Protocol for acquisition of images and measurement of transabdominal ultrasound pancreatic two-dimensional shear wave elastography (2D-SWE)

Abstract

Introduction

Transabdominal ultrasound (TU) pancreatic 2D-SWE elastography is a developing technique that needs to be protocolized.

Objectives

Establish a protocol for image acquisition and measurement of TU pancreatic — 2D-SWE elastography and estimate the minimum number of measurements to be performed.

Materials and methods

Ten measurements of pancreatic elasticity were taken in healthy volunteers using TU-2D-SWE, following a strict protocol for image acquisition and measurement.

Results

The 70% of the participants were women, with an average age, weight, and BMI of 49.5 ± 15.7 years, 65.9 ± 11.9 kg, and 24.5 ± 4.2 kg/m², respectively. Measurements were taken from the body (70%), tail (16.7%), and pancreatic head (13.3%). The median mean velocity and elasticity were 1.46 ± 0.25 cm/s and 6.46 ± 2.87 kPa, respectively. The ROI depth was 4.12 ± 1 cm and the SP-ROI distance was 5.2 mm on average. There were no statistically significant differences between the 10 measurements. The reliability analysis of the measurements showed high internal consistency and repeatability. Taking 5–6 measurements ensured high concordance with the ten reference measurements. The measurements were significantly lower when the SP-ROI values were intermediate (0.3–0.6 cm). The measurement accuracy was higher when performed at a depth less than 4.8 cm.

Conclusion

To measure pancreatic elasticity using TU-2D-SWE, we propose a strict protocol for image acquisition and measurement, taking a minimum of 5 measurements in the best visualized and accessible pancreatic portion, and preferably at a depth of less than 4.8 cm.