Impact of respiratory motion on liver stiffness measurements according to different shear wave elastography techniques and region of interest methods: a phantom study

Abstract

Purpose: This study quantified the impact of respiratory motion on liver stiffness measurements according to different shear wave elastography (SWE) techniques and region of interest (ROI) methods, using liver fibrosis phantoms. Methods: Three operators measured stiffness values in four phantoms with different stiffness on a moving platform with two SWE techniques (point-SWE [pSWE] and 2-dimensional SWE [2D-SWE]), three types of motion (static mode and moving mode at low and high speeds), and four ROI methods in 2D-SWE (circle, point, box, and multiple). The circular ROI method was used to compare the two SWE techniques. The occurrence of technical failure and unreliable measurements, stiffness values, and measurement time were evaluated. Results: Technical failure was observed only in moving mode for pSWE and 2D-SWE (n=1 for both). Unreliable measurements were also only observed in moving mode and were significantly less common in 2D-SWE (n=1) than in pSWE (n=12) (P<0.001). No statistically significant differences in the technical failure rate or stiffness values were noted between the static and moving modes for both SWE techniques. The technical failure and unreliable measurement rates were not significantly different among the ROI methods for 2D-SWE. Stiffness values did not differ significantly according to the ROI method used in any moving mode. However, the multiple ROI method had significantly shorter measurement times than the circular ROI method for all moving modes. Conclusion: 2D-SWE may be preferable for evaluating liver fibrosis in patients with poor breathhold. Furthermore, 2D-SWE with multiple ROIs enables rapid measurements, without affecting liver stiffness values.