, Guo J, Lin Y: EUS elastography for the differentiation of benign and malignant lymph nodes: a meta-analysis. Gastrointest Endosc 2011, 74, 1001–1009.
- Giovannini M, Thomas B, Erwan B, Christian P, Fabrice C, Benjamin E, Genevieve M, Paolo A, Pierre D, Robert Y, Walter S, Hanz S, Carl S, Christoph D, Pierre E, Jean-Luc VL, Jacques D, Peter V, Andrian S: Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: A multicenter study. World J Gastroenterol 2009, 7, 15, 1587–1593.
- Schaar JA, de Korte CL, Mastik F, Strijder C, Pasterkamp G, Boersma E, Serruys PW, van der Steen AFW: Characterizing vulnerable plaque features with intravascular elastography. Circulation 2003, 25, 108, 2636–2641.
- Friedrich-Rust M, Ong M-F, Martens S, Sarrazin C, Bojunga J, Zeuzem S, Herrmann E: Performance of transient elastography for the staging of liver fibrosis: a meta-analysis. Gastroenterology 2008, 134, 960–974.
- Kirk GD, Astemborski J, Mehta SH, Spoler C, Fisher C, Allen D, Higgins Y, Moore RD, Afdhal N, Torbenson M, Sulkowski M, Thomas DL: Assessment of Liver Fibrosis by Transient Elastography in Persons with Hepatitis C Virus Infection or HIV–Hepatitis C Virus Coinfection. Clin Inf Dis 2009, 48, 963–972.
- Cho SH, Lee JY, Han JK, Choi BI: Acoustic radiation force impulse elastography for the evaluation of focal solid hepatic lesions: preliminary findings. Ultrasound Med Biol 2010, 36, 202–208.
- Friedman SL: Evolving challenges in hepatic fibrosis. Nature reviews. Gastroenterol Hepatol 2010, 7.8, 425.
- Lai C, Yuen M, Fung JY: Clinical Application of Transient Elastography (Fibroscan) in Liver Diseases. Medical Bulletin 2009, 14, 22–25.
- Castéra L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, de Lédinghen V: Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 2005, 128, 343–350.
- Cobbold JFL, Morin S, Taylor-Robinson SD: Transient elastography for the assessment of chronic liver disease: Ready for the clinic? World J Gastroenterol 2007, 13.36, 4791.
- Ferraioli G, Tinelli C, Dal Bello B, Zicchetti M, Filice G, Filice C: Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: A pilot study. Hepatology 2012, 56, 2125–2133.
- Bavu É, Gennisson JL, Couade M, Bercoff J, Mallet V, Fink M, Pol S: Noninvasive< i> In Vivo Liver Fibrosis Evaluation Using Supersonic Shear Imaging: A Clinical Study on 113 Hepatitis C Virus Patients. Ultrasound Med Biol 2011, 37, 1361–1373.
- Chen S, Sanchez W, Callstrom MR, Gorman B, Lewis JT, Sanderson SO, Metz S: Assessment of liver viscoelasticity by using shear waves induced by ultrasound radiation force. Radiology 2013, 266, 964–970.
- Garra, BS, Cespedes, EI, Ophir J, Spratt SR, Zuurbier RA, Magnant CM, Pennanen MF: Elastography of breast lesions: initial clinical results. Radiology 1997, 202, 79–86.
- Itoh A, Ueno E, Tohno E, Kamma H, Takahashi H, Shiina T, Matsumura T: Breast Disease: Clinical Application of US Elastography for Diagnosis1. Radiology 2006, 239, 341–350.
- Hui H Zhi, Bing B Ou, Bao-Ming BM Luo, Xia X Feng, Yan-Ling YL Wen, Hai-Yun HY Yang: Comparison of Ultrasound Elastography, Mammography, and Sonography in the Diagnosis of Solid Breast Lesions. J Ultrasound Med 2007, 26, 807–815.
- Bojunga J, Herrmann E, Meyer G, Weber S, Zeuzem S, Friedrich-Rust M: Real-time elastography for the differentiation of benign and malignant thyroid nodules: a meta-analysis. Thyroid 2010 Oct, 20, 1145–1150.
- Bhatia KS, Tong CS, Cho CC, Yuen EH, Lee YY, Ahuja AT: Shear wave elastography of thyroid nodules in routine clinical practice: preliminary observations and utility for detecting malignancy. Eur Radiol 2012 Nov, 22, 2397–2406.
- Sebag F, Vaillant-Lombard J, Berbis J, Griset V, Henry JF, Petit P, Oliver C: Shear wave elastography: a new ultrasound imaging mode for the differential diagnosis of benign and malignant thyroid nodules. J Clin Endocrinol Metab 2010 Dec, 95, 5281–5288.
- Sporea I, Sirli R, Bota S, Vlad M, Popescu A, Zosin I: ARFI elastography for the evaluation of diffuse thyroid gland pathology: Preliminary results. World J Radiol 2012 Apr 28, 4, 174–178.
- Wojcinski S, Dupont J, Schmidt W, Cassel M, Hillemanns P: Real-time ultrasound elastography in 180 axillary lymph nodes: elasticity distribution in healthy lymph nodes and prediction of breast cancer metastases. BMC Med Imaging 2012 Dec 19, 12, 35.
- Janssen J, Dietrich CF, Will U, Greiner L: Endosonographic elastography in the diagnosis of mediastinal lymph nodes. Endoscopy 2007, 39, 952–957.
- Choi JJ, Kang BJ, Kim SH, Lee JH, Jeong SH, Yim HW, Song BJ, Jung SS: Role of sonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer. J Ultrasound Med 2011 Apr, 30, 429–436.
- Lyshchik A, Higashi T, Asato R, Tanaka S, Ito J, Hiraoka M, Insana MF, Brill AB, Saga T, Togashi K: Cervical lymph node metastases: diagnosis at sonoelastography – Initial experience. Radiology 2007, 243, 258–267.
- Pozzi E, Mantica G, Gastaldi C, Berardinelli M, Choussos D, Bianchi CM, Roggia A: The role of the elastography in the diagnosis of prostate cancer: a retrospective study on 460 patients. Arch Ital Urol Androl 2012 Sep, 84, 151–154.
- Walz J, Marcy M, Pianna JT, Brunelle S, Gravis G, Salem N, Bladou F: Identification of the prostate cancer index lesion by real-time elastography: considerations for focal therapy of prostate cancer. World J Urol 2011 Oct, 29, 589–594.
- Brock M, Eggert T, Löppenberg B, Braun K, Roghmann F, Palisaar RJ, Noldus J, von Bodman C: Value of RealTime Elastography to Guide the Systematic Prostate Biopsy in Men with Normal Digital Rectal Exam. Aktuelle Urol 2013 Jan, 44, 40–44.
- Salomon G, Köllerman J, Thederan I, Chun FK, Budäus L, Schlomm T, Isbarn H, Heinzer H, Huland H, Graefen M: Evaluation of prostate cancer detection with ultrasound real-time elastography: a comparison with step section pathological analysis after radical prostatectomy. Eur Urol 2008 Dec 54, 1354–1362.
- Tsutsumi M, Miyagawa T, Matsumura T, Kawazoe N, Ishikawa S, Shimokama T, Shiina T, Miyanaga N, Akaza H: The impact of real-time tissue elasticity imaging (elastography) on the detection of prostate cancer: clinicopathological analysis. Int J Clin Oncol 2007 Aug, 12, 250–255.