Superficial ultrasound shear wave speed measurements in soft and hard elasticity phantoms: repeatability and reproducibility using two ultrasound systems

Abstract

Background: There is a paucity of data available regarding the repeatability and reproducibility of superficial shear wave speed (SWS) measurements at imaging depths relevant to the pediatric population.

Objective: To assess the repeatability and reproducibility of superficial shear wave speed measurements acquired from elasticity phantoms at varying imaging depths using three imaging methods, two US systems and multiple operators.

Materials and methods: Soft and hard elasticity phantoms manufactured by Computerized Imaging Reference Systems Inc. (Norfolk, VA) were utilized for our investigation. Institution No. 1 used an Acuson S3000 US system (Siemens Medical Solutions USA, Malvern, PA) and three shear wave imaging method/transducer combinations, while institution No. 2 used an Aixplorer US system (SuperSonic Imagine, Bothell, WA) and two different transducers. Ten stiffness measurements were acquired from each phantom at three depths (1.0 cm, 2.5 cm and 4.0 cm) by four operators at each institution. Student's t-test was used to compare SWS measurements between imaging techniques, while SWS measurement agreement was assessed with two-way random effects single-measure intra-class correlation coefficients (ICCs) and coefficients of variation. Mixed model regression analysis determined the effect of predictor variables on SWS measurements.

Results: For the soft phantom, the average of mean SWS measurements across the various imaging methods and depths was 0.84 ± 0.04 m/s (mean ± standard deviation) for the Acuson S3000 system and 0.90 ± 0.02 m/s for the Aixplorer system (P = 0.003). For the hard phantom, the average of mean SWS measurements across the various imaging methods and depths was 2.14 ± 0.08 m/s for the Acuson S3000 system and 2.07 ± 0.03 m/s Aixplorer system (P > 0.05). The coefficients of variation were low (0.5-6.8%), and interoperator agreement was near-perfect (ICCs ≥ 0.99). Shear wave imaging method and imaging depth significantly affected measured SWS (P < 0.0001).

Conclusion: Superficial shear wave speed measurements in elasticity phantoms demonstrate minimal variability across imaging method/transducer combinations, imaging depths and operators. The exact clinical significance of this variation is uncertain and may change according to organ and specific disease state.

Fig 1

Shear wave elastography images showing shear wave speed measurements acquired from soft elasticity phantom using three different shear wave imaging method/transducer combinations (Acuson S3000 ultrasound system; Siemens Medical Solutions USA, Inc.). A, Virtual Touch IQ (VTIQ); B, Virtual Touch Quantification using 9L4 transducer (VTQ –9L4); and C, Virtual Touch Quantification using 4C1 transducer (VTQ –4C1). Shear wave speed measurements at 2.5 cm imaging depth range from 0.82–0.91 m/s on the images shown.

Fig 1

Shear wave elastography images showing shear wave speed measurements acquired from soft elasticity phantom using three different shear wave imaging method/transducer combinations (Acuson S3000 ultrasound system; Siemens Medical Solutions USA, Inc.). A, Virtual Touch IQ (VTIQ); B, Virtual Touch Quantification using 9L4 transducer (VTQ –9L4); and C, Virtual Touch Quantification using 4C1 transducer (VTQ –4C1). Shear wave speed measurements at 2.5 cm imaging depth range from 0.82–0.91 m/s on the images shown.

Fig 2

Shear Wave Elastography mode image showing Young’s modulus measured in kilopascals (kPa) acquired from hard elasticity phantom using Aixplorer ultrasound system (Supersonic Imagine) and SL10-2 transducer. Mean stiffness within the circular region-of-interest is estimated to be 12.2 kPa (shear wave speed = 2.02 m/s).

Fig 3

Box plots showing shear wave speed measurements acquired in a soft elasticity phantom using 5 different shear wave imaging method/transducer combinations(N=40 measurements for each combination). A, 1 cm imaging depth; B, 2.5 cm imaging depth; C, 4 cm imaging depth. Dots represent statistical outliers (greater than 1.5 interquartile ranges above Quartile 3 or below Quartile 1).

Fig 3

Box plots showing shear wave speed measurements acquired in a soft elasticity phantom using 5 different shear wave imaging method/transducer combinations(N=40 measurements for each combination). A, 1 cm imaging depth; B, 2.5 cm imaging depth; C, 4 cm imaging depth. Dots represent statistical outliers (greater than 1.5 interquartile ranges above Quartile 3 or below Quartile 1).

Fig 3

Box plots showing shear wave speed measurements acquired in a soft elasticity phantom using 5 different shear wave imaging method/transducer combinations(N=40 measurements for each combination). A, 1 cm imaging depth; B, 2.5 cm imaging depth; C, 4 cm imaging depth. Dots represent statistical outliers (greater than 1.5 interquartile ranges above Quartile 3 or below Quartile 1).

Fig 4

Box plots showing shear wave speed measurements acquired in a hard elasticity phantom using 5 different shear wave imaging method/transducer combinations(N=40 measurements for each imaging combination). A, 1 cm imaging depth; B, 2.5 cm imaging depth; C, 4 cm imaging depth. Dots represent statistical outliers (greater than 1.5 interquartile ranges above Quartile 3 or below Quartile 1).

Fig 4

Box plots showing shear wave speed measurements acquired in a hard elasticity phantom using 5 different shear wave imaging method/transducer combinations(N=40 measurements for each imaging combination). A, 1 cm imaging depth; B, 2.5 cm imaging depth; C, 4 cm imaging depth. Dots represent statistical outliers (greater than 1.5 interquartile ranges above Quartile 3 or below Quartile 1).

Fig 4

Box plots showing shear wave speed measurements acquired in a hard elasticity phantom using 5 different shear wave imaging method/transducer combinations(N=40 measurements for each imaging combination). A, 1 cm imaging depth; B, 2.5 cm imaging depth; C, 4 cm imaging depth. Dots represent statistical outliers (greater than 1.5 interquartile ranges above Quartile 3 or below Quartile 1).