Elastography — МЕДТРЕЙН Asia

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Assessment of tissue stiffness: liver, breast, and thyroid glands.

Elastography

SWE of Ovarian and Adnexal Masses: Possibilities for Differentiating Benign and Malignant

The provided source fragments do not contain data on the application of SWE (shear wave elastography) for ovarian and adnexal masses, including stiffness thresholds, criteria, and …

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Elastography

Precompression Artifact in Elastography: How Probe Pressure Overestimates SWE and Strain

Precompression — excessive pressure by the probe — artificially increases tissue stiffness in elastography. According to EFSUMB (2018, non-hepatic), precompression should be avoided as it increases …

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Elastography

Shear Wave Speed (m/s) vs. Young's Modulus (kPa): Conversion and Accurate Reporting in Elastography

The scanner directly measures the shear wave speed c_s (m/s). Conversion to Young's modulus E (kPa) is performed using the simplified formula E = 3ρc², assuming …

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Elastography

Inter-vendor Variability of Liver SWE: Why kPa from Different Devices Are Incomparable

Liver stiffness values in kPa obtained from different SWE systems are directly incomparable: results depend on the method (TE, pSWE, 2D-SWE), device model, and frequency dependence …

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Elastography

Impact of Depth and ROI Size on the Reliability of SWE Measurement

The reliability of SWE directly depends on the measurement geometry: for 2D-SWE, the ROI size should be at least 10 mm, and the measurement box should …

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Elastography

How to Read Quality and Reliability Maps in 2D-SWE: A Practical Guide for Physicians

Quality maps in 2D-SWE reflect the reliability of shear wave speed (SWS) measurement based on raw data analysis: SNR signal, penetration depth, and wavefront parallelism. The …

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Elastography

SWE of Salivary Glands in Sjögren's Syndrome: Stiffness Patterns

There is no direct data on threshold values of salivary gland stiffness in Sjögren's syndrome in the available source fragments [clarification needed]. Below are general principles …

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Elastography

EUS Elastography of the Pancreas: Differential Diagnosis of Chronic Pancreatitis and Solid Tumor

EUS elastography is used to differentiate focal chronic pancreatitis from solid pancreatic tumors by assessing tissue stiffness and the degree of fibrosis. The method is used …

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Elastography

Testicular SWE: Tumor Stiffness vs. Benign Lesion

According to the EFSUMB guidelines on multiparametric ultrasound of the scrotum (Bertolotto et al., 2026), elastography is not used as an independent method for characterizing testicular …

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Elastography

Lymph Node Elastography: Differentiation of Benign and Metastatic Lesions

Shear wave elastography (SWE) aids in differentiating malignant from benign lymph nodes: sensitivity 82%, specificity 80%, accuracy 81% (Griffith, 2025). The method complements standard B-mode ultrasound …

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Elastography

SWE of the Bowel Wall in Crohn's Disease: Differentiation of Fibrotic and Inflammatory Strictures

According to EFSUMB guidelines, elastography (SE/SWE) is used for the clinical differentiation of fibrotic and inflammatory strictures in Crohn's disease: increased wall stiffness is associated with …

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Elastography

Cervical Elastography for Predicting Preterm Birth: Capabilities and Limitations of the Method

According to ACR/SRU (2024), cervical elastography during pregnancy serves as a marker of its softening and may predict pregnancy loss. The method is also used to …

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Elastography

Choosing FibroScan XL or M Probe: Skin-to-Capsule Distance and BMI

According to the manufacturer's recommendations (EFSUMB Course Book, 2018), the M-probe of FibroScan is intended for patients of normal weight, the XL-probe for overweight and obese …

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Elastography

Liver Stiffness (LSM) in Dynamic Monitoring: Risk Stratification of Portal Hypertension and HCC

Liver stiffness (LSM) is a validated marker not only for fibrosis and portal hypertension but also for HCC risk: according to Masuzaki et al. (Hepatology 2009), …

