Diagnostic problems in two-dimensional shear wave elastography of the liver

Area of Science:

• Medical Imaging
• Hepatology
• Biophysics

Background:

• Two-dimensional shear wave elastography (2D-SWE) is a valuable clinical tool for liver observation.
• Artifacts frequently occur in 2D-SWE liver imaging, with their mechanisms not fully understood.

Purpose of the Study:

• To present common artifactual images in liver 2D-SWE.
• To analyze these artifacts using computer simulation models to support clinical findings.

Main Methods:

• Review of artifactual images encountered in clinical 2D-SWE of the liver.
• Computer simulation modeling to investigate artifact mechanisms.

Main Results:

• Computer simulations suggest measuring shear wave values on the least irregular hepatic surface in chronic liver disease.
• 2D-SWE can detect poorly visible focal lesions and differentiate tumors from pseudo-tumors.
• Avoid measuring shear wave values posterior to focal lesions.

Conclusions:

• Understanding 2D-SWE artifacts through simulation aids accurate liver assessment.
• Specific guidelines are proposed for optimizing 2D-SWE in liver disease and focal lesion evaluation.