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Elastography

Chris de Korte explains what elastography is and how he investigates this innovative ultrasound technique.
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My name is Chris de Korte and I ‘m chair of the Medical Ultrasound Imaging Centre of the Radboud University Nijmegen Medical Centre. We develop ultrasound methods to characterize tissue and detect tumors better and faster. Therefore, we use elastography which is not more than a technique that images strain. In elastography multiple images are used to determine deformation of tissue. We compare these ultrasound signals to each other in order to quantify the movement with high accuracy. If we know the movement of all small parts of the tissue, we can determine the deformation of this tissue. This deformation can be caused by an internal force, or a force that’s imposed by the user.
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For example, an internal force can be blood pressure in arteries, or the movement by breathing in breast applications Another possibility is that the user exerts a force on the tissue. This can be done manually, by moving the transducer slowly towards and from the tissue. And finally ultrasound itself can also be used to push the tissue, but this requires dedicated hardware on your ultrasound system. Strain imaging is primarily used for the detection of tumours and to determine whether these tumours are benign or malignant. Malignant tumours are typically harder than benign tumours and malignant tumours are also larger on an elastogram than on a regular ultrasound image.
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This is possibly caused by the infiltration of malignant tumours in their environment, which is not visible on the ultrasound image. We apply this technique mainly on blood vessels. For vessels, we want to detect plaques with a high risk for rupture. These so called vulnerable plaques give a higher risk for a myocardial infarction or a stroke. Our hypothesis is that these plaques have relatively high strain values. We focus on techniques to make the local deformation measurement more accurate. In this way we developed a diagnostic tool to detect the vulnerable plaque. Furthermore, we focus on ultrafast imaging in combination with elastography. With this combination we are able to image an organ in three dimensions and also to make a 3D elastogram.
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Elastography is being used and applied more and more. The initial patent has now expired so manufacturers are able to integrate this technique in their systems. Scientific research should demonstrate the clinical relevance of elastography in the near future. Additional ultrasound techniques that are also able to determine the mechanical properties of tissue, like shear wave imaging, are investigated as well. So for now it is important that engineers and clinicians join forces to improve and evaluate the elastographic techniques and this will result in a large benefit for the patient.

Chris de Korte explains what elastography is and how he investigates this innovative ultrasound technique. He demonstrates on a phantom what you can expect when there is tissue like a tumor present that has an other stiffness than its surrounding tissue.

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