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Erschienen in: European Radiology 6/2014

01.06.2014 | Ultrasound

Ultrasound point shear wave elastography assessment of liver and spleen stiffness: effect of training on repeatability of measurements

verfasst von: Giovanna Ferraioli, Carmine Tinelli, Raffaella Lissandrin, Mabel Zicchetti, Stefano Bernuzzi, Laura Salvaneschi, Carlo Filice, on behalf of the Elastography Study Group

Erschienen in: European Radiology | Ausgabe 6/2014

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Abstract

Objectives

To evaluate reproducibility of measurements of spleen stiffness (SS) and liver stiffness (LS) at several sites by using point shear wave elastography (pSWE) and to investigate any training effect.

Methods

Healthy volunteers were consecutively enrolled. Measurements of SS and LS were performed by an expert (observer 1) and a novice (observer 2) at three different sites of liver and spleen. To assess the effect of training the study was conducted in two periods (period 1 and period 2). Concordance correlation coefficient was used to assess intra-observer and inter-observer reproducibility.

Results

A total of 92 subjects (67 men and 25 women) were enrolled in the study. Both intra-observer and inter-observer agreement were higher for the liver than for the spleen. Overall, the highest intra-observer and inter-observer agreement were obtained for the assessment of LS through intercostal space, and for measurements at this site there was a significantly better performance of observer 2 after the training period. For both observers, training improved the repeatability of SS measurements at all sites. A good intra-observer agreement was obtained only for measurements at the spleen lower pole.

Conclusions

The results of this study show that a learning curve in pSWE acquisition should be taken into account both for SS and LS measurements.

