title: WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 1: basic principles and terminology.
abstract: Conventional diagnostic ultrasound images of the anatomy (as opposed to blood flow) reveal differences in the acoustic properties of soft tissues (mainly echogenicity but also, to some extent, attenuation), whereas ultrasound-based elasticity images are able to reveal the differences in the elastic properties of soft tissues (e.g., elasticity and viscosity). The benefit of elasticity imaging lies in the fact that many soft tissues can share similar ultrasonic echogenicities but may have different mechanical properties that can be used to clearly visualize normal anatomy and delineate pathologic lesions. Typically, all elasticity measurement and imaging methods introduce a mechanical excitation and monitor the resulting tissue response. Some of the most widely available commercial elasticity imaging methods are 'quasi-static' and use external tissue compression to generate images of the resulting tissue strain (or deformation). In addition, many manufacturers now provide shear wave imaging and measurement methods, which deliver stiffness images based upon the shear wave propagation speed. The goal of this review is to describe the fundamental physics and the associated terminology underlying these technologies. We have included a questions and answers section, an extensive appendix, and a glossary of terms in this manuscript. We have also endeavored to ensure that the terminology and descriptions, although not identical, are broadly compatible across the WFUMB and EFSUMB sets of guidelines on elastography (Bamber et al. 2013; Cosgrove et al. 2013).
authors: Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: shiina.tsuyoshi.6w@kyoto-u.ac.jp.
authors: Tsuyoshi
authors: T
authors: Shiina
authors: Department of Biomedical Engineering, Duke University, Durham, NC, USA.
authors: Kathryn R
authors: KR
authors: Nightingale
authors: Department of Biomedical Engineering, Duke University, Durham, NC, USA.
authors: Mark L
authors: ML
authors: Palmeri
authors: Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA.
authors: Timothy J
authors: TJ
authors: Hall
authors: Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, London, UK.
authors: Jeffrey C
authors: JC
authors: Bamber
authors: Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio and Radiology Consultants Inc., Youngstown, Ohio, USA.
authors: Richard G
authors: RG
authors: Barr
authors: Service d'Hépatologie, Hôpital Beaujon, Clichy, Assistance Publique-Hôpitaux de Paris, INSERM U 773 CRB3, Université Denis Diderot Paris-VII, France.
authors: Laurent
authors: L
authors: Castera
authors: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors: Byung Ihn
authors: BI
authors: Choi
authors: Department of Radiology, Veterans General Hospital and National Yang-Ming University, School of Medicine, Taipei.
authors: Yi-Hong
authors: YH
authors: Chou
authors: Imaging Departments, Imperial and Kings Colleges, London, United Kingdom.
authors: David
authors: D
authors: Cosgrove
authors: Medizinische Klinik 2, Caritas-Krankenhaus Bad Mergentheim, Germany.
authors: Christoph F
authors: CF
authors: Dietrich
authors: Department of Ultrasound, Zhongshan Hospital, Fudan University, China.
authors: Hong
authors: H
authors: Ding
authors: Breast Center, 21 Ave V. Hugo 13100 Aix-en-Provence, France.
authors: Dominique
authors: D
authors: Amy
authors: Department of Gynecology and Obstetrics, University Hospital RWTH Aachen, Germany.
authors: Andre
authors: A
authors: Farrokh
authors: Ultrasound Unit - Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo - University of Pavia, Italy.
authors: Giovanna
authors: G
authors: Ferraioli
authors: Ultrasound Unit - Infectious Diseases Department, Fondazione IRCCS Policlinico San Matteo - University of Pavia, Italy.
authors: Carlo
authors: C
authors: Filice
authors: Department of Internal Medicine 1, J. W. Goethe University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
authors: Mireen
authors: M
authors: Friedrich-Rust
authors: Department of General Surgery, Kawasaki Medical School, Okayama, Japan.
authors: Kazutaka
authors: K
authors: Nakashima
authors: Department of Breast Imaging and Interventions, University Hospital Schleswig-Holstein Campus Kiel, Germany.
authors: Fritz
authors: F
authors: Schafer
authors: Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timişoara, Romania.
authors: Ioan
authors: I
authors: Sporea
authors: Department of Thyroid and Endocrinology, Fukushima Medical University, School of Medicine, Fukushima, Japan.
authors: Shinichi
authors: S
authors: Suzuki
authors: Department of Diagnostic Imaging, Foothills Medical Centre, University of Calgary, Calgary, AB, Canada.
authors: Stephanie
authors: S
authors: Wilson
authors: Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan.
authors: Masatoshi
authors: M
authors: Kudo
mesh_terms: D054459:Elasticity Imaging Techniques / Q000145:classification* / Q000592:standards*; D006801:Humans; D038622:Internationality; D017410:Practice Guidelines as Topic; D011871:Radiology / Q000592:standards*; D009626:Terminology as Topic
keywords: acoustic radiation force; elasticity; elastogram; elastography; shear wave; stiffness; strain; transient elastography; ultrasonography