Liver Elastography Provides Excellent Strain and Contrast Imaging Capability

Liver stiffness evaluation has been made possible with a second-generation implementation of new radiation force impulse (ARFI) ultrasound technology.

The Royal Liverpool University Hospital (UK), part of The Royal Liverpool and Broadgreen University Hospitals NHS [National Health Service] Trust, is conducting strain and contrast imaging of the liver for the first time following delivery of its third Acuson S2000 diagnostic ultrasound system, developed by Siemens Healthcare (Erlangen, Germany). Located in the ultrasound department, apart from the general imaging applications, it is being used to measure the stiffness of liver tissue using its advanced liver tissue analysis package.

The liver stiffness evaluation has been made possible via Siemens’ second-generation implementation ARFI technology in the S2000’s Virtual Touch high-definition (HD) application. Using the 4C1 transducer, which the hospital has also purchased, ARFI uses an acoustic “push pulse” to provide both qualitative and quantitative analysis of the strain properties or stiffness of deep tissue.

With the further addition of Siemens’ Cadence contrast agent imaging and contrast quantification package, the hospital anticipates being able to characterize focal liver lesions utilizing the ultrasound scan and contrast examination. A nonlinear imaging technique to separate and display tissue or contrast effectively, Cadence is suitable for border and lesion detection and characterization. Staff at the hospital hope its use will prevent the need for a follow up magnetic resonance imaging (MRI) or computed tomography (CT) scan, which in turn will speed up the patient pathway, reduce cost impact on the hospital and radiation dose for the patient.

“We chose the S2000 to replace our old system because of its superb image quality and capability for performing advanced elastography,” said Colin Griffin, ultrasound lead at The Royal Liverpool University Hospital. “Staff are already familiar and very happy with the other S2000s we have in the department so Siemens was the logical choice especially due to the ARFI quantification package for giving specific values for tissue stiffness. In the future we are looking to use the system for an internal research project to evaluate its suitability for other types of contrast examinations.”

“It is very pleasing that the installation of the S2000 has enabled the Royal Liverpool University Hospital to improve the service offered to its patients,” said Bernadette Leonard, regional sales and clinical applications manager for ultrasound at Siemens Healthcare. “Its capacity for yielding penetrating insight into complex anatomy will enable clinicians to offer confident diagnosis on liver lesions, plus its versatility as a general imaging system is advantageous for various other procedures.”

The hospital will also use the S2000 for vascular work including renal transplant imaging, dialysis patients, DVT imaging, and carotid examinations. In addition to the 4C1, the hospital has also purchased a number of Siemens’ other lightweight, ergonomic transducers including the 9L4, 9EVF4, and 14L5.

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