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.
To assess the repeatability and reproducibility of superficial shear wave speed (SWS) measurements acquired from elasticity phantoms at varying imaging depths using three different imaging methods, two different ultrasound systems, and multiple operators.
Methods and Materials
Soft and hard elasticity phantoms manufactured by Computerized Imaging Reference Systems, Inc. (Norfolk, VA) were utilized for our investigation. Institution #1 used an Acuson S3000 ultrasound system (Siemens Medical Solutions USA, Inc.) and three different shear wave imaging method/transducer combinations, while institution #2 used an Aixplorer ultrasound system (Supersonic Imagine) and two different transducers. Ten stiffness measurements were acquired from each phantom at three depths (1.0, 2.5, 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 and coefficients of variation. Mixed model regression analysis determined the effect of predictor variables on SWS measurements.
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 inter-operator agreement was near-perfect (ICCs ≥0.99). Shear wave imaging method and imaging depth significantly affected measured SWS (p<0.0001).
Superficial SWS measurements in elasticity phantoms demonstrate minimal variability across imaging method/transducer combinations, imaging depths, and between operators. The exact clinical significance of this variability is uncertain and may vary by organ and specific disease state.