applied sciences Ultrasound Elastography Edited by Christoph F. Dietrich Printed Edition of the Special Issue Published in Applied Sciences www.mdpi.com/journal/applsci Ultrasound Elastography Ultrasound Elastography SpecialIssueEditor ChristophF.Dietrich MDPI•Basel•Beijing•Wuhan•Barcelona•Belgrade SpecialIssueEditor ChristophF.Dietrich CaritasKrankenhausBadMergentheim Germany EditorialOffice MDPI St.Alban-Anlage66 4052Basel,Switzerland This is a reprint of articles from the Special Issue published online in the open access journal AppliedSciences(ISSN2076-3417)from2017to2018(availableat: https://www.mdpi.com/journal/ applsci/specialissues/UltrasoundElastography). Forcitationpurposes,citeeacharticleindependentlyasindicatedonthearticlepageonlineandas indicatedbelow: LastName,A.A.; LastName,B.B.; LastName,C.C.ArticleTitle. JournalNameYear,ArticleNumber, PageRange. ISBN978-3-03897-910-4(Pbk) ISBN978-3-03897-911-1(PDF) (cid:2)c 2019bytheauthors. ArticlesinthisbookareOpenAccessanddistributedundertheCreative Commons Attribution (CC BY) license, which allows users to download, copy and build upon publishedarticles,aslongastheauthorandpublisherareproperlycredited,whichensuresmaximum disseminationandawiderimpactofourpublications. ThebookasawholeisdistributedbyMDPIunderthetermsandconditionsoftheCreativeCommons licenseCCBY-NC-ND. Contents AbouttheSpecialIssueEditor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii ChristophF.DietrichandJeffreyC.Bamber EditorialontheSpecialIssueofAppliedSciencesontheTopicofElastography Reprintedfrom:AppliedSciences2018,8,1232,doi:10.3390/app8081232 . . . . . . . . . . . . . . . 1 Faisal N. Baig, Shirley Y. W. Liu, Hoi-Chun Lam, Shea-Ping Yip, Helen K. W. Law and MichaelYing ShearWaveElastographyCombiningwithConventionalGreyScaleUltrasoundImprovesthe DiagnosticAccuracyinDifferentiatingBenignandMalignantThyroidNodules Reprintedfrom:AppliedSciences2017,7,1103,doi:10.3390/app7111103 . . . . . . . . . . . . . . . 8 Cheng-HanLee,Yung-LiangWan,Tse-HwaHsu,Shiu-FengHuang,Ming-ChinYu, Wei-ChenLