Versatile diagnosis and interventional guidance
RADIOLOGY CLEARLY DEFINED
Hitachi provides clinicians with optimal platforms, specialised transducer and innovative technology combinations. With more than 40 compatible transducers and the most advanced image-processing technology, your ultrasound system can become a powerful, highly versatile diagnostic tool. Additional endocavity or interventional transducers and optional features, such as Real-time Virtual Sonography (RVS), Real-time Bi-Plane Imaging (RTBi), Real-time Tissue Elastography (RTE) or Contrast Harmonic Imaging (CHI) - can further elevate your performance.
- Shear Wave Measurement (SWM)
SWM incorporates a reliability indicator, VsN, from which the precision and reproducibility of the median shear wave speed measurement can be assessed. Combinational use of SWM and RTE is now achievable with one transducer, to gain a better understanding of the tissue elasticity.
- Real-time Tissue Elastography (RTE)
In breast applications, RTE has been shown to improve both the accuracy in differentiating between benign and malignant tumours (especially if smaller than 1cm) and specificity compared with US BIRADS classification, for benign lesions. As a result, elastography can reduce the biopsy rate in atypical cysts and may suggest appropriate workup for cancers with atypical presentation.
In the prostate, elastography can improve the visualization of cancer. Real-time elastography targeted biopsy has been shown to be significantly more likely to detect prostate cancer than systematic US guided biopsy. Using an endoscopic approach, RTE of the pancreas and lymph nodes has been shown to be capable of further defining the characteristics of benign and malignant lesions and can be used to guide biopsy sampling for diagnosis.
Within the thyroid gland, RTE provides additional features of malignancy and can be used to guide biopsies of complex lesions.
Other clinical examination areas for which preliminary studies have shown that Real-time Tissue Elastography can provide additional diagnostic information include musculoskeletal, cervix and testes.
- Real-time Virtual Sonography (RVS)
Offering a real-time simultaneous display of the CT or MRI scan plane which corresponds to the ultrasound image, RVS offers superior image guidance for all interventional procedures. It can provide a better understanding of the US imaging anatomy, enabling more accurate needle placement and (during ablative therapies) a more precise monitoring of the treatment area. By using ultrasound throughout the procedure, rather than CT guidance, the patient's exposure to radiation is reduced. Compatible with B-mode, colour Doppler and dynamic Contrast Harmonic Imaging modes.
- Real-time Bi-Plane (RTBi) Imaging
This technology which simultaneously displays two images from two different transducers, on-screen, can be a supporting tool for liver and other interventional treatments. RTBi allows the interventionalist to have a better understanding of the needle position, to monitor the ablation process in two scan planes and to avoid excess ablation which can cause severe pain.
- Dynamic Contrast Harmonic Imaging (dCHI)
dCHI offers increased agent-to-tissue specificity, using a wideband pulse inversion technique which modulates both the phase and transmitted frequency range between pulses. Customised and factory presets are available for high and low MI techniques using first- and second-generation contrast agents. Features include the real-time, dual display of contrast harmonic and fundamental B-mode, with independent imaging parameter adjustment and the option to display biopsy guidelines on both images. Microbubble Trace Imaging, a bubble accumulation mode, is available with customisable destruction/replenishment protocols. On-board digital storage of images and clips is provided, along with the generation and analysis of time-intensity curves, for a more detailed evaluation of the contrast enhancement.
- Aigner F, Mitterberger M, et al. Status of transrectal ultrasound imaging of the prostate. J Endourol. 2010 May;24(5):685-91.
- Ariji Y., Katsumata A., Hiraiwa Y., et al. Use of sonographic elastography of the masseter muscles for optimizing massage pressure: a preliminary study. Journal of Oral Rehabilitation 2009 36; 627–635
- Asteria C., Giovanardi A., Pizzocaro A., et al. US-elastography in the differential diagnosis of benign and malignant thyroid nodules. Thyroid. 2008 May;18(5):523-31.
- Cho N., Moon W.K., Park J.S., et al. Nonpalpable breast masses: evaluation by US elastography. Korean J Radiol, March 1, 2008; 9(2): 111-8.
- Cho N., Moon W.K., Park J.S. Real-time US elastography in the differentiation of suspicious microcalcifications on mammography. Eur Radiol. 2009 Jul;19(7):1621-8.
- Cho N., Moon W.K., Kim H.Y., et al. Sonoelastographic strain index for differentiation of benign and malignant nonpalpable breast masses. . J Ultrasound Med 2010; 29:1–7
- Chung SYMoon WK, Choi JW, et al. Differentiation of benign from malignant nonpalpable breast masses: a comparison of computer-assisted quantification and visual assessment of lesion stiffness with the use of sonographic elastography. Acta Radiol. 2010 Feb;51(1):9-14.
- De Zordo T, Fink C, Feuchtner GM, et al. Real-time sonoelastography findings in healthy achilles tendons. Am J Roentgenol. 2009 Aug;193(2):W134-8.
- De Zordo T, Lill SR, Fink C, Feuchtner GM, et al. Real-time sonoelastography of lateral epicondylitis: comparison of findings between patients and healthy volunteers. Am J Roentgenol. 2009 Jul;193(1):180-5
- Dighe MKim J, Luo S, et al. Utility of the ultrasound elastographic systolic thyroid stiffness index in reducing fine-needle aspirations. J Ultrasound Med. 2010 Apr;29(4):565-74.
- Drakonaki EE, Allen GM, Wilson DJ. Real-time ultrasound elastography of the normal Achilles tendon: reproducibility and pattern description. Clin Radiol. 2009 Dec;64(12):1196-202. Epub 2009 Oct 8
- Drakonaki EE, Allen GM. Magnetic resonance imaging, ultrasound and real-time ultrasound elastography of the thigh muscles in congenital muscle dystrophy. Skeletal Radiol. 2010 Jan 9.
- Farrokh A, Wojcinski S, Degenhardt F. Diagnostic value of strain ratio measurement in the differentiation of malignant and benign breast lesions. Ultraschall Med. 2010 Apr 27.
- Ferrari FS., Scorzelli A., Megliola A. et al. Real-time elastography in the diagnosis of prostate tumor. Journal of Ultrasound (2009) 12, 22-31
- Friedrich-Rust M., Ong M.F., Herrmann E., et al. Real-time elastography for noninvasive assessment of liver fibrosis in chronic viral hepatitis. AJR 2007; 188:758–764
- Friedrich-Rust M., Schwarz A.,Ong M.F., et al. Real-time tissue elastography versus Fibroscan for noninvasive assessment of liver fibrosis in chronic liver disease. Ultraschall in Med 2009; 30: 478 - 484
- Friedrich-Rust M, Sperber A, Holzer K, et al. Real-time elastography and contrast-enhanced ultrasound for the assessment of thyroid nodules. Exp Clin Endocrinol Diabetes. 2009 Oct 23.
- Gheonea DI, S?ftoiu A, Ciurea T, et al. Real-time sono-elastography in the diagnosis of diffuse liver diseases. World J Gastroenterol. 2010 Apr 14;16(14):1720-6.
- Gheorghe L., Iacob S., Gheorghe C. Real-time sonoelastography - a new application in the field of liver disease. J Gastrointestin Liver Dis, December 2008 Vol.17 No 4, 469-474
- Havre R.F., Elde E., Gilja O.H., et al. Freehand real-time elastography: impact of scanning parameters on image quality and in vitro intra- and interobserver validations. Ultrasound Med Biol. 2008 Oct;34(10):1638-50.
- Hong Y., Liu X., Li Z., et al. Real-time ultrasound elastography in the differential diagnosis of benign and malignant thyroid nodules. J Ultrasound Med 2009; 28:861–867
- Itoh A., Ueno E., Tohno E., et al. Breast disease: clinical application of US elastography for diagnosis. Radiology 2006;239:341-350
- Kato K., Sugimoto H., Kanazumi N., et al. Intra-operative application of real-time tissue elastography for the diagnosis of liver tumours. Liver International ISSN 1478-3223
- Kamoi K., Okihara K., Ochiai A., et al. The utility of transrectal real-time elastography in the diagnosis of prostate cancer. Ultrasound in Med. and Biol. 2008; 34(7):1025-1032
- Miyanaga N.,Akaza H., Yamakawa M., et al. Tissue elasticity imaging for diagnosis of prostate cancer: a preliminary report. Int J Urol. 2006 Dec;13(12):1514-8.
- Miyagawa T., Tsutsumi M., Matsumura T., et al. Real-time elastography for the diagnosis of prostate cancer: evaluation of elastographic moving images. Japanese Journal of Clinical Oncology Advance Access published April 9, 2009
- Moon W.K., Huang C-S., Shen W-C., et al. Analysis of elastographic and B-mode features at sonoelastography for breast tumor classification. Ultrasound Med Biol, 2009 Nov;35(11):1794-802
- Pallwein L., Mitterberger M., Pinggera G., et al. Sonoelastography of the prostate: comparison with systematic biopsy findings in 492 patients. Eur J Radiol. 2008 Feb;65(2):304-10
- Pallwein L., Mitterberger M., Struve P., et al. Comparison of sonoelastography guided biopsy with systematic biopsy: impact on prostate cancer detection. Eur Radiol. 2007 Sep;17(9):2278-85
- Pallwein L., Mitterberger M., Gradl J., et al. Value of contrast-enhanced ultrasound and elastography in imaging of prostate cancer. Curr Opin Urol. 2007 Jan;17(1):39-47.
- Pallwein L., Mitterberger M., Struve P., et al. Real-time elastography for detecting prostate cancer: preliminary experience. BJU Int. 2007 Jul;100(1):42-6
- Pallwein L., Mitterberger M., Pelzer A., et al. Ultrasound of prostate cancer: recent advances. Eur Radiology 2008 Apr;18(4):707-15
- Pallwein L.,Aigner F., Faschingbauer R., et al. Prostate cancer diagnosis: value of real-time elastography. Abdom Imaging. 2008 Nov-Dec;33(6):729-35. Review
- Rago T., Santini F., Scutari M., et al. Elastography: new developments in ultrasound for predicting malignancy in thyroid nodules. J Clin Endocrinol Metab. 2007 Aug;92(8):2917-22
- Raza S., Odulate A., Ong E., et al. Using real-time tissue elastography for breast lesion evaluation. Our initial experience. J Ultrasound Med 2010; 29:551–563
- Rubaltelli L., Corradin S., Dorigo A., et al. Differential diagnosis of benign and malignant thyroid nodules at Elastosonography. Ultraschall Med. 2009 Apr;30(2):175-9.
- Salomon G., Köllerman J., Thederan I., et al. Evaluation of prostate cancer detection with ultrasound real-time elastography: a comparison with step section pathological analysis after radical prostatectomy. Eur Urol. 2008 Dec;54(6):1354-62
- Scaperrotta G., Ferranti C., Costa C., et al. Role of sonoelastography in non-palpable breast lesions. Eur Radiol. 2008:18 (11); 2381 - 9
- Sumura M., Shigeno K., Hyuga T., et al. Initial evaluation of prostate cancer with real-time elastography based on step-section pathologic analysis after radical prostatectomy: a preliminary study. Int J Urol. 2007 Sep;14(9):811-6.
- Tan S.M., Teh H.S., Kent Mancer J.F., et al. Improving B mode ultrasound evaluation of breast lesions with real-time ultrasound elastography- a clinical approach.The Breast; 17 (2008):252 – 257
- Tatsumi C, Kudo M, Ueshima K, et al. Non-invasive evaluation of hepatic fibrosis for type C chronic hepatitis. Intervirology. 2010;53(1):76-81. Epub 2010 Jan 5.
- Thomas A., Fischer T., Frey H., et al. Real-time elastography - an advanced method of ultrasound: first results in 108 patients with breast lesions. Ultrasound Obstet Gynecol 2006, Sep;28 (3): 335-340
- Thomas A., Kümmel S., Fritzsche F., et al. Real-time sonoelastography performed in addition to B-mode ultrasound and mammography: improved differentiation of breast lesions? Acad Radiol. 2006 Dec;13(12):1496-504
- Thomas A, Degenhardt F, Farrokh A, et al. Significant differentiation of focal breast lesions: calculation of strain ratio in breast sonoelastography. Acad Radiol. 2010 May;17(5):558-63. Epub 2010 Feb 20.
- Tranquart F., Bleuzen A., Pierre-Renoult P., et al. Elastosonography of thyroid lesions [Article in French]. J Radiol. 2008 Jan;89(1 Pt 1):35-9.
- Tsutsumi M., Miyagawa T., Matsumura T., et al. The impact of real-time tissue elasticity imaging (elastography) on the detection of prostate cancer: clinicopathological analysis. Int J Clin Oncol. 2007 Aug; 12(4):250-5. Epub 2007 Aug 20.
- Tsutsumi M., Miyagawa T., Matsumura T., et al. Real-time balloon inflation elastography for prostate cancer detection and initial evaluation of clinicopathologic analysis. Am J Roentgenol. 2010 Jun;194(6):W471-6.
- Wojcinski S, Farrokh A, Weber S, et al. Multicenter study of ultrasound real-time tissue elastography in 779 cases for the assessment of breast lesions: improved diagnostic performance by combining the BI-RADS®-US classification system with sonoelastography. Ultraschall Med. 2010 Apr 20.
- Zhi H., Ou B., Luo B., et al. Comparison of ultrasound elastography, mammography, and sonography in the diagnosis of solid breast lesions. J Ultrasound Med 2007; 26: 807–815
- Zhi H., Xiaa XY., Yang H-Y., et al. Semi-quantitating stiffness of breast solid lesions in ultrasonic elastography. Acad Radlol 2008; 15:1347-1353
- Recommended reading:
EFSUMB Guidelines for the Use of Contrast Agents in Ultrasound at EFSUMB.ORG