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Elastography

Renal SWE in CKD: Diagnosis of Parenchymal Fibrosis — Value and Limitations

Validated threshold values for renal parenchymal stiffness for staging fibrosis in CKD do not exist — unlike the liver, where SWE thresholds are validated. Renal elastography …

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Elastography

Elastography of Renal Transplant for Fibrosis Assessment (IF/TA): Opportunities and Limitations

Ultrasound elastography (transient, ARFI/pSWE, SWE) is being explored as a non-invasive method for assessing fibrosis of renal transplant parenchyma and its dysfunction. Based on the available …

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Elastography

Anisotropy of the Renal Cortex and SWE Distortion: Impact of Probe Orientation on Stiffness Values

Anisotropy is an artifact of ordered fibrous structures: when the beam angle deviates from 90°, part of the signal is lost, and the area appears hypo-/anechoic. …

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Elastography

Elastography of the Achilles Tendon: Normal and Tendinopathy Stiffness

According to available sources, a healthy Achilles tendon demonstrates high stiffness on SWE (example: 497 kPa), whereas in severe tendinosis, the tissue becomes softer and heterogeneous …

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Elastography

Elastography (SWE) of the Supraspinatus Muscle and Rotator Cuff in Shoulder Tendinopathy: Capabilities and Limitations of the Method

SWE of the rotator cuff is used as an adjunct to grayscale ultrasound in tendinopathy: shear wave speed is measured to assess tendon elasticity. Unlike compression …

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Elastography

SWE of Muscles in Spasticity: Assessment of Passive Stiffness and Positioning

Shear wave elastography (SWE) is a quantitative, less operator-dependent method for assessing muscle stiffness in neurological conditions. According to EFSUMB (2019), SWE is a reliable technique …

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Elastography

SWE of Liver Transplant: Capabilities, Fibrosis Thresholds, and Method Limitations

There are no directly validated SWE thresholds for assessing fibrosis and rejection specifically in liver transplants in the available fragments [clarify]. General fibrosis thresholds for point …

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Elastography

SWE Thresholds (kPa) for Thyroid Nodules: Opportunities and Limitations in Malignancy Risk Assessment

A single SWE threshold in kPa for differentiating malignant and benign thyroid nodules has not been established: values vary between manufacturers (EFSUMB 2026). According to a …

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Elastography

2D-SWE of the Breast: Stiffness Thresholds in kPa for Revising BI-RADS Category

According to the fragments, the key quantitative indicator of 2D-SWE is maximum elasticity (Emax): with values < 20 kPa, benign BI-RADS 3 findings can be downgraded, …

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Elastography

Bull's-eye Artifact in Breast SWE: How to Recognize

The bull's-eye artifact in breast elastography is a round or oval elastographic pattern: a soft (fluid) center surrounded by a stiff ring. It is characteristic of …

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Elastography

SWE of the Prostate and PI-RADS: Stiffness of the Peripheral Zone — What is Known and What is Missing in the Sources

The source fragments do not contain numerical stiffness thresholds for SWE in prostate peripheral zone cancer and lack data on specific integration of SWE with PI-RADS. …

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Elastography

Liver Stiffness in Congestive Hepatopathy and Right Ventricular Failure: Interpretation of Elastography

In right ventricular failure, venous congestion increases the stiffness of the liver parenchyma independently of fibrosis, leading to falsely elevated elastographic values. Heart failure is directly …

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Elastography

Liver Shear Wave Dispersion (SWD): Assessment of Necroinflammation and Viscosity

Shear Wave Dispersion (SWD) is a parameter of multiparametric liver ultrasound aimed at characterizing the viscous properties of the parenchyma. The provided excerpts do not include …

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Elastography

Attenuation Coefficient (ATI/UGAP) vs. CAP for Quantitative Assessment of Liver Steatosis

ATI/UGAP and CAP are different physical parameters for assessing steatosis: the attenuation coefficient in ultrasound imaging is measured in dB/cm/MHz, while CAP (FibroScan) is measured in …

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Elastography

Interpretation of Liver Stiffness Measurement (LSM) Reduction After Antiviral Therapy

A decrease in LSM during antiviral therapy for HBV/HCV reflects dynamics but does not prove fibrosis regression. According to EFSUMB (Update 2017), LSM thresholds differ between …

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Elastography

Liver Stiffness Norms by SWE in Children: Age-Related Reference Values

In children, the 'rule of four' for adults is not applicable (WFUMB, 2024). A value <5 kPa allows exclusion of fibrosis, >15 kPa suggests progressive disease …

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Elastography

2D-SWE and FibroScan Discrepancies in Liver Fibrosis Staging: Which Method to Trust

When discrepancies arise between 2D-SWE and transient elastography (FibroScan/TE) in liver fibrosis staging, it is important to consider that several studies have shown 2D-SWE to have …

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Elastography

Reliability Criteria for 2D-SWE of the Liver: IQR/Median and Number of Samples

For 2D-SWE of the liver, a reliable measurement (LSM) is obtained from the median of at least three valid samples (EFSUMB 2017; WFUMB 2024). When using …

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Elastography

MPUS of Thyroid Nodules Bethesda III–IV and Cervical Lymph Nodes: EFSUMB 2026

EFSUMB 2026 considers MPUS of the thyroid gland as a combination of B-mode, Doppler, and elastography; in complex scenarios, it complements but does not replace cytology. …

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Elastography

Elastography in Focal Scrotal Lesions: EFSUMB 2026

In the EFSUMB 2026 guidelines, elastography is included in multiparametric scrotal ultrasound (MPUS) as an adjunctive, rather than standalone, method for tissue characterization. Key practical numbers: …

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Elastography

SWE Thresholds for Liver Fibrosis in MASLD and Viral Hepatitis: WFUMB 2024

In the WFUMB 2024 update for pSWE/2D-SWE, key clinical liver thresholds are: around 7 kPa for significant fibrosis, <9 kPa makes cACLD unlikely, 9–13 kPa is …

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Elastography

Spleen and Liver Stiffness in Portal Hypertension: WFUMB 2024

In the WFUMB 2024 update, key non-invasive thresholds for clinically significant portal hypertension are based on Baveno VII: LSM by transient elastography ≤15 kPa along with …

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Elastography

Ultrasound Quantification of Liver Steatosis: Attenuation Coefficient by WFUMB 2024

WFUMB 2024 considers the built-in scanner quantitative assessment of liver fat as an image-guided alternative to CAP: the key practical parameter is the attenuation coefficient, designated …

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Elastography

Elastography of Thyroid Nodules: MPUS by EFSUMB 2026

EFSUMB 2026 considers elastography as part of multiparametric ultrasound rather than a standalone test for deciding on FNA: stiffness increases suspicion, softness decreases it, but the …

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Elastography

Elastography Training for Ultrasound Physicians: Program Structure, Practice, and Enrollment

Elastography training for ultrasound physicians is built on three components: theory (physics, knobology, indications, anatomy, interpretation), hands-on practice on the device under supervision, and integration into …

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Elastography

Ultrasound Machine with Elastography for the Clinic: SE vs SWE, Probes and Single Crystal Technology for Purchase

When purchasing an ultrasound scanner with elastography, consider the type of technology: strain elastography (SE) provides qualitative/semi-quantitative stiffness assessment, while shear wave elastography (SWE) offers quantitative …

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Elastography

Elastography in MASLD: Fibrosis Thresholds by WFUMB 2024

According to WFUMB 2024, the key practical algorithm for liver elastography in MASLD is: LSM <8 kPa — exclusion of advanced fibrosis, LSM ≥12 kPa — …

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Elastography

Elastography in Alcoholic Liver Disease: kPa Thresholds

According to WFUMB 2024 for alcoholic liver disease, key VCTE benchmarks are: <10 kPa excludes cACLD, 10–15 kPa requires clinical-laboratory verification, >15 kPa makes cACLD highly …

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Elastography

Ultrasound Assessment of Liver Fat: Attenuation Coefficient and UDFF

According to WFUMB 2024, quantitative ultrasound of liver fat should not be limited to CAP: methods for assessing attenuation, backscatter, speed of sound, and derived indicators, …

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Elastography

Falsely Elevated Liver Stiffness: Inflammation, Cholestasis, Congestion

According to WFUMB 2024, liver stiffness reflects more than just fibrosis: results can be falsely elevated in cases of active inflammation, extrahepatic cholestasis, and venous congestion. …

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Elastography

False-Positive Liver Stiffness: Food, Transaminases, Cholestasis, Congestion, and M/XL Probe Selection in Obesity

Liver stiffness is falsely elevated in postprandial states, elevated transaminases, right ventricular failure, and extrahepatic cholestasis (VTQ/ARFI). In obesity with significant steatosis, the M-probe TE yields …

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Elastography

Spleen Stiffness Measurement (SSM) in Elastography: Non-Invasive Prediction of Esophageal Varices and Cirrhosis Decompensation

Measurement of spleen stiffness (SSM) using elastography methods (Fibroscan, pSWE, 2D-SWE) is a non-invasive marker of portal hypertension, used to assess the presence of esophageal varices …

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Elastography

The 'Rule of Five' Baveno VII: LSM Thresholds for Clinically Significant Portal Hypertension

The 'Rule of Five' Baveno VII utilizes liver stiffness measurement (LSM) thresholds of 10–15–20–25 kPa to stratify the risk of clinically significant portal hypertension (CSPH) in …

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Elastography

Elastography and EU-TIRADS: Integration of Nodule Stiffness into Thyroid Malignancy Risk Stratification

Elastography (strain and 2D-SWE) is applied as an additional parameter to EU-TIRADS categorization within the framework of multiparametric thyroid ultrasound. The combination of nodule stiffness assessment …

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Elastography

Elastography of Thyroid Nodules: Strain Ratio, Stiffness Scales, and Indications for FNA

Elastography (strain and 2D shear-wave) is used as an adjunct to TI-RADS for differentiating benign and malignant thyroid nodules. According to EFSUMB and ACR-SRU, combining TI-RADS …

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Elastography

Breast Elastography in BI-RADS 3–4: Tsukuba Scale, Strain Ratio, and Biopsy Decision

Elastography complements B-mode in categorizing breast lesions. The Tsukuba scale (Itoh/Ueno) is a five-point visual assessment of stiff tissue distribution, strain ratio, and E/B ratio are …

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Elastography

Breast Elastography: Threshold Values and Benign/Malignant Differentiation

According to available excerpts (ACR/SRU 2024, WFUMB 2015, BE1 study), shear wave elastography increases the specificity of breast ultrasound and may reduce the number of unnecessary …

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Elastography

Compression (SE) vs Shear Wave (SWE) Elastography: Physics, Limitations, and Method Selection

SE is a qualitative method comparing the relative stiffness of tissues in the field of view under external stress (compression, physiological movement, or ARFI). SWE is …

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Elastography

CAP (Controlled Attenuation Parameter): Interpretation of Steatosis S0–S3 and Joint Assessment with Fibrosis

CAP is a method for the quantitative assessment of liver steatosis using the FibroScan device, correlating with the histological degree of steatosis (r=0.81). Proposed thresholds (EFSUMB): …

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Elastography

Liver Elastography Protocol: Probe Positioning, Number of Measurements, and Quality Criteria (IQR/M)

According to ACR/SRU (2024), the ROI in liver elastography should be positioned away from large vessels, bile ducts, and focal lesions; for pSWE, 10 measurements from …

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Elastography

Liver Stiffness Norms in Elastography: kPa Thresholds by Fibrosis Stages F0–F4 (METAVIR)

According to the Society of Radiologists in Ultrasound consensus, values <5 kPa (1.3 m/s) are highly likely to be normal; 9–13 kPa (1.7–2.1 m/s) indicate compensated …

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