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Toward Quantitative and Operator-independent Quasi-static Ultrasound Elastography: An Ex Vivo Feasibility Study
Ultrasonic Imaging ( IF 2.3 ) Pub Date : 2020-05-25 , DOI: 10.1177/0161734620921532
Sathiyamoorthy Selladurai 1 , Abhilash Verma 1 , Arun K Thittai 1
Affiliation  

It is known that the elasticity of liver reduces progressively in the case of diffuse liver disease. Currently, the diagnosis of diffuse liver disease requires a biopsy, which is an invasive procedure. In this paper, we evaluate and report a noninvasive method that can be used to quantify liver stiffness using quasi-static ultrasound elastography approach. Quasi-static elastography is popular in clinical applications where the qualitative assessment of relative tissue stiffness is enough, whereas its potential is relatively underutilized in liver imaging due to lack of local stiffness contrast in the case of diffuse liver disease. Recently, we demonstrated an approach of using a calibrated reference layer to produce quantitative modulus elastograms of the target tissue in simulations and phantom experiments. In a separate work, we reported the development of a compact handheld device to reduce inter- and intraoperator variability in freehand elastography. In this work, we have integrated the reference layer with a handheld controlled compression device and evaluate it for quantitative liver stiffness imaging application. The performance of this technique was assessed on ex vivo goat liver samples. The Young’s modulus values obtained from indentation measurements of liver samples acted as the ground truth for comparison. The results from this work demonstrate that by combining the handheld device along with reference layer, the estimated Young’s modulus value approaches the ground truth with less error compared with that obtained using freehand compression (8% vs. 15%). The results suggest that the intra- and interoperator reproducibility of the liver elasticity also improved when using the handheld device. Elastography with a handheld compression device and reference layer is a reliable and simple technique to provide a quantitative measure of elasticity.

中文翻译:

走向定量和独立于操作员的准静态超声弹性成像:体外可行性研究

众所周知,在弥漫性肝病的情况下,肝脏的弹性会逐渐降低。目前,弥漫性肝病的诊断需要活检,这是一种侵入性程序。在本文中,我们评估并报告了一种可用于使用准静态超声弹性成像方法量化肝脏硬度的无创方法。准静态弹性成像在临床应用中很受欢迎,其中相对组织刚度的定性评估就足够了,而由于在弥漫性肝病的情况下缺乏局部刚度对比,它的潜力在肝脏成像中相对未得到充分利用。最近,我们展示了一种使用校准参考层在模拟和体模实验中生成目标组织的定量模量弹性图的方法。在单独的作品中,我们报告了一种紧凑型手持设备的开发,以减少手绘弹性成像中的操作员间和操作员内的可变性。在这项工作中,我们将参考层与手持控制的压缩设备集成在一起,并对其进行定量肝脏硬度成像应用的评估。该技术的性能在离体山羊肝脏样本上进行了评估。从肝脏样品的压痕测量中获得的杨氏模量值用作比较的基本事实。这项工作的结果表明,通过将手持设备与参考层相结合,估计的杨氏模量值接近地面实况,与使用徒手压缩(8% 对 15%)获得的误差相比,误差更小。结果表明,在使用手持设备时,肝脏弹性的操作者内和操作者间可重复性也得到了改善。使用手持压缩装置和参考层的弹性成像是一种可靠且简单的技术,可提供弹性的定量测量。
更新日期:2020-05-25
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