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Hitachi Medical Systems Singapore

Hitachi

Ultrasound : Elastography

An innovative ultrasound modality for the assessment of tissue elasticity


Hitachi Real-time Tissue Elastography is an emerging technology in ultrasound diagnosis for the assessment and real-time colour display of tissue elasticity. The benefit of this new generation ultrasound technology has been studied in different clinical areas including breast, urology, prostate, thyroid, endoscopy and many other applications.


A unique technology…


  • Extracting strain data through measurements from the Strain Ratio tool
  • Performing fast, accurate and reproducible results
  • Incorporating an adjustable colour transparency feature enabling a co-relation between the native B-mode and elastography image in real-time

Features

HI-RTE Image

  • An important characteristic of tissue is its elasticity which changes through pathophysiological processes, in particular, chronic or acute inflammation, malignancy and aging processes all of which can affect the elastic nature of tissues. Therefore the assessment and visualisation of tissue elasticity can provide potentially vital information in disease diagnosis.
  • Hitachi’s Real-time Tissue Elastography module uses an Extended Combined Autocorrelation Method (ECAM) to produce an elasticity image in real time.
    It uses a freehand approach to compress the tissues with the ultrasound transducer - a technique which is easily integrated into the routine ultrasound examination.

  • Relative tissue elasticity is calculated and displayed as a colour overlay of the conventional B-mode image. Stiffer tissue structures are displayed in blue, while the more easily deformed tissues are in red.
  • The ECAM elastography algorithm performs a 2D correlation in both axial and lateral directions, overcoming the problem of sideslip and improving the accuracy of the strain image.
  • Clinical evaluation of the modality has shown that lesions can be characterised more rapidly and with a higher degree of accuracy, when elastography is incorporated into the conventional examination.

Clinical Applications

Hitachi Real-time Tissue Elastography is compatible with over 20 different transducers and its diagnostic value has been proven in a variety of different clinical areas, notably breast, urology, pancreas and lymph nodes.

Breast

In breast applications, Hitachi Real-time Tissue Elastography has a complementary diagnostic role to the conventional B-mode:

  • The assessment of elasticity can be made in real-time
  • The Tsukuba score classification is simple to use and suitable for routine clinical use (see figure 3)
  • Hitachi Real-time Tissue Elastography is proven in multicentre studies to be an effective and reproducible US modality and is not time-consuming
  • Hitachi Real-time Tissue Elastography offers increased specificity afforded by the addition of new benign criteria
  • Hitachi Real-time Tissue Elastography has the potential to eliminate unnecessary benign core biopsies especially in breast masses categorised as BI-RADS categories 3 and 4
  • The Fat to Lesion Ratio (Strain Ratio) can provide greater objectivity in assessing the elastography image

Urology

Hitachi Real-time Tissue Elastography of the prostate offers a new approach for the detection and visualisation of cancer:

  • Hitachi Real-time Tissue Elastography can detect prostate cancer foci with good accuracy
  • It allows the estimation of tumour location and extent
  • The cancer yield with Hitachi Real-time Tissue Elastography - guided targeted biopsies can equal that of systematic biopsy for less than half the number of cores

Endoscopic Ultrasound

Hitachi Real-time Tissue Elastography can also improve the detection and differentiation of testicular masses

  • Endoscopic Hitachi Real-time Tissue Elastography allows the characterisation and differentiation of benign and malignant lymph nodes with a high sensitivity, specificity and accuracy
  • It provides better targeting for fine needle aspiration (FNA) procedures in patients with multiple enlarged lymph nodes
  • Mapping of the tissue elasticity distribution can provide more information for differentiation of focal pancreatic masses
  • Hitachi Real-time Tissue Elastography can be used to target EUS-FNA biopsy into stiffer regions of the pancreas suspicious for malignancy

Thyroid

Thyroid nodules are very common, but less than 5% are malignant. Conventional US can predict malignancy with high specificity in less than 20% patients.

  • Hitachi Real-time Tissue Elastography can provide quick and easy characterisation of thyroid nodules thereby allowing identification of patients at high risk of malignancy
  • A low elasticity score on Hitachi Real-time Tissue Elastography (stiff lesion) has been shown to be highly predictive of malignancy
  • An entirely elastic nodule pattern has been observed only in relation to benign nodules, in which case the indication for a biopsy is questionable
  • In a multinodular goiter, high true positive results have been achieved when Hitachi Real-time Tissue Elastography is used to target a particular nodule for biopsy which is hard on Hitachi Real-time Tissue Elastography

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Hitachi Real-time Tissue Elastography

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