Key Points

Reproducibility of SS measurements depends on the expertise of the operator.
To achieve good reproducibility between measurements a training period is required.
A learning curve in pSWE acquisition should be taken into account.
SS measurements are less reproducible than LS measurements.
Literatur
1.
Zurück zum Zitat Nightingale K, Soo MS, Nightingale R et al (2002) Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility. Ultrasound Med Biol 28:227–235PubMedCrossRef Nightingale K, Soo MS, Nightingale R et al (2002) Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility. Ultrasound Med Biol 28:227–235PubMedCrossRef
2.
Zurück zum Zitat Palmeri ML, Wang MH, Dahl JJ et al (2008) Quantifying hepatic shear modulus in vivo using acoustic radiation force. Ultrasound Med Biol 34:546–558PubMedCentralPubMedCrossRef Palmeri ML, Wang MH, Dahl JJ et al (2008) Quantifying hepatic shear modulus in vivo using acoustic radiation force. Ultrasound Med Biol 34:546–558PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat Rizzo L, Calvaruso V, Cacopardo B et al (2011) Comparison of transient elastography and acoustic radiation force impulse for non-invasive staging of liver fibrosis in patients with chronic hepatitis C. Am J Gastroenterol 106:2112–2120PubMedCrossRef Rizzo L, Calvaruso V, Cacopardo B et al (2011) Comparison of transient elastography and acoustic radiation force impulse for non-invasive staging of liver fibrosis in patients with chronic hepatitis C. Am J Gastroenterol 106:2112–2120PubMedCrossRef
5.
Zurück zum Zitat Palmeri ML, Wang MH, Rouze NC et al (2011) Noninvasive evaluation of hepatic fibrosis using acoustic radiation force-based shear stiffness in patients with nonalcoholic fatty liver disease. J Hepatol 55:666–672PubMedCentralPubMedCrossRef Palmeri ML, Wang MH, Rouze NC et al (2011) Noninvasive evaluation of hepatic fibrosis using acoustic radiation force-based shear stiffness in patients with nonalcoholic fatty liver disease. J Hepatol 55:666–672PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Friedrich-Rust M, Wunder K, Kriener S et al (2009) Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology 252:595–604PubMedCrossRef Friedrich-Rust M, Wunder K, Kriener S et al (2009) Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology 252:595–604PubMedCrossRef
7.
Zurück zum Zitat Piscaglia F, Salvatore V, Di Donato R et al (2011) Accuracy of VirtualTouch acoustic radiation force impulse (ARFI) imaging for the diagnosis of cirrhosis during liver ultrasonography. Ultraschall Med 32:167–175PubMedCrossRef Piscaglia F, Salvatore V, Di Donato R et al (2011) Accuracy of VirtualTouch acoustic radiation force impulse (ARFI) imaging for the diagnosis of cirrhosis during liver ultrasonography. Ultraschall Med 32:167–175PubMedCrossRef
8.
Zurück zum Zitat Sporea I, Bota S, Peck-Radosavljevic M et al (2012) Acoustic radiation force impulse elastography for fibrosis evaluation in patients with chronic hepatitis C: an international multicenter study. Eur J Radiol 81:4112–4118PubMedCrossRef Sporea I, Bota S, Peck-Radosavljevic M et al (2012) Acoustic radiation force impulse elastography for fibrosis evaluation in patients with chronic hepatitis C: an international multicenter study. Eur J Radiol 81:4112–4118PubMedCrossRef
9.
Zurück zum Zitat Friedrich-Rust M, Nierhoff J, Lupsor M et al (2012) Performance of acoustic radiation force impulse imaging for the staging of liver fibrosis: a pooled meta-analysis. J Viral Hepat 19:212–219CrossRef Friedrich-Rust M, Nierhoff J, Lupsor M et al (2012) Performance of acoustic radiation force impulse imaging for the staging of liver fibrosis: a pooled meta-analysis. J Viral Hepat 19:212–219CrossRef
10.
Zurück zum Zitat Sporea I, Sirli R, Bota S, Popescu A, Sendroiu M, Jurchis A (2012) Comparative study concerning the value of acoustic radiation force impulse elastography (ARFI) in comparison with transient elastography (TE) for the assessment of liver fibrosis in patients with chronic hepatitis B and C. Ultrasound Med Biol 38:1310–1316PubMedCrossRef Sporea I, Sirli R, Bota S, Popescu A, Sendroiu M, Jurchis A (2012) Comparative study concerning the value of acoustic radiation force impulse elastography (ARFI) in comparison with transient elastography (TE) for the assessment of liver fibrosis in patients with chronic hepatitis B and C. Ultrasound Med Biol 38:1310–1316PubMedCrossRef
11.
Zurück zum Zitat Nierhoff J, Chavez Ortiz AA, Herrmann E, Zeuzem S, Friedrich-Rust M (2013) The efficiency of acoustic radiation force impulse imaging for the staging of liver fibrosis: a meta-analysis. Eur Radiol 23:3040–3053PubMedCrossRef Nierhoff J, Chavez Ortiz AA, Herrmann E, Zeuzem S, Friedrich-Rust M (2013) The efficiency of acoustic radiation force impulse imaging for the staging of liver fibrosis: a meta-analysis. Eur Radiol 23:3040–3053PubMedCrossRef
12.
Zurück zum Zitat Colecchia A, Montrone L, Scaioli E et al (2012) Measurement of spleen stiffness to evaluate portal hypertension and the presence of esophageal varices in patients with HCV-related cirrhosis. Gastroenterology 143:646–654PubMedCrossRef Colecchia A, Montrone L, Scaioli E et al (2012) Measurement of spleen stiffness to evaluate portal hypertension and the presence of esophageal varices in patients with HCV-related cirrhosis. Gastroenterology 143:646–654PubMedCrossRef
13.
Zurück zum Zitat Regev A, Berho M, Jeffers LJ et al (2002) Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol 97:2614–2618PubMedCrossRef Regev A, Berho M, Jeffers LJ et al (2002) Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol 97:2614–2618PubMedCrossRef
14.
Zurück zum Zitat Abraldes JG, Reverter E, Berzigotti A (2013) Spleen stiffness: toward a noninvasive portal sphygmomanometer? Hepatology 57:1278–1280PubMedCrossRef Abraldes JG, Reverter E, Berzigotti A (2013) Spleen stiffness: toward a noninvasive portal sphygmomanometer? Hepatology 57:1278–1280PubMedCrossRef
15.
Zurück zum Zitat Grgurevic I, Cikara I, Horvat J et al (2011) Noninvasive assessment of liver fibrosis with acoustic radiation force impulse imaging: increased liver and splenic stiffness in patients with liver fibrosis and cirrhosis. Ultraschall Med 32:160–166PubMedCrossRef Grgurevic I, Cikara I, Horvat J et al (2011) Noninvasive assessment of liver fibrosis with acoustic radiation force impulse imaging: increased liver and splenic stiffness in patients with liver fibrosis and cirrhosis. Ultraschall Med 32:160–166PubMedCrossRef
