Accuracy of Visual Scoring and Semi-Quantification of Ultrasound Strain Elastography: A Phantom Study
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Accuracy of Visual Scoring and Semi-Quantification of Ultrasound Strain Elastography : A Phantom Study. / Carlsen, Jonathan F.; Ewertsen, Caroline; Săftoiu, Adrian; Lönn, Lars; Nielsen, Michael Bachmann.
In: P L o S One, Vol. 9, No. 2, e88699, 2014, p. 1-8.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Accuracy of Visual Scoring and Semi-Quantification of Ultrasound Strain Elastography
T2 - A Phantom Study
AU - Carlsen, Jonathan F.
AU - Ewertsen, Caroline
AU - Săftoiu, Adrian
AU - Lönn, Lars
AU - Nielsen, Michael Bachmann
PY - 2014
Y1 - 2014
N2 - PURPOSE: The aim of this study was to evaluate the performance of strain elastography in an elasticity phantom and to assess which factors influenced visual scoring, strain histograms and strain ratios. Furthermore this study aimed to evaluate the effect of observer experience on visual scorings.MATERIALS AND METHODS: Two operators examined 20 targets of various stiffness and size (16.7 to 2.5 mm) in an elasticity phantom at a depth of 3.5 cm with a 5-18 MHz transducer. Two pre-settings were used yielding 80 scans. Eight evaluators, four experienced, four inexperienced, performed visual scorings. Cut-offs for semi-quantitative methods were established for prediction of target stiffness. Data was pooled in two categories allowing calculations of sensitivity and specificity. Statistical tests chi-square test and linear regression as relevant.RESULTS: Strain ratios and strain histograms were superior to visual scorings of both experienced and inexperienced observers (p = 0.025, strain histograms vs. experienced observers, p<0.001, strain histograms vs. inexperienced observers, p = 0.044 strain ratios vs. experienced observers and p = 0.002 strain ratios vs. inexperienced observers). No significant difference in predicting target stiffness between strain ratios and strain histograms (p = 0.83) nor between experienced and inexperienced observers (p = 0.054) was shown when using four categories. When pooling data in two groups (80 kPa/45 kPa vs. 14/8 kPa) the difference between the observers became significant (p<0.001). Target size had a significant influence on strain ratios measurements (p = 0.017) and on visual scorings (p<0.001) but not on the strain histograms(p = 0.358). Observer experience had significant effect on visual scorings(p = 0.003).CONCLUSION: Strain ratios and strain histograms are superior to visual scoring in assessing target stiffness in a phantom. Target size had a significant impact on strain ratios and visual scoring, but not on strain histograms. Experience influenced visual scorings but the difference between experienced and inexperienced observers was only significant when looking at two classes of target stiffness.
AB - PURPOSE: The aim of this study was to evaluate the performance of strain elastography in an elasticity phantom and to assess which factors influenced visual scoring, strain histograms and strain ratios. Furthermore this study aimed to evaluate the effect of observer experience on visual scorings.MATERIALS AND METHODS: Two operators examined 20 targets of various stiffness and size (16.7 to 2.5 mm) in an elasticity phantom at a depth of 3.5 cm with a 5-18 MHz transducer. Two pre-settings were used yielding 80 scans. Eight evaluators, four experienced, four inexperienced, performed visual scorings. Cut-offs for semi-quantitative methods were established for prediction of target stiffness. Data was pooled in two categories allowing calculations of sensitivity and specificity. Statistical tests chi-square test and linear regression as relevant.RESULTS: Strain ratios and strain histograms were superior to visual scorings of both experienced and inexperienced observers (p = 0.025, strain histograms vs. experienced observers, p<0.001, strain histograms vs. inexperienced observers, p = 0.044 strain ratios vs. experienced observers and p = 0.002 strain ratios vs. inexperienced observers). No significant difference in predicting target stiffness between strain ratios and strain histograms (p = 0.83) nor between experienced and inexperienced observers (p = 0.054) was shown when using four categories. When pooling data in two groups (80 kPa/45 kPa vs. 14/8 kPa) the difference between the observers became significant (p<0.001). Target size had a significant influence on strain ratios measurements (p = 0.017) and on visual scorings (p<0.001) but not on the strain histograms(p = 0.358). Observer experience had significant effect on visual scorings(p = 0.003).CONCLUSION: Strain ratios and strain histograms are superior to visual scoring in assessing target stiffness in a phantom. Target size had a significant impact on strain ratios and visual scoring, but not on strain histograms. Experience influenced visual scorings but the difference between experienced and inexperienced observers was only significant when looking at two classes of target stiffness.
KW - Elasticity
KW - Elasticity Imaging Techniques
KW - Humans
KW - Linear Models
KW - Observer Variation
KW - Phantoms, Imaging
KW - Polymers
KW - Pressure
KW - Reproducibility of Results
KW - Sensitivity and Specificity
KW - Ultrasonography
U2 - 10.1371/journal.pone.0088699
DO - 10.1371/journal.pone.0088699
M3 - Journal article
C2 - 24533138
VL - 9
SP - 1
EP - 8
JO - PLoS ONE
JF - PLoS ONE
SN - 1932-6203
IS - 2
M1 - e88699
ER -
ID: 134910951