Comparison of Liver Shear Wave Elastography Measurements using Siemens Acuson S3000, GE LOGIQ E9, Philips EPIQ7 and Toshiba Aplio 500 (Software Versions 5.0 and 6.0) in Healthy Volunteers

Abstract

Aim To compare ARFI-based elastography procedures of the GE LOGIQ E9, Philips EPIQ7, and Toshiba Aplio 500 (versions 5.0 and 6.0) ultrasound scanners with the Siemens Acuson S3000 reference scanner in subjects with healthy livers, taking various impact factors into account.

Materials and Methods The study consisted of two subsequent study parts. Study 1 (n = 205) evaluated the 2D-SWE techniques of GE and Toshiba 5.0 and the pSWE technique of the Philips scanner against the reference scanner Siemens. Study 2 (n = 113) evaluated Toshiba 6.0 against Siemens in a different cohort. Out of 433 study participants in both studies, 318 (M:F = 122:196) met the inclusion criteria. Elastography measurements were performed in the right lobe of the liver at depths of 3, 5 and 7 cm. At each depth, five measurements were acquired with the Siemens and Philips scanners and one measurement each with the GE and Toshiba machines.

Results The Philips (r = 0.58, p < 0.0001) and the GE (r = 0.63, p < 0.0001) scanners showed the strongest correlation of shear wave velocities between Siemens and comparator scanners, at a depth of 5 cm. We found the strongest relationship with Toshiba (software version 6.0) at a depth of 3 cm (r = 0.57, p < 0.0001). Toshiba software version 5.0 did not give satisfactory results. The factors of sex and BMI showed scanner-specific differences in the values measured (p < 0.05). The age of the subjects did not seem to have any effect.

Conclusion With the exception of Toshiba software version 5.0, all of the scanners we tested can be recommended without reservation for comparative ultrasound elastography of the healthy liver at measurement depths of 3 cm up to 5 cm.

Zusammenfassung

Ziel Vergleich der ARFI-basierten Elastografie-Verfahren der Sonografie-Geräte GE LOGIQ E9, Philips EPIQ7 und Toshiba Aplio 500 (Softwareversion 5.0 und 6.0) mit dem Referenzgerät Siemens Acuson S3000 an Lebergesunden, unter Berücksichtigung verschiedener Einflussfaktoren.

Material und Methoden Die Studie bestand aus 2 Folgestudien: In der ersten Studie (n = 205) wurden die 2D-SWE-Geräte GE und Toshiba 5.0 sowie das pSWE-Gerät von Philips gegen das Siemens-Referenzgerät getestet. In einer zweiten Studie (n = 113) wurde an einem weiteren Kollektiv Toshiba 6.0 mit Siemens verglichen. Insgesamt erfüllten 318 (M:F = 122:196) von 433 Studienteilnehmern die Einschlusskriterien. Die Elastografie-Messungen wurden im rechten Leberlappen in 3, 5 und 7 cm Tiefe durchgeführt. Für Siemens und Philips wurden pro Tiefe je 5 Messungen, für GE und Toshiba jeweils 1 Messung durchgeführt.

Ergebnisse Die stärkste Korrelation der Scherwellengeschwindigkeiten zwischen Siemens und Vergleichsgeräten konnte für Philips (r = 0,58, p < 0,0001) und GE (r = 0,63, p < 0,0001) in 5 cm Messtiefe erfasst werden. Bei Toshiba (Softwareversion 6.0) fand sich die stärkste Korrelation in 3 cm Messtiefe (r = 0,57, p < 0,0001). Die Toshiba-Softwareversion 5.0 lieferte keine zufriedenstellenden Ergebnisse. Gerätespezifische Unterschiede der Messwerte zeigten sich für die Einflussfaktoren Geschlecht und BMI (p < 0,05). Das Alter der Probanden scheint keinen Einfluss zu haben.

Schlussfolgerung Alle untersuchten Geräte, mit Ausnahme der Toshiba-Softwareversion 5.0, können für die Messtiefen von 3 und 5 cm uneingeschränkt für vergleichende Ultraschall-Elastografie-Untersuchungen an Lebergesunden empfohlen werden.

Key words

liver - shear wave elastography - ultrasound scanner - comparative study

• References

• 1 Bota S, Herkner H, Sporea I. et al. Meta-analysis: ARFI elastography versus transient elastography for the evaluation of liver fibrosis. Liver Int 2013; 33: 1138-1147
• 2 Sporea I, Bota S, Jurchis A. et al. Acoustic radiation force impulse and supersonic shear imaging versus transient elastography for liver fibrosis assessment. Ultrasound Med Biol 2013; 39: 1933-1941
• 3 Bamber J, Cosgrove D, Dietrich CF. et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic Principles and Technology. Ultraschall in Med 2013; 34: 238-253
• 4 Friedrich-Rust M, Nierhoff J, Lupsor M. et al. Performance of Acoustic Radiation Force Impulse imaging for the staging of liver fibrosis: A pooled meta-analysis. J Viral Hepat 2012; 19: 212-219
• 5 Ferraioli G, Tinelli C, Lissandrin R. et al. Point shear wave elastography method for assessing liver stiffness. World J Gastroenterol 2014; 20: 4787-4796
• 6 Mulazzani L, Salvatore V, Ravaioli F. et al. Point shear wave ultrasound elastography with Esaote compared to real-time 2D shear wave elastography with supersonic imagine for the quantification of liver stiffness. J Ultrasound Springer International Publishing 2017; 20: 213-225
• 7 Schellhaas B, Strobel D, Wildner D. et al. Two-dimensional shear-wave elastography: a new method comparable to acoustic radiation force impulse imaging?. Eur J Gastroenterol Hepatol 2017; 29: 723-729
• 8 Piscaglia F, Salvatore V, Mulazzani L. et al. Ultrasound Shear Wave Elastography for Liver Disease. A Critical Appraisal of the Many Actors on the Stage. Ultraschall in Med 2016; 37: 1-5
• 9 Dong Y, Sirli R, Ferraioli G. et al. Shear wave elastography of the liver – review on normal values. Z Gastroenterol 2017; 55: 153-166
• 10 Galgenmueller S, Jaeger H, Kratzer W. et al. Parameters affecting different acoustic radiation force impulse applications in the diagnosis of fibrotic liver changes. World J Gastroenterol 2015; 21: 8425-8432
• 11 Keller J, Kaltenbach TEM, Haenle MM. et al. Comparison of Acoustic Structure Quantification (ASQ), shearwave elastography and histology in patients with diffuse hepatopathies. BMC Med Imaging BMC Medical Imaging 2015; 15: 58
• 12 Hall TJ, Milkowski A, Garra B. et al. RSNA/QIBA : Shear wave speed as a biomarker for liver fibrosis staging. Jt UFFC, EFTF PFM Symp; 2013: 1-4
• 13 Sporea I, Bota S, Grădinaru-Taşcău O. et al. Comparative study between two point Shear Wave Elastographic techniques: Acoustic Radiation Force Impulse (ARFI) elastography and ElastPQ. Med Ultrason 2014; 16: 309-314
• 14 Shin HJ, Kim MJ, Kim HY. et al. Comparison of shear wave velocities on ultrasound elastography between different machines, transducers, and acquisition depths: a phantom study. Eur Radiol European Radiology 2016; 26: 1-7
• 15 Potthoff A, Attia D, Pischke S. et al. Influence of different frequencies and insertion depths on the diagnostic accuracy of liver elastography by acoustic radiation force impulse imaging (ARFI). Eur J Radiol Elsevier Ireland Ltd 2013; 82: 1207-1212
• 16 Dietrich CF, Bamber J, Berzigotti A. et al. EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version). Ultraschall in Med 2017; 38: 16-24
• 17 Gersak MM, Badea R, Lenghel LM. et al. Influence of Food Intake on 2-D Shear Wave Elastography Assessment of Liver Stiffness in Healthy Subjects. Ultrasound Med Biol 2016; 42: 1295-1302
• 18 Huang Z, Zheng J, Zeng J. et al. 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
• 19 Liao LY, Kuo KL, Chiang HS. et al. Acoustic Radiation Force Impulse Elastography of the Liver in Healthy Patients: Test Location, Reference Range and Influence of Gender and Body Mass Index. Ultrasound Med Biol 2015; 41: 698-704
• 20 Madhok R, Tapasvi C, Prasad U. et al. Acoustic Radiation Force Impulse imaging of the liver: Measurement of the normal mean values of the shearing wave velocity in a healthy liver. J Clin Diagnostic Res 2013; 7: 39-42
• 21 Popescu A, Sporea I, Sirli R. et al. The mean values of liver stiffness assessed by Acoustic Radiation Force Impulse elastography in normal subjects. Med Ultrason 2011; 13: 33-37
• 22 Ferraioli G, Tinelli C, Zicchetti M. et al. Reproducibility of real-time shear wave elastography in the evaluation of liver elasticity. Eur J Radiol Elsevier Ireland Ltd 2012; 81: 3102-3106
• 23 Yoon JH, Lee JM, Han JK. et al. Shear Wave Elastography for Liver Stiffness Measurement in Clinical Sonographic Examinations: Evaluation of Intraobserver Reproducibility, Technical Failure, and Unreliable Stiffness Measurements. J Ultrasound in Med 2014; 33: 437-447
• 24 Goertz RS, Egger C, Neurath MF. et al. Impact of food intake, ultrasound transducer, breathing maneuvers and body position on acoustic radiation force impulse (ARFI) elastometry of the liver. Ultraschall der Medizin 2012; 33: 380-385
• 25 Rizzo L, Calvaruso V, Cacopardo B. et al. 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 2011; 106: 2112-2120
• 26 Takahashi H, Ono N, Eguchi Y. et al. Evaluation of acoustic radiation force impulse elastography for fibrosis staging of chronic liver disease: A pilot study. Liver Int 2010; 30: 538-545
• 27 Iijima H. Medical review: approaches to the diagnosis of liver fibrosis. 2014 abrufbar unter: https://medical.toshiba.com/.../ul-aplio-500-TMR-Approaches-to-the-Diagnosis-of-Liver-Fibrosis (26.07.2016)
• 28 Cassinotto C, Boursier J, de Lédinghen V. et al. Liver stiffness in nonalcoholic fatty liver disease: A comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy. Hepatology 2016; 63: 1817-1827
• 29 Goya C, Hamidi C, Yavuz A. et al. The Role of Acoustic Radiation Force Impulse Elastography in the Differentiation of Infectious and Neoplastic Liver Lesions. Ultrason Imaging 2015; 37: 312-322
• 30 Kiani A, Brun V, Lainé F. et al. Acoustic radiation force impulse imaging for assessing liver fibrosis in alcoholic liver disease. World J Gastroenterol 2016; 22: 4926-4935