Wang HP, Zheng PC, Wang XM, Sang L. Artifacts in two-dimensional shear wave elastography of liver. World J Gastroenterol 2023; 29(21): 3318-3327 [PMID: 37377588 DOI: 10.3748/wjg.v29.i21.3318]
Corresponding Author of This Article
Liang Sang, MD, PhD, Associate Professor, Doctor, Department of Ultrasound, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang 110001, Liaoning Province, China. 13889167622@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jun 7, 2023; 29(21): 3318-3327 Published online Jun 7, 2023. doi: 10.3748/wjg.v29.i21.3318
Artifacts in two-dimensional shear wave elastography of liver
Hui-Peng Wang, Peng-Chao Zheng, Xue-Mei Wang, Liang Sang
Hui-Peng Wang, Peng-Chao Zheng, Xue-Mei Wang, Liang Sang, Department of Ultrasound, The First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Wang HP and Sang L designed the research study; Wang HP and Zheng PC performed the research; Wang HP and Wang XM collected and analyzed the data; Wang HP and Sang L wrote the manuscript; all authors reviewed and approved the manuscript.
Institutional review board statement: The study was approved by the Institutional Ethical Review Board of The First Hospital of China Medical University (Approval No. AF-SOP-07-1.1-01).
Informed consent statement: All patients provided written informed consent prior to study enrollment.
Conflict-of-interest statement: The authors of this manuscript having no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Liang Sang, MD, PhD, Associate Professor, Doctor, Department of Ultrasound, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang 110001, Liaoning Province, China. 13889167622@163.com
Received: February 27, 2023 Peer-review started: February 27, 2023 First decision: March 14, 2023 Revised: March 23, 2023 Accepted: May 6, 2023 Article in press: May 6, 2023 Published online: June 7, 2023
Abstract
BACKGROUND
Artifacts are common when using two-dimensional shear wave elastography (2-D SWE) to measure liver stiffness (LS), but they are poorly recognized.
AIM
To investigate the presence and influence of artifacts in 2-D SWE of liver.
METHODS
We included 158 patients with chronic liver disease, who underwent 2-D SWE examination by a novice and an expert. A cross line at the center of the elastogram was drawn and was divided it into four locations: top-left, top-right, bottom-left, and bottom-right. The occurrence frequency of artifacts in different locations was compared. The influence of artifacts on the LS measurements was evaluated by comparing the elastogram with the most artifacts (EMA) and the elastogram with the least artifacts (ELA).
RESULTS
The percentage of elastograms with artifacts in the novice (51.7%) was significantly higher than that of the expert (19.6%) (P < 0.001). It was found that both operators had the highest frequency of artifacts at bottom-left, followed by top-left and bottom-right, and top-right had the lowest frequency. The LS values (LSVs) and standard deviation values of EMAs were significantly higher than those of ELAs for both operators. An intraclass correlation coefficient value of 0.96 was found in the LSVs of EMAs of the two operators, and it increased to 0.98 when the LSVs of the ELAs were used. Both operators had lower stability index values for EMAs than ELAs, but the difference was only statistically significant for the novice.
CONCLUSION
Artifacts are common when using 2-D SWE to measure LS, especially for the novice. Artifacts may lead to the overestimation of LS and reduce the repeatability and reliability of LS measurements.
Core Tip: Artifacts are common when using two-dimensional shear wave elastography (2-D SWE) to measure liver stiffness (LS), especially for the novice. We investigated the presence and influence of artifacts in 2-D SWE of liver. Our results showed artifacts were more likely to occur in the bottom-left corner of the elastogram. Artifacts may lead to the overestimation of LS and reduce the repeatability and reliability of LS measurements. For the elastograms with artifacts, we should place the Q-Box away from the artifacts.
