title: Superficial ultrasound shear wave speed measurements in soft and hard elasticity phantoms: repeatability and reproducibility using two ultrasound systems.
abstract: BACKGROUND
  There is a paucity of data available regarding the repeatability and reproducibility of superficial shear wave speed (SWS) measurements at imaging depths relevant to the pediatric population.
  
  
  OBJECTIVE
  To assess the repeatability and reproducibility of superficial shear wave speed measurements acquired from elasticity phantoms at varying imaging depths using three imaging methods, two US systems and multiple operators.
  
  
  METHODS
  Soft and hard elasticity phantoms manufactured by Computerized Imaging Reference Systems Inc. (Norfolk, VA) were utilized for our investigation. Institution No. 1 used an Acuson S3000 US system (Siemens Medical Solutions USA, Malvern, PA) and three shear wave imaging method/transducer combinations, while institution No. 2 used an Aixplorer US system (SuperSonic Imagine, Bothell, WA) and two different transducers. Ten stiffness measurements were acquired from each phantom at three depths (1.0 cm, 2.5 cm and 4.0 cm) by four operators at each institution. Student's t-test was used to compare SWS measurements between imaging techniques, while SWS measurement agreement was assessed with two-way random effects single-measure intra-class correlation coefficients (ICCs) and coefficients of variation. Mixed model regression analysis determined the effect of predictor variables on SWS measurements.
  
  
  RESULTS
  For the soft phantom, the average of mean SWS measurements across the various imaging methods and depths was 0.84 ± 0.04 m/s (mean ± standard deviation) for the Acuson S3000 system and 0.90 ± 0.02 m/s for the Aixplorer system (P = 0.003). For the hard phantom, the average of mean SWS measurements across the various imaging methods and depths was 2.14 ± 0.08 m/s for the Acuson S3000 system and 2.07 ± 0.03 m/s Aixplorer system (P > 0.05). The coefficients of variation were low (0.5-6.8%), and interoperator agreement was near-perfect (ICCs ≥ 0.99). Shear wave imaging method and imaging depth significantly affected measured SWS (P < 0.0001).
  
  
  CONCLUSIONS
  Superficial shear wave speed measurements in elasticity phantoms demonstrate minimal variability across imaging method/transducer combinations, imaging depths and operators. The exact clinical significance of this variation is uncertain and may change according to organ and specific disease state.
authors.affiliation: Department of Radiology, Section of Pediatric Radiology, University of Michigan Health System, C. S. Mott Children's Hospital, 1540 E. Hospital Drive, Ann Arbor, MI, 48109, USA, jonadill@med.umich.edu.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Dillman
authors.forename: Shigao
authors.initials: S
authors.lastname: Chen
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Davenport
authors.forename: Heng
authors.initials: H
authors.lastname: Zhao
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Urban
authors.forename: Pengfei
authors.initials: P
authors.lastname: Song
authors.forename: Kuanwong
authors.initials: K
authors.lastname: Watcharotone
authors.forename: Paul L
authors.initials: PL
authors.lastname: Carson
mesh_terms: D000465:Algorithms; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D019047:Phantoms, Imaging; D015203:Reproducibility of Results; D014159:Transducers