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Ultraschall Med 2013; 34(2): 169-184
DOI: 10.1055/s-0033-1335205
Guideline
© Georg Thieme Verlag KG Stuttgart · New York

EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography. Part 1: Basic Principles and Technology

J. Bamber
1   The Joint Department of Physics, Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, UK
,
D. Cosgrove
2   Div. of Radiology, Imperial and Kings Colleges, London, UK
,
C. F. Dietrich
3   Div. Gastroenterology & Oncology, Caritas Krankenhaus, Bad Mergentheim, Germany
,
J. Fromageau
1   The Joint Department of Physics, Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, Sutton, UK
,
J. Bojunga
4   Department of Internal Medicine I, Endocrinology and Diabetology, Goethe-University, Frankfurt, Germany
,
F. Calliada
5   Div. of Radiology, University of Pavia, Policlinico San Matteo, Italy
,
V. Cantisani
6   Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I, Univ. Sapienza, Rome, Italy
,
J.-M. Correas
7   Adult Radiology, Paris Descartes University & Necker University Hospital, France, Institut Langevin – Ondes et Images ESPCI Paris Tech, CNRS UMR 7587 INSERM U 979
,
M. D’Onofrio
8   Department of Radiology, GB Rossi University Hospital, University of Verona, Italy
,
E. E. Drakonaki
9   Radiologist, University Hospital Heraklion, Crete, Greece
,
M. Fink
10   Ecole Supérieure de Physique et de Chimie de la Ville de Paris, France
,
M. Friedrich-Rust
11   Department of Internal Medicine I, Gastroenterology and Hepatology, Goethe-University, Frankfurt, Germany
,
O. H. Gilja
12   National Centre for Ultrasound in Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway and Department of Clinical Medicine, University of Bergen, Norway
,
R. F. Havre
13   National Centre for Ultrasound in Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway
,
C. Jenssen
14   Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strassberg, Germany
,
A. S. Klauser
15   Department of Radiology, Innsbruck Medical University, Austria
,
R. Ohlinger
16   Department of Obstetrics and Gynecology, Breast unit, University Greifswald, Germany
,
A. Saftoiu
17   Department of Gastroenterology, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania
,
F. Schaefer
18   Unit of Breast Imaging and Interventions, University Hospital Schleswig-Holstein Campus Kiel, Germany
,
I. Sporea
19   Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babeş” Timişoara, Romania
,
F. Piscaglia
20   Div. Internal Medicine, University of Bologna, Bologna Italy
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Publikationsverlauf

Publikationsdatum:
04. April 2013 (online)

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Abstract

The technical part of these Guidelines and Recommendations, produced under the auspices of EFSUMB, provides an introduction to the physical principles and technology on which all forms of current commercially available ultrasound elastography are based. A difference in shear modulus is the common underlying physical mechanism that provides tissue contrast in all elastograms. The relationship between the alternative technologies is considered in terms of the method used to take advantage of this. The practical advantages and disadvantages associated with each of the techniques are described, and guidance is provided on optimisation of scanning technique, image display, image interpretation and some of the known image artefacts.

Zusammenfassung

Der technische Teil dieser Leitlinien und Empfehlungen, der unter der Federführung der EFSUMB entstanden ist, enthält eine Einleitung zu allen physikalischen Grundlagen und Methoden der aktuell kommerziell erhältlichen Ultraschall-Elastografie-Technologien. Unterschiede in der Schersteifigkeit sind der wesentliche physikalische Mechanismus, dem der Gewebekontrast in allen Elastogrammen zu Grunde liegt. Die Beziehung zu alternativen Technologien wird und die Vorteile der angewandten Methode herausgearbeitet. Die praktischen Vorteile und Nachteile jeder Technik werden beschrieben und Empfehlungen zur Optimierung der Scantechnik, der Bildqualität und der Bildinterpretation gegeben, ebenso werden einige der bekannten Artefakte dargestellt.

Key words

elastography - elasticity - radiation force - shear wave - stiffness - shear modulus - strain - transient - ultrasonography

Appendix

 

  • References

  • 1 Wilkins RH. Neurosurgical Classic. Xvii. J Neurosurg 1964; 21: 240-244
    PubMedGoogle Scholar
  • 2 Claudon M, Dietrich CF, Choi BI et al. Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2012. Ultraschall in Med 2013; 34: 11-29
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 3 Piscaglia F, Nolsoe C, Dietrich CF et al. The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall in Med 2012; 33: 33-59
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 4 Cosgrove D, Piscaglia F, Dietrich CF et al. EFSUMB Guidelines and Recommendations on the Clinical Use of Elastography. Part 2: Clinical Applications. Ultraschall in Med 2013; in press
    PubMedGoogle Scholar
  • 5 Hoskins PR. In: Hoskins PR, Thrush A, Martin K, et al. (eds) Diagnostic ultrasound physics and equipment. London: Greenwich Medical Media; 2003
  • 6 Hill CR. In: Hill CR, Bamber JC, ter HaarGR, (eds) Physical Principles of Medical Ultrasonics. 2nd ed. Chichester: John Wiley; 2004
    Crossref
  • 7 Szabo TL. Diagnostic ultrasound imaging: inside out. Burlington: Elsevier Academic Press; 2004
    Google Scholar
  • 8 Shung KK. Diagnostic ultrasound: imaging and blood flow measurement. Boca Raton: CRC Press; 2006
    Google Scholar
  • 9 Cobbold RSC. Foundations of biochemical ultrasound. Oxford: Oxford University Press; 2007
    Google Scholar
  • 10 Bamber JC, Miller N, Tristam M. Diagnostic ultrasound. In: Flower MA, (ed) Webb’s Physics of Medical Imaging. Bristol: Taylor & Francis; 2012
    Google Scholar
  • 11 Odegaard S, Gilja OH, Gregersen H. Basic and new aspects of gastrointestinal ultrasonography. In: Odegaard S, Gilja OH, Gregersen H, (eds) Singapore: Wold Scientific Publisher; 2005
    Google Scholar
  • 12 Sarvazyan A, Hill CR. Physical chemistry of the ultrasound-tissue intereaction. In: Hill CR, Bamber JC, ter HaarGR, (eds) Physical Principles of Medical Ultrasonics. 2nd ed. Chichester: John Wiley; 2004: 223-235
    CrossrefGoogle Scholar
  • 13 Eckersley RJ, Bamber JC. Methodology for imaging time-dependent phenomena. In: Hill CR, Bumber JC, ter Haar GR, (eds) Physical Principles of Medical Ultrasonics. 2nd ed. Chichester: John Wiley; 2004: 304-335
    CrossrefGoogle Scholar
  • 14 Housden RJ, Chen L, Gee AH et al. A new method for the acquisition of ultrasonic strain image volumes. Ultrasound Med Biol 2011; 37: 434-441
    CrossrefPubMedGoogle Scholar
  • 15 Sutherland GR, Stewart MJ, Groundstroem KW et al. Color Doppler myocardial imaging: a new technique for the assessment of myocardial function. J Am Soc Echocardiogr 1994; 7: 441-458
    PubMedGoogle Scholar
  • 16 Gilja OH, Heimdal A, Hausken T et al. Strain during gastric contractions can be measured using Doppler ultrasonography. Ultrasound Med Biol 2002; 28: 1457-1465
    CrossrefPubMedGoogle Scholar
  • 17 Ahmed AB, Matre K, Hausken T et al. Rome III subgroups of functional dyspepsia exhibit different characteristics of antral contractions measured by strain rate imaging – a pilot study. Ultraschall in Med 2012; 33: E233-E240
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 18 Thitaikumar A, Ophir J. Effect of lesion boundary conditions on axial strain elastograms: a parametric study. Ultrasound Med Biol 2007; 33: 1463-1467
    CrossrefPubMedGoogle Scholar
  • 19 Chakraborty A, Bamber JC, Dorward NL. Slip elastography: a novel method for visualising and characterizing adherence between two surfaces in contact. Ultrasonics 2012; 52: 364-376
    CrossrefPubMedGoogle Scholar
  • 20 Garcia L, Fromageau J, Bamber J et al. Further characterisation of changes in axial strain elastograms due to the presence of slippery tumor boundaries part 1: simulation study. In: Proceedings of the Ninth International Conference on the Ultrasonic Measurement and Imaging of Tissue Elasticity.. Snowbird, Utah, USA: www.elasticityconference.org/prior_conf/2010/2010conf.htm 2010. 114.
    Google Scholar
  • 21 Garcia L, Fromageau J, Bamber J et al. Further characterisation of changes in axial strain elastograms due to the presence of slippery tumor boundaries part 2: experimental verification. In: Proceedings of the Ninth International Conference on the Ultrasonic Measurement and Imaging of Tissue Elasticity.. Snowbird, Utah, USA: International Tissue Elasticity Conference; www.elasticityconference.org/prior_conf/2010/2010conf.htm 2010. 115.
    Google Scholar
  • 22 Goenezen S, Dord JF, Sink Z et al. Linear and nonlinear elastic modulus imaging: an application to breast cancer diagnosis. IEEE Trans Med Imaging 2012; 31: 1628-1637
    CrossrefPubMedGoogle Scholar
  • 23 Krouskop TA, Wheeler TM, Kallel F et al. Elastic moduli of breast and prostate tissues under compression. Ultrason Imaging 1998; 20: 260-274
    CrossrefPubMedGoogle Scholar
  • 24 Oberai AA, Gokhale NH, Goenezen S et al. Linear and nonlinear elasticity imaging of soft tissue in vivo: demonstration of feasibility. Phys Med Biol 2009; 54: 1191-1207
    CrossrefPubMedGoogle Scholar
  • 25 Berry GP, Bamber JC, Mortimer PS et al. The spatio-temporal strain response of oedematous and nonoedematous tissue to sustained compression in vivo. Ultrasound Med Biol 2008; 34: 617-629
    CrossrefPubMedGoogle Scholar
  • 26 Qiu Y, Sridhar M, Tsou JK et al. Ultrasonic viscoelasticity imaging of nonpalpable breast tumors: preliminary results. Acad Radiol 2008; 15: 1526-1533
    CrossrefPubMedGoogle Scholar
  • 27 Ophir J, Alam SK, Garra BS et al. Elastography: imaging the elastic properties of soft tissues with ultrasound. J Med Ultrasonics 2003; 29: 155-171
    PubMedGoogle Scholar
  • 28 Ponnekanti H, Ophir J, Huang Y et al. Fundamental mechanical limitations on the visualization of elasticity contrast in elastography. Ultrasound Med Biol 1995; 21: 533-543
    CrossrefPubMedGoogle Scholar
  • 29 Varghese T, Ophir J. A theoretical framework for performance characterization of elastography: the strain filter. IEEE Trans Ultrason Ferroelectr Freq Control 1997; 44: 164-172
    CrossrefPubMedGoogle Scholar
  • 30 Doyley MM, Bamber JC, Fuechsel F et al. A freehand elastographic imaging approach for clinical breast imaging: system development and performance evaluation. Ultrasound Med Biol 2001; 27: 1347-1357
    CrossrefPubMedGoogle Scholar
  • 31 Havre RF, Elde E, Gilja OH et al. Freehand real-time elastography: impact of scanning parameters on image quality and in vitro intra- and interobserver validations. Ultrasound Med Biol 2008; 34: 1638-1650
    CrossrefPubMedGoogle Scholar
  • 32 Barr RG, Lackey AE. The utility of the “bull’s-eye” artifact on breast elasticity imaging in reducing breast lesion biopsy rate. Ultrasound Q 2011; 27: 151-155
    CrossrefPubMedGoogle Scholar
  • 33 Miller NR, Bamber JC. Thresholds for visual detection of Young’s modulus contrast in simulated ultrasound image movies. Phys Med Biol 2000; 45: 2057-2079
    CrossrefPubMedGoogle Scholar
  • 34 Doyley MM. Model-based elastography: a survey of approaches to the inverse elasticity problem. Phys Med Biol 2012; 57: R35-R73
    CrossrefPubMedGoogle Scholar
  • 35 Havre RF, Waage JR, Gilja OH et al. Real-time elastography: strain ratio measurements are influenced by the position of the reference area. Ultraschall in Med 2012; 33: 559-568
    PubMedGoogle Scholar
  • 36 Sarvazyan AP, Rudenko OV, Swanson SD et al. Shear wave elasticity imaging: a new ultrasonic technology of medical diagnostics. Ultrasound Med Biol 1998; 24: 1419-1435
    CrossrefPubMedGoogle Scholar
  • 37 Nightingale K, Soo MS, Nightingale R et al. Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility. Ultrasound Med Biol 2002; 28: 227-235
    CrossrefPubMedGoogle Scholar
  • 38 Palmeri ML, Nightingale KR. Acoustic radiation force-based elasticity imaging methods. Interface Focus 2011; 1: 553-564
    CrossrefPubMedGoogle Scholar
  • 39 Melodelima D, Bamber JC, Duck FA et al. Transient elastography using impulsive ultrasound radiation force: a preliminary comparison with surface palpation elastography. Ultrasound Med Biol 2007; 33: 959-969
    CrossrefPubMedGoogle Scholar
  • 40 Meng W, Zhang G, Wu C et al. Preliminary results of acoustic radiation force impulse (ARFI) ultrasound imaging of breast lesions. Ultrasound Med Biol 2011; 37: 1436-1443
    CrossrefPubMedGoogle Scholar
  • 41 Sandrin L, Tanter M, Gennisson JL et al. Shear elasticity probe for soft tissues with 1-D transient elastography. IEEE Trans Ultrason Ferroelectr Freq Control 2002; 49: 436-446
    CrossrefPubMedGoogle Scholar
  • 42 Castera L, Vergniol J, Foucher J et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 2005; 128: 343-350
    CrossrefPubMedGoogle Scholar
  • 43 Foucher J, Chanteloup E, Vergniol J et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study. Gut 2006; 55: 403-408
    CrossrefPubMedGoogle Scholar
  • 44 Fraquelli M, Rigamonti C, Casazza G et al. Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver disease. Gut 2007; 56: 968-973
    CrossrefPubMedGoogle Scholar
  • 45 Rockey DC. Noninvasive assessment of liver fibrosis and portal hypertension with transient elastography. Gastroenterology 2008; 134: 8-14
    CrossrefPubMedGoogle Scholar
  • 46 Nightingale K, Palmeri M, Trahey G. Analysis of contrast in images generated with transient acoustic radiation force. Ultrasound Med Biol 2006; 32: 61-72
    CrossrefPubMedGoogle Scholar
  • 47 Palmeri ML, Wang MH, Rouze NC et al. Noninvasive evaluation of hepatic fibrosis using acoustic radiation force-based shear stiffness in patients with nonalcoholic fatty liver disease. J Hepatol 2011; 55: 666-672
    CrossrefPubMedGoogle Scholar
  • 48 Bercoff J, Pernot M, Tanter M et al. Monitoring thermally-induced lesions with supersonic shear imaging. Ultrason Imaging 2004; 26: 71-84
    CrossrefPubMedGoogle Scholar
  • 49 Bercoff J, Tanter M, Fink M. Supersonic shear imaging: a new technique for soft tissue elasticity mapping. IEEE Trans Ultrason Ferroelectr Freq Control 2004; 51: 396-409
    CrossrefPubMedGoogle Scholar
  • 50 Tanter M, Bercoff J, Athanasiou A et al. Quantitative assessment of breast lesion viscoelasticity: initial clinical results using supersonic shear imaging. Ultrasound Med Biol 2008; 34: 1373-1386
    CrossrefPubMedGoogle Scholar
  • 51 Muller M, Gennisson JL, Deffieux T et al. Quantitative viscoelasticity mapping of human liver using supersonic shear imaging: preliminary in vivo feasibility study. Ultrasound Med Biol 2009; 35: 219-229
    CrossrefPubMedGoogle Scholar
  • 52 Bavu E, Gennisson JL, Couade M et al. Noninvasive 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
    CrossrefPubMedGoogle Scholar
  • 53 Deffieux T, Montaldo G, Tanter M et al. Shear wave spectroscopy for in vivo quantification of human soft tissues visco-elasticity. IEEE Trans Med Imaging 2009; 28: 313-322
    CrossrefPubMedGoogle Scholar
  • 54 Palmeri ML, Nightingale KR. On the thermal effects associated with radiation force imaging of soft tissue. IEEE Trans Ultrason Ferroelectr Freq Control 2004; 51: 551-565
    CrossrefPubMedGoogle Scholar
  • 55 Skurczynski MJ, Duck FA, Shipley JA et al. Evaluation of experimental methods for assessing safety for ultrasound radiation force elastography. Br J Radiol 2009; 82: 666-674
    CrossrefPubMedGoogle Scholar
  • 56 Tabaru M, Yoshikawa H, Azuma T et al. Experimental study on temperature rise of acoustic radiation force elastography. J Med Ultrasonics 2012; 39: 137-146
    CrossrefPubMedGoogle Scholar
  • 57 Wells PN, Liang HD. Medical ultrasound: imaging of soft tissue strain and elasticity. J R Soc Interface 2011; 8: 1521-1549
    CrossrefPubMedGoogle Scholar
  • 58 Parker KJ, Doyley MM, Rubens DJ. Imaging the elastic properties of tissue: the 20 year perspective. Phys Med Biol 2011; 56: R1-R29
    CrossrefPubMedGoogle Scholar
  • 59 Bamber JC. Ultrasound elasticity imaging: definition and technology. Eur Radiol 1999; 9: S327-S330
    CrossrefPubMedGoogle Scholar
  • 60 Bamber JC, Barbone PE, Bush NL et al. Progress in freehand elastography of the breast. IEICE Trans Inf Syst 2002; 85: 5-14
    PubMedGoogle Scholar
  • 61 Gao L, Parker KJ, Lerner RM et al. Imaging of the elastic properties of tissue – a review. Ultrasound Med Biol 1996; 22: 959-977
    CrossrefPubMedGoogle Scholar
  • 62 Greenleaf JF, Fatemi M, Insana M. Selected methods for imaging elastic properties of biological tissues. Annu Rev Biomed Eng 2003; 5: 57-78
    CrossrefPubMedGoogle Scholar
  • 63 Ophir J, Alam SK, Garra B et al. Elastography: ultrasonic estimation and imaging of the elastic properties of tissues. Proc Inst Mech Eng H 1999; 213: 203-233
    PubMedGoogle Scholar
  • 64 Ophir J, Garra B, Kallel F et al. Elastographic imaging. Ultrasound Med Biol 2000; 26: S23-S29
    CrossrefPubMedGoogle Scholar
  • 65 Kolen AF. Elasticity imaging for monitoring thermal ablation therapy in liver. In: PhD Thesis: University of London; 2003
    Google Scholar
  • 66 Brusseau E, Detti V, Coulon A et al. A two-dimensional locally regularized strain estimation technique: preliminary clinical results for the assessment of benign and malignant breast lesions. In: D’hooge J, Doyley M, (eds) Medical Imaging 2011: Ultrasonic Imaging, Tomography, and Therapy. Lake buena vista, Florida: SPIE Proceedings; 2011: 79680J
    CrossrefGoogle Scholar
  • 67 Uff C, Garcia L, Fromageau J et al. Real-time ultrasound elastography in neurosurgery. In: Yuhas MP, (ed) 2009 IEEE International Ultrasonics Symposium. Rome: 2009: 467-470
    CrossrefGoogle Scholar
  • 68 Lindop JE, Treece GM, Gee AH et al. An intelligent interface for freehand strain imaging. Ultrasound Med Biol 2008; 34: 1117-1128
    CrossrefPubMedGoogle Scholar