Clinical Endoscopy

Defining the optimal technique for endoscopic ultrasound shear wave elastography: a combined benchtop and animal model study with comparison to transabdominal shear wave elastography: Thomas J. Wang, Marvin Ryou; Clin Endosc 2023;56(2):229-238. Published online February 28, 2023; DOI: https://doi.org/10.5946/ce.2022.135

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Shear wave elastography (SWE) is used for liver fibrosis staging based on stiffness measurements. It can be performed using endoscopic ultrasound (EUS) or a transabdominal approach. Transabdominal accuracy can be limited in patients with obesity because of the thick abdomen. Theoretically, EUS-SWE overcomes this limitation by internally assessing the liver. We aimed to define the optimal technique for EUS-SWE for future research and clinical use and compare its accuracy with that of transabdominal SWE.
Methods
Benchtop study: A standardized phantom model was used. The compared variables included the region of interest (ROI) size, depth, and orientation and transducer pressure. Porcine study: Phantom models with varying stiffness values were surgically implanted between the hepatic lobes.
Results
For EUS-SWE, a larger ROI size of 1.5 cm and a smaller ROI depth of 1 cm demonstrated a significantly higher accuracy. For transabdominal SWE, the ROI size was nonadjustable, and the optimal ROI depth ranged from 2 to 4 cm. The transducer pressure and ROI orientation did not significantly affect the accuracy. There were no significant differences in the accuracy between transabdominal SWE and EUS-SWE in the animal model. The variability among the operators was more pronounced for the higher stiffness values. Small lesion measurements were accurate only when the ROI was entirely situated within the lesion.
Conclusions
We defined the optimal viewing windows for EUS-SWE and transabdominal SWE. The accuracy was comparable in the non-obese porcine model. EUS-SWE may have a higher utility for evaluating small lesions than transabdominal SWE.

Citations

Citations to this article as recorded by

Endoscopic Ultrasound-based Shear Wave Elastography for Detection of Advanced Liver Disease
Jad AbiMansour, Jerry Yung-Lun Chin, Jyotroop Kaur, Eric J. Vargas, Barham K. Abu Dayyeh, Ryan Law, Vishal Garimella, Michael J. Levy, Andrew C. Storm, Ross Dierkhising, Alina Allen, Sudhakar Venkatesh, Vinay Chandrasekhara
Journal of Clinical Gastroenterology.2024;[Epub] CrossRef
Response
Divyanshoo R. Kohli, Mohammad Shadab Siddiqui
Gastrointestinal Endoscopy.2024; 100(1): 161. CrossRef
Advancements and challenges in gastrointestinal imaging
Eun Jeong Gong, Chang Seok Bang
World Journal of Clinical Cases.2024; 12(33): 6591. CrossRef
The Role of Endoscopic Ultrasound-Guided Shear Wave Elastography in Pancreatic Diseases
Yazan Abboud, Srinivas Gaddam
Diagnostics.2024; 14(20): 2329. CrossRef
EUS-based shear wave elastography of the spleen for detection of clinically significant portal hypertension
Jad P. AbiMansour, Jerry Yung-Lun Chin, Eric J. Vargas, Jyotroop Kaur, Barham K. Abu Dayyeh, Ryan J. Law, Vishal Garimella, Michael J. Levy, Andrew C. Storm, Ross Dierkhising, Alina Allen, Vinay Chandrasekhara
iGIE.2024; 3(4): 507. CrossRef
EUS-guided shear wave elastography for fibrosis screening in patients with obesity and metabolic dysfunction–associated steatotic liver disease: a pilot study (with video)
Thomas J. Wang, Pichamol Jirapinyo, Raj Shah, Kimberly Schuster, David J. Papke, Christopher C. Thompson, Laura Doyon, David B. Lautz, Marvin Ryou
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Reproducibility of EUS-guided shear wave elastography for assessment of hepatic fibrosis: a prospective pilot cohort study
David L. Diehl, Vikas Sangwan, Sandeep Khurana, Harshit S. Khara, Jianying Zhang, Bradley D. Confer
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Standardization of endoscopic ultrasound shear wave elastography
Julio Iglesias-García, J. Enrique Domínguez-Muñoz
Clinical Endoscopy.2023; 56(2): 185. CrossRef

3,000 View
189 Download
3 Web of Science
8 Crossref

Utility of Over-the-Scope Clipping for Closure of a Persistent Post-Percutaneous Endoscopic Gastrostomy Fistula under Long-Term Steroid Therapy: Yoshihisa Arao, Yuichi Sato, Satoru Hashimoto, Hiroki Honda, Kazumi Yoko, Masaaki Takamura, Ken-ichi Mizuno, Masaaki Kobayashi; Clin Endosc 2015;48(6):563-565. Published online November 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.6.563

Abstract PDF PubReader ePub

A 50-year-old woman had a percutaneous endoscopic gastrostomy (PEG) tube placed after surgery for pharyngeal cancer. After 21 months, the PEG tube was removed due to improvement of per-oral ingestion. She had taken prednisolone for 31 years for systemic lupus erythematosus. The post-PEG fistula did not close spontaneously. The cause of the fistula was slow wound healing and gastrostomy site inflammation due to long-term steroid therapy. We were able to close the fistula with an over-the-scope clipping (OTSC) system. This case suggests that OTSC is useful for closing persistent post-PEG fistulas in patients receiving long-term prednisolone therapy.

Citations

Citations to this article as recorded by

UEG Week 2016 Poster Presentations

United European Gastroenterology Journal.2016; 4(5_suppl): A157. CrossRef

10,241 View
69 Download
1 Crossref

Acute Duodenal Ischemia and Periampullary Intramural Hematoma after an Uneventful Endoscopic Retrograde Cholangiopancreatography in a Patient with Primary Myelofibrosis: Chang Ho Jung, Jong Jin Hyun, Dae Hoe Gu, Eul Sun Moon, Jae Seon Kim, Hong Sik Lee, Chang Duck Kim; Clin Endosc 2014;47(3):270-274. Published online May 31, 2014; DOI: https://doi.org/10.5946/ce.2014.47.3.270

Abstract PDF PubReader ePub

Acute duodenal ischemia and periampullary intramural hematoma are rare complications after endoscopic retrograde cholangiopancreatography (ERCP). A 77-year-old man with splenomegaly complained of abdominal pain caused by common bile duct (CBD) stone. After successful removal of the CBD stone without immediate complications, the patient developed intramural hematoma around the ampulla of Vater along with diffuse duodenal edema. The findings were compatible with acute intestinal ischemia, and further evaluation revealed that he had underlying primary myelofibrosis. Myeloproliferative diseases are known to be significantly associated with an increased risk of thrombohemorrhagic complications. Therefore, particular attention should be given to this group of patients when a high-risk procedure such as ERCP is performed.

Citations

Citations to this article as recorded by

Ischemic duodenitis after endoscopic retrograde cholangiopancreatography‐related procedure
Yuki Tanisaka, Akashi Fujita, Shomei Ryozawa
Digestive Endoscopy.2022; 34(6): 1264. CrossRef
Ruptured Dissecting Intramural Duodenal Hematoma Following Endoscopic Retrograde Cholangiopancreatography
Eric Weiss, Madeline Tadley, Pak S. Leung, Mark Kaplan
ACG Case Reports Journal.2017; 4(1): e70. CrossRef

6,724 View
67 Download
2 Web of Science
2 Crossref

식도 정맥류 출혈을 동반한 원발성 골수섬유증 1예 ( A Case of Idiopathic Myelofibrosis Causing an Esophageal Variceal Hemorrhage ): Korean J Gastrointest Endosc 2000;21(1):549-553. Published online November 30, 1999

Abstract PDF: Idiopathic Myelofibrosis (IMF), a clonal disorder of a multipotent hemtopoietic progenitor cell of unknown etiology, is characterized by massive splenomegaly, leukoerythroblastic blood changes, and bone marrow fibrosis. Portal hypertension occurs in approximately 10% of patients with IMF. Alsom there mey be bleeding from esophageal varices. A 59-year-old woman was admitted with intermittent abdominal distension and melena. An esophagogastroduodenoscopy revealed extensive esophageal varices with red colored signs, and subsequently esophageal variceal ligation was performed. Marked splenomegaly and ascites was observed through abdominal US and MRI scan. Bone marrow biopsy revealed an increase in reticulin and fibrosis. Extramedullary hematopoiesis and sinusoidal change were observed in the liver biopsy specimen. This case of IMF causing an esophageal variceal hemorrhage is herein reported. (Korean J Gastrointest Endosc 2000;21:549-553)

1,602 View
2 Download

다낭성 신질환을 동반한 선천성 간 섬유화증 1예 ( A Case of Congenital Hepatic Fibrosis Associated with Polycystic Kidney Disease ): Korean J Gastrointest Endosc 1999;19(5):848-852. Published online November 30, 1998

Abstract PDF: Congenital hepatic fibrosis is a developmental abnormality that may appear either sporadically or in a familial form. It is an inherited disease defined pathologically by bands of fibrous tissue within the liver, and is occasionally associated with cystic kidney disease. A 21-year-old woman was admitted to our hospital for evaluation of pancytopenia. She showed esophageal varices, hepatomegaly and splenomegaly, but had normal results on her liver function test. Peripheral stigmata of chronic liver disease such as palmar erythema or spider angioma was not found. Hepatosplenomegaly, polycystic kidney and psoas muscle cyst were detected through an abdominal CT and MRI. The patient is diagnosis was confirmed as congenital hepatic fibrosis using laparoscopic liver biopsy. The first case of congenital hepatic fibrosis associated with polycystic kidney disease in Korea is herein reported. (Korean J Gastrointest Endosc 19: 848∼852, 1999)

1,435 View
1 Download

선천성 감섬유증 1예 ( A Case of Congenital Hepatic Fibrosis ): Korean J Gastrointest Endosc 1991;11(2):317-321. Published online November 30, 1990

Abstract PDF: We experienced a case of congental hepatic fibrosis in a 21-year-old Korean male. He had frequent episodes of esophageal variceal bleeding. His liver and kidney functions were preserved. He had cystic lesions on both kidneys. A diagnosis of congenital hepatic fibrosis was made by an inferior venacavogram and peritoneoscopic liver biopsy. A Kobayashi operation was performed for esophageal varices. He had no more variceal bleeding and his general condition was good after operation.

1,273 View
2 Download

Search