Real-Time Elastography Using an External Reference Material: a Pilot Feasiblity Study on Achilles Tendon

Schneebeli, Alessandro and Cescon, Corrado and Egloff, Michele and Del Grande, Filippo and Vincenzo, Gabriele and Barbero, Marco (2013) Real-Time Elastography Using an External Reference Material: a Pilot Feasiblity Study on Achilles Tendon. In: 3° Congresso Nazionale S.I.F, 24-25 Maggio 2013, Napoli.

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BACKGROUND AND AIM Real-time elastography (RTE) is an ultrasound technique to obtain a qualitative assessment of tissue elasticity. It is performed by compressing tissue and then producing a coloured image that reflects the elasticity pattern of the tissue. The principle of RTE is that tissue compression produces displacement within the tissue, which is less pronounced in harder than in softer materials. This technique has previously been shown to be useful in the differential diagnosis between benign and malignant tumours. Recently it has been used also to evaluate the musculoskeletal system, especially in tendon disorders. The aim of this pilot study is to explore RTE application using an external reference material placed on Achilles tendon. MATERIALS AND METHODS Four healthy subjects were recruited. Longitudinal and transversal RTE ultrasound (MyLab™ ClassC) images of left and right Achilles tendon were acquired in a test-test session (Scan1, Scan2). An external reference material (Zerdine®, CIRS, Inc., Norfolk), with known elastic properties, was placed on the subject’s tendon and included in the b-mode scans (Fig. 1). A strain ratio between tendon and the external reference material has been computed offline using the region of interest method. Descriptive statistics have been used to summarize the results. RESULTS Results are reported in table 1. The mean strain ratio for longitudinal scans was respectively 0.29 for Scan1 and 0.32 for Scan2. The mean strain ratio for transversal scans was respectively 0.17 for Scan1 and 0.19 for Scan2. The mean of the difference of the strain ratio between the two scans was 0.03 for the longitudinal and 0.04 for the transverse scan. DISCUSSION The external reference material did not interfered with b-mode scanning and allowed to perform the RTE. Additionally it allowed to compute among subjects the strain ratio including a region of interest with known elastic properties. Strain ratio values between sessions seem to be reproducible, and among subjects similar. CONCLUSION Preliminary findings indicate that RTE using an external reference material is feasible. Reliability of RTE should be investigated in a larger sample including patients. KEY WORDS Real-time elastography, feasibility, Achilles tendon. ACKNOWLEDGEMENT Thim van der Laan Foundation for funding the study.

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