Artifacts in two-dimensional shear wave elastography of liver.

Area of Science:

• Medical imaging
• Hepatology
• Diagnostic techniques

Background:

• Two-dimensional shear wave elastography (2-D SWE) is widely used for liver stiffness (LS) assessment.
• Artifacts are frequently encountered in 2-D SWE but are often unrecognized.
• The impact of these artifacts on LS measurements requires further investigation.

Purpose of the Study:

• To investigate the prevalence and influence of artifacts during 2-D SWE liver examinations.
• To compare artifact occurrence between novice and expert operators.
• To evaluate the effect of artifacts on the accuracy and reliability of LS measurements.

Main Methods:

• 158 patients with chronic liver disease underwent 2-D SWE by a novice and an expert.
• Elastograms were analyzed for artifact presence and location (top-left, top-right, bottom-left, bottom-right).
• Liver stiffness values (LSVs) and stability were compared between elastograms with most artifacts (EMA) and least artifacts (ELA).

Main Results:

• Artifacts were significantly more frequent in novice (51.7%) versus expert (19.6%) operators.
• The bottom-left quadrant showed the highest artifact frequency for both operators.
• EMAs exhibited higher LSVs and standard deviations, and lower stability indices compared to ELAs, impacting reliability.

Conclusions:

• Artifacts are a significant issue in 2-D SWE for LS measurement, particularly for less experienced operators.
• The presence of artifacts can lead to overestimation of liver stiffness.
• Artifacts reduce the repeatability and reliability of LS measurements obtained via 2-D SWE.