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Palm-Sized Wireless Transient Elastography System with Real-Time B-Mode Ultrasound Imaging Guidance: Toward Point-of-Care Liver Fibrosis Assessment. | LitMetric

AI Article Synopsis

  • - Transient elastography (TE) is a WHO-recommended method for measuring liver stiffness to assess liver fibrosis, but traditional systems have limitations like size and the need for wired connections.
  • - A new, palm-sized TE system has been designed to integrate B-mode imaging with liver stiffness measurement, tested with tissue phantoms and evaluated in a clinical setting with 121 patients suffering from chronic liver diseases.
  • - The new system showed strong correlation with conventional TE, good operator reliability, and promises to improve liver fibrosis screening at the point of care, making it more efficient and user-friendly.

Article Abstract

Transient elastography (TE), recommended by the WHO, is an established method for characterizing liver fibrosis via liver stiffness measurement (LSM). However, technical barriers remain towards point-of-care application, as conventional TE requires wired connections, possesses a bulky size, and lacks adequate imaging guidance for precise liver localization. In this work, we report the design, phantom validation, and clinical evaluation of a palm-sized TE system that enables simultaneous B-mode imaging and LSM. The performance of this system was validated experimentally using tissue-equivalent reference phantoms (1.45-75 kPa). Comparative studies against other liver elastography techniques, including conventional TE and two-dimensional shear wave elastography (2D-SWE), were performed to evaluate its reliability and validity in adults with various chronic liver diseases. Intra- and inter-operator reliability of LSM were established by an elastography expert and a novice. A good agreement was observed between the Young's modulus reported by the phantom manufacturer and this system (bias: 1.1-8.6%). Among 121 patients, liver stiffness measured by this system and conventional TE were highly correlated ( = 0.975) and strongly agreed with each other (mean difference: -0.77 kPa). Inter-correlation of this system with conventional TE and 2D-SWE was observed. Excellent-to-good operator reliability was demonstrated in 60 patients (ICCs: 0.824-0.913). We demonstrated the feasibility of employing a fully integrated phased array probe for reliable and valid LSM, guided by real-time B-mode imaging of liver anatomy. This system represents the first technical advancement toward point-of-care liver fibrosis assessment. Its small footprint, along with B-mode guidance capability, improves examination efficiency and scales up screening for liver fibrosis.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11154523PMC
http://dx.doi.org/10.3390/diagnostics14020189DOI Listing

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