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Appl. Sci. 2018, 8(8), 1273; https://doi.org/10.3390/app8081273

Strain Ratio as a Quantification Tool in Strain Imaging

1
Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
2
National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, 5021 Bergen, Norway
3
Department of Surgery, Nordsjællands Hospital, 3400 Hillerød, Denmark
4
Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
*
Author to whom correspondence should be addressed.
Received: 22 June 2018 / Revised: 20 July 2018 / Accepted: 23 July 2018 / Published: 1 August 2018
(This article belongs to the Special Issue Ultrasound Elastography)
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Abstract

Ultrasound-based strain imaging is available in several ultrasound (US) scanners. Strain ratio (SR) can be used to quantify the strain recorded simultaneously in two different user-selected areas, ideally exposed to the same amount of stress. The aim of this study was to evaluate SR variability when assessed in an in-vitro setup with a tissue-mimicking phantom on resected tissue samples and in live tissue scanning with endoscopic applications. We performed an in vivo retrospective analysis of SR variability used for quantification of elastic contrasts in a tissue-mimicking phantom containing four homogenous inclusion in 38 resected bowel wall lesions and 48 focal pancreatic lesions. Median SR and the inter-quartile range (IQR) were calculated for all external and endoscopic ultrasound (EUS) applications. The IQR and median provide a measure of SR variability focusing on the two percentiles of the data closest to the median value. The overall SR variability was lowest in a tissue-mimicking phantom (mean QR/median SR: 0.07). In resected bowel wall lesions representing adenomas, adenocarcinomas, or Crohn lesions, the variability increased (mean IQR/Median: 0.62). During an in vivo endoscopic examination of focal pancreatic lesions, the variability increased further (mean IQR/Median: 2.04). SR variability increased when assessed for different targets with growing heterogeneity and biological variability from homogeneous media to live tissues and endoscopic application. This may indicate a limitation for the accuracy of SR evaluation in some clinical applications. View Full-Text
Keywords: ultrasound; strain elastography; quantification; strain ratio; strain quantification; measurement variability; pancreas; endoscopic ultrasound (EUS); Crohn’s disease; carcinoma ultrasound; strain elastography; quantification; strain ratio; strain quantification; measurement variability; pancreas; endoscopic ultrasound (EUS); Crohn’s disease; carcinoma
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Havre, R.F.; Waage, J.E.R.; Mulabecirovic, A.; Gilja, O.H.; Nesje, L.B. Strain Ratio as a Quantification Tool in Strain Imaging. Appl. Sci. 2018, 8, 1273.

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