Elastography · Advanced

Elastography in the practice of an ultrasound diagnostics physician

Elastography as a working tool for the ultrasound physician: techniques, indications and interpretation across all major organs.

72academic hours

Advancedlevel

Distance learningmode of study

Course curriculum

Elastography in the practice of an ultrasound diagnostics physician
- — 1.1 Fundamental difference in image construction and visualization in B-mode and in elastography
- — 1.2 The concept of stiffness and elasticity
- — 1.3 Dependence of the elastogram on tissue histology
- — 1.4 Principles of elastography – Young’s modulus, Shear (G) modulus, Bulk modulus
- — 1.5 Types of impact on the tissues under study
- — 1.6 Types of elastography and their principles of operation – Strain, Shear Wave, ARFI, TE
- — 1.7 Main methods of elastogram interpretation
Elastography of the breast, testes and thyroid gland
- — 2.1 Breast elastography as the primary source of the method
- — 2.2 Scanning technique of superficial organs – 3 main maneuvers when using elastography of superficial organs
- — 2.3 Advantages and limitations of the maneuvers
- — 2.4 Image quality criteria when examining superficial organs
- — 2.5 Selection of the region of interest size and quality control systems
- — 2.6 Near-field artifacts
- — 2.7 Methods for assessing lesions of superficial organs – E/B ratio, length ratio, width ratio, area ratio
- — 2.8 Working principles of Strain Ratio – Lesion-to-fat ratio, Lesion-to-Parenchyma Ratio, Share wave measurement
- — 2.9 Threshold criteria - Cut-off criteria of breast assessment methods
- — 2.10 Visual assessment systems – Tsukubo scale, bull eye pattern, BGR pattern
- — 2.11 Relationship between the Bi-RADS US system and elastography, algorithm for correcting the Bi-RADS US assessment, determination of the true tumor size
- — 2.12 Share Wave assessment criteria – color map and absolute values. Features of elastography in tumor and non-tumor lesions of superficial organs
Modern approaches to thyroid elastography
- — 3.1 Rules for working with compression (Strain) elastography and shear wave elastography (SWE, Share Wave), limitations of the methods
- — 3.2 Maneuvers in the technique of thyroid elastography, features of scanning the isthmus
- — 3.3 Principles of field-of-view selection and the technique of working with the Strain Ratio method: Lesion-to-muscle ratio, Lesion-to-Parenchyma Ratio
- — 3.4 Application of visual scales for assessing thyroid formations, their use for identifying indications for gland biopsy (FNA) - the RAGO color scale and the Ding black-and-white scale
- — 3.5 Relationship between Ti-RADS and elastography. Features of elastography in normal parenchyma and thyroiditis. Cut-off criteria of thyroid assessment methods
Testicular scanning technique using elastography, the role of elastography among scanning methods
- — 4.1 Normal picture and pathology picture
- — 4.2 Why is vibration elastography not used?
- — 4.3 Correlation of the elastogram with histological structure
- — 4.4 Capabilities of compression (strain) elastography and shear wave elastography (Shear Wave, SWE) in detecting benign and malignant lesions
- — 4.5 Application of visual assessment scales for testicular lesions – the VES scale. Cut-off criteria of the assessment methods
- — 4.6 Informativeness of elastography in testicular torsion
- — 4.7 Features of testicular tumors in elastography modes: germ cell tumors (seminomas), non-seminomatous tumors (carcinoma, teratoma, choriocarcinoma, mixed tumors), stromal cell tumors (Sertoli and Leydig), lymphomas, epidermoid and dermoid lesions, testicular hemangiomas
- — 4.8 Features of non-tumor testicular lesions in elastography modes: orchitis, cysts, focal infarction, torsion, hematoma, fibrosis
Liver elastography
- — 5.1 Relevance of liver elastography, issues of preparation for the examination
- — 5.2 Scanning techniques using different methods – Strain (compression, deformation), SWE (shear wave, transverse wave), STQ, TE (vibration-controlled elastography)
- — 5.3 Stages of fibrosis and cirrhosis according to the METAVIR classification
- — 5.4 Vibration-controlled elastography using the FibroScan as an example, scanning technique and interpretation of results
- — 5.5 Methods of statistical analysis of results - quartiles and interquartile range, ratio of the interquartile range to the median
- — 5.6 Ultrasound wave attenuation for diagnosing hepatic steatosis (CAP Score), risks of developing hepatocellular carcinoma against the background of fibrosis and cirrhosis
- — 5.7 Assessment of the probability of survival in fibrosis and cirrhosis
- — 5.8 Limitations of using vibration-controlled elastography and factors of measurement error
- — 5.9 Prognosis of esophageal varices
- — 5.10 Quality control systems and the method of generating a liver elastography report. Capabilities of elastography in differentiating focal liver lesions
Pancreatic elastography
- — 6.1 Pancreas scanning technique, capabilities of transesophageal and transabdominal elastography approaches
- — 6.2 Technique of using SWE (shear wave, transverse wave, Shear wave) and Strain (deformational, compression) elastography in pancreas examination
- — 6.3 Analysis of the colour map of the pancreas elastogram
- — 6.4 Strain Ratio (pancreas-to-pancreas) method for assessing pancreatic lesions
- — 6.5 Strain Histogram assessment method in pancreas examination
- — 6.6 Technique for detecting pancreatic fibrosis and chronic pancreatitis, as well as detecting acute pancreatitis using elastography
- — 6.7 Probability of postoperative fistula development
Renal elastography
- — 7.1 Relevance of early diagnosis of chronic kidney disease and the potential of elastography in diagnosing renal pathology
- — 7.2 Methodology of kidney elastography
- — 7.3 Analysis of elastography data and its correlation with the stage of chronic kidney disease
Prostate elastography
- — 8.1 The problem of prostate cancer and its diagnosis
- — 8.2 Prostate elastography technique in transrectal examination
- — 8.4 The problem of prostate cancer through the eyes of a urologist — Gleason score, advantages of elastography-guided biopsy
- — 8.5 Technique of (deformational, compression) Strain elastography in prostate examination and principles of semi-quantitative analysis of prostate lesions
- — 8.6 Working with the compression quality control system, the ring artefact, and the three-component analysis system
- — 8.7 Elastography colour map assessment systems — Kamoi scale, Xu scale
- — 8.8 Limitations of the elastography method
- — 8.9 Application of Shear Wave (shear wave, transverse wave) elastography in prostate examination, capabilities of SWE and limitations of the method
- — 8.10 Quantitative assessment of prostate lesions
Elastography in gynecology
- — 9.1 Why is there no unified guideline on elastography in gynecology, and what are the prospects for the method's development?
- — 9.2 The logic of working with the elastography tool in examining the female pelvic organs
- — 9.3 Scanning technique using elastography: differential diagnosis of leiomyomas and sarcomas, the typical elastographic picture of normal endometrium, normal myometrium, adenomyosis, fibroid, hematometra, retained placental tissue, intrauterine devices
- — 9.4 The potential of elastography in diagnosing cervical cancer
- — 9.5 Visual scales for assessing lesions: Thomas scale, Lu scale, Bakay scale, Xie scale
- — 9.6 We will study the technique of using Strain Ratio with different reference options, as well as the possibilities of assessing the dynamics of cancer therapy using elastography
- — 9.7 The potential of elastography in predicting preterm birth — meta-analysis data of published cases, the potential of elastography in diagnosing polycystic ovary syndrome

A complete practical course on elastography. You will master compression and shear-wave elastography, learn to choose the right technique and confidently interpret tissue stiffness — and add an objective quantitative criterion to your conclusions.

Knyazev Konstantin Andreevich

Leading instructor of the MEDTRAIN Training Center, physician in ultrasound and functional diagnostics

Ultrasound diagnostics physician, Member of the Eurasian Association of Ultrasound and Functional Diagnostics Specialists. Member of the European Federation of Societies for Ultrasound in Medicine and Biology.

Knyazev Konstantin Andreevich is a practising specialist with a foundational clinical background in internal medicine and many years of experience in ultrasound and functional diagnostics. He graduated from the Ural State Medical Academy with a degree in General Medicine (2012), completed an internship in internal medicine (2013), and subsequently underwent professional retraining in Ultrasound Diagnostics and Functional Diagnostics.

Konstantin Andreevich is a member of the Eurasian Association of Specialists in Ultrasound and Functional Diagnostics, as well as a member of the European Federation of Societies for Ultrasound in Medicine and Biology. A leading instructor at the MEDTRAIN Training Centre and chair of the examination board, he has developed and teaches more than 25 educational courses and training cycles devoted to the modern capabilities of ultrasound and functional diagnostics.

Konstantin Andreevich's professional interests include neurosonography, paediatric echocardiography with the diagnosis of congenital heart defects, ultrasound assessment of the lower-limb arteries, and ultrasound monitoring of arterial shunts and endovascular interventions. In his teaching he combines current international guidelines with clinical cases, paying particular attention to practical skills and the safe application of ultrasound techniques in real clinical practice.

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