Liver and Spleen Stiffness Measurements by Sound Touch Elastography and Sound Touch Quantification

doi:10.37015/AUDT.2020.190038

Advanced Ultrasound in Diagnosis and Therapy ›› 2020, Vol. 4 ›› Issue (4): 315-321.doi: 10.37015/AUDT.2020.190038

• Original Research • Previous Articles Next Articles

Liver and Spleen Stiffness Measurements by Sound Touch Elastography and Sound Touch Quantification

Jian Zheng, MD^a^,^b^,¹, Manli Wu, MD^c^,¹, Qingjuan Wang, MD^a, Rizhen Gu, MD^a, Xiaohong Yao, MD^a, Yuansen Chen, MD^a, Jing Huang, MD^a, Lexiang Long, MD^a, Rongqin Zheng, MD^c^,^*()

^a Department of Medical Ultrasound, Third Hospital of Longgang, Shenzhen, China
^b Department of Medical Ultrasound, Longgang District People’s Hospital of Shenzhen, The Third Affiliated Hospital (Provisional) of The Chinese University of Hong Kong, Shenzhen
^c Department of Medical Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangdong Key Laboratory of Liver Disease Research, Sun Yat-Sen University, Guangzhou, China

Received:2019-11-19 Online:2020-12-30 Published:2020-09-29
Contact: Rongqin Zheng, MD, E-mail:zhengrq@mail.sysu.edu.cn

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Abstract

Abstract:

Objective: To evaluate the technical success rate and reproducibility of sound touch elastography (STE) and sound touch quantification (STQ) in liver and spleen stiffness measurement and the reference ranges of normal liver and spleen stiffness. We also compared with a previous validated acoustic radiation force impulse (ARFI) technique.
Methods: Two hundred and fifty-three healthy adults and 40 chronic hepatitis B patients were recruited. All patients underwent liver and spleen stiffness measurements using STE, STQ, and ARFI. A hundred and five patients (36 patients with chronic hepatitis and 69 healthy adults) were examined twice, by two trained sonographers who are familiar with STE and STQ techniques independently. Another 36 healthy adults were examined twice by ARFI imaging. The technical success rates and reproducibility were evaluated.
Results: The success rates of STE, STQ, and ARFI were 96.5%, 95.1%, and 94.8% in liver, and 87.5%, 84.0%, and 78.0% in spleen, respectively. The inter-observer reproducibility of STE, STQ and ARFI were 0.914, 0.896, and 0.845 in liver, and 0.629, 0.601, and 0.543 in spleen, respectively. When the thickness of spleen was greater than 30mm, the reproducibility was 0.704 in STE and 0.668 in STQ. The normal ranges of liver stiffness were 5.80-6.04 kPa measured by STE and 5.87-6.13 kPa measured by STQ, and normal spleen stiffness ranged from 14.83-15.54 kPa measured by STE and 15.85-16.62 kPa measured by STQ.
Conclusion: Our study showed STE and STQ in liver and spleen stiffness measurement had a high success rate with good reproducibility, which were comparable to ARFI. The inter-observer reproducibility of spleen was barely satisfactory, but was good when the thickness of spleen was greater than 30mm.

Key words: Liver stiffness; Spleen stiffness; Sound touch elastography; Sound touch quantification; Elasticity imaging techniques

Jian Zheng, MD, Manli Wu, MD, Qingjuan Wang, MD, Rizhen Gu, MD, Xiaohong Yao, MD, Yuansen Chen, MD, Jing Huang, MD, Lexiang Long, MD, Rongqin Zheng, MD. Liver and Spleen Stiffness Measurements by Sound Touch Elastography and Sound Touch Quantification. Advanced Ultrasound in Diagnosis and Therapy, 2020, 4(4): 315-321.

References

[1]	Guo H, Liao M, Jin J, Zeng J, Li S, Schroeder DR, et al. How intrahepatic cholestasis affects liver stiffness in patients with chronic hepatitis B: a study of 1197 patients with liver biopsy. Eur Radiol 2020; 30:1096-1104.
[2]	Gao Y, Zheng J, Liang P, Tong M, Wang J, Wu C, et al. Liver fibrosis with two-dimensional us shear-wave elastography in participants with chronic hepatitis B: a prospective multicenter study. Radiology 2018; 289:407-415.
[3]	Abe H, Midorikawa Y, Matsumoto N, Moriyama M, Shibutani K, Okada M, et al. Prediction of esophageal varices by liver and spleen MR elastography. Eur Radiol 2019; 29:6611-6619.
[4]	Ferraioli G, Wong VW, Castera L, Berzigotti A, Sporea I, Dietrich CF, et al. Liver ultrasound elastography: an update to the world federation for ultrasound in medicine and biology guidelines and recommendations. Ultrasound Med Biol 2018; 44:2419-2440.
[5]	European Association for the Study of the Liver. EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol 2017; 67:370-398.
[6]	Bamber J, Cosgrove D, Dietrich CF, Fromageau J, Bojunga J, Calliada F, et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall Med 2013; 34:169-184.
[7]	de Franchis R; Baveno VI Faculty. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol 2015; 63:743-752.
[8]	Gibiino G, Garcovich M, Ainora ME, Zocco MA. Spleen ultrasound elastography: state of the art and future directions - a systematic review. Eur Rev Med Pharmacol Sci 2019; 23:4368-4381.
[9]	Zhang L, Xu J, Wu H, Liang W, Ye X, Tian H, et al. Screening breast lesions using shear modulus and its 1-mm shell in sound touch elastography. Ultrasound Med Biol 2019; 45:710-719.
[10]	Xia S, Ren X, Ni Z, Zhan W. A noninvasive method-shear-wave elastography compared with transient elastography in evaluation of liver fibrosis in patients with chronic hepatitis B. Ultrasound Q 2019; 35:147-152.
[11]	Castéra L, Foucher J, Bernard PH, Carvalho F, Allaix D, Merrouche W, et al. Pitfalls of liver stiffness measurement: a 5-year prospective study of 13,369 examinations. Hepatology 2010; 51:828-35.
[12]	Zheng J, Guo H, Zeng J, Huang Z, Zheng B, Ren J, et al. Two-dimensional shear-wave elastography and conventional US: the optimal evaluation of liver fibrosis and cirrhosis. Radiology 2015; 275:290-300.
[13]	Cho YS, Lim S, Kim Y, Sohn JH, Jeong JY. Spleen stiffness measurement using 2-dimensional shear wave elastography: the predictors of measurability and the normal spleen stiffness value. J Ultrasound Med 2019; 38:423-431.
[14]	Elkrief L, Ronot M, Andrade F, Dioguardi Burgio M, Issoufaly T, Zappa M, et al. Non-invasive evaluation of portal hypertension using shear-wave elastography: analysis of two algorithms combining liver and spleen stiffness in 191 patients with cirrhosis. Aliment Pharmacol Ther 2018; 47:621-630.
[15]	Balakrishnan M, Souza F, Mu?oz C, Augustin S, Loo N, Deng Y, et al. Liver and spleen stiffness measurements by point shear wave elastography via acoustic radiation force impulse: intraobserver and interobserver variability and predictors of variability in a US population. J Ultrasound Med 2016; 35:2373-2380.
[16]	Jiang W, Huang S, Teng H, Wang P, Wu M, Zhou X, et al. Diagnostic accuracy of point shear wave elastography and transient elastography for staging hepatic fibrosis in patients with non-alcoholic fatty liver disease: a meta-analysis. BMJ Open 2018; 8:e021787.
[17]	Huang Z, Zheng J, Zeng J, Wang X, Wu T, Zheng R. Normal liver stiffness in healthy adults assessed by real-time shear wave elastography and factors that influence this method. Ultrasound Med Biol 2014; 40:2549-2555.
[18]	Zhang Y, Ding H, Wu SD, Fan PL, Li Z, Zeng WJ, et al. Histological reference for shear wave elastography in liver fibrosis: collagen quantification and scoring system. Advanced Ultrasound in Diagnosis and Therapy 2019; 3:87-96. DOI: 10.37015/AUDT.2019.190815.

Liver and Spleen Stiffness Measurements by Sound Touch Elastography and Sound Touch Quantification

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