16.
Zurück zum Zitat Chen SH, Li YF, Lai HC et al (2012) Noninvasive assessment of liver fibrosis via spleen stiffness measurement using acoustic radiation force impulse sonoelastography in patients with chronic hepatitis B or C. J Viral Hepat 19:654–663PubMedCrossRef Chen SH, Li YF, Lai HC et al (2012) Noninvasive assessment of liver fibrosis via spleen stiffness measurement using acoustic radiation force impulse sonoelastography in patients with chronic hepatitis B or C. J Viral Hepat 19:654–663PubMedCrossRef
17.
Zurück zum Zitat Lin LI (1989) A concordance correlation coefficient to evaluate reproducibility. Biometrics 45:255–268PubMedCrossRef Lin LI (1989) A concordance correlation coefficient to evaluate reproducibility. Biometrics 45:255–268PubMedCrossRef
18.
Zurück zum Zitat Altman DG (1997) Practical statistics for medical research. Chapman & Hall, London Altman DG (1997) Practical statistics for medical research. Chapman & Hall, London
19.
Zurück zum Zitat Karlas T, Pfrepper C, Wiegand J et al (2011) Acoustic radiation force impulse imaging (ARFI) for non-invasive detection of liver fibrosis: examination standards and evaluation of interlobe differences in healthy subjects and chronic liver disease. Scand J Gastroenterol 46:1458–1467PubMedCrossRef Karlas T, Pfrepper C, Wiegand J et al (2011) Acoustic radiation force impulse imaging (ARFI) for non-invasive detection of liver fibrosis: examination standards and evaluation of interlobe differences in healthy subjects and chronic liver disease. Scand J Gastroenterol 46:1458–1467PubMedCrossRef
20.
Zurück zum Zitat Takuma Y, Nouso K, Morimoto Y et al (2013) Measurement of spleen stiffness by acoustic radiation force impulse imaging identifies cirrhotic patients with esophageal varices. Gastroenterology 144:92–101PubMedCrossRef Takuma Y, Nouso K, Morimoto Y et al (2013) Measurement of spleen stiffness by acoustic radiation force impulse imaging identifies cirrhotic patients with esophageal varices. Gastroenterology 144:92–101PubMedCrossRef
21.
Zurück zum Zitat Kircheis G, Sagir A, Vogt C, Vom Dahl S, Kubitz R, Häussinger D (2012) Evaluation of acoustic radiation force impulse imaging for determination of liver stiffness using transient elastography as a reference. World J Gastroenterol 18:1077–1084PubMedCentralPubMedCrossRef Kircheis G, Sagir A, Vogt C, Vom Dahl S, Kubitz R, Häussinger D (2012) Evaluation of acoustic radiation force impulse imaging for determination of liver stiffness using transient elastography as a reference. World J Gastroenterol 18:1077–1084PubMedCentralPubMedCrossRef
22.
Zurück zum Zitat Boursier J, Isselin G, Fouchard-Hubert I et al (2010) Acoustic radiation force impulse: a new ultrasonographic technology for the widespread noninvasive diagnosis of liver fibrosis. Eur J Gastroenterol Hepatol 22:1074–1084PubMedCrossRef Boursier J, Isselin G, Fouchard-Hubert I et al (2010) Acoustic radiation force impulse: a new ultrasonographic technology for the widespread noninvasive diagnosis of liver fibrosis. Eur J Gastroenterol Hepatol 22:1074–1084PubMedCrossRef
23.
Zurück zum Zitat Jaffer OS, Lung PF, Bosanac D et al (2012) Acoustic radiation force impulse quantification: repeatability of measurements in selected liver segments and influence of age, body mass index and liver capsule-to-box distance. Br J Radiol 85:e858–e863PubMedCentralPubMedCrossRef Jaffer OS, Lung PF, Bosanac D et al (2012) Acoustic radiation force impulse quantification: repeatability of measurements in selected liver segments and influence of age, body mass index and liver capsule-to-box distance. Br J Radiol 85:e858–e863PubMedCentralPubMedCrossRef
24.
Zurück zum Zitat Guzmán-Aroca F, Reus M, Berná-Serna JD et al (2011) Reproducibility of shear wave velocity measurements by acoustic radiation force impulse imaging of the liver: a study in healthy volunteers. J Ultrasound Med 30:975–979PubMed Guzmán-Aroca F, Reus M, Berná-Serna JD et al (2011) Reproducibility of shear wave velocity measurements by acoustic radiation force impulse imaging of the liver: a study in healthy volunteers. J Ultrasound Med 30:975–979PubMed
25.
Zurück zum Zitat Toshima T, Shirabe K, Takeishi K et al (2011) New method for assessing liver fibrosis based on acoustic radiation force impulse: a special reference to the difference between right and left liver. J Gastroenterol 46:705–711PubMedCrossRef Toshima T, Shirabe K, Takeishi K et al (2011) New method for assessing liver fibrosis based on acoustic radiation force impulse: a special reference to the difference between right and left liver. J Gastroenterol 46:705–711PubMedCrossRef
26.
Zurück zum Zitat D'Onofrio M, Gallotti A, Mucelli RP (2010) Tissue quantification with acoustic radiation force impulse imaging: measurement repeatability and normal values in the healthy liver. AJR Am J Roentgenol 195:132–136PubMedCrossRef D'Onofrio M, Gallotti A, Mucelli RP (2010) Tissue quantification with acoustic radiation force impulse imaging: measurement repeatability and normal values in the healthy liver. AJR Am J Roentgenol 195:132–136PubMedCrossRef
27.
Zurück zum Zitat Bamber J, Cosgrove D, Dietrich CF et al (2013) EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: basic principles and technology. Ultraschall Med 34:169–184PubMedCrossRef Bamber J, Cosgrove D, Dietrich CF et al (2013) EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: basic principles and technology. Ultraschall Med 34:169–184PubMedCrossRef
Metadaten
Titel
Ultrasound point shear wave elastography assessment of liver and spleen stiffness: effect of training on repeatability of measurements
verfasst von
Giovanna Ferraioli
Carmine Tinelli
Raffaella Lissandrin
Mabel Zicchetti
Stefano Bernuzzi
Laura Salvaneschi
Carlo Filice
on behalf of the Elastography Study Group
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 6/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3140-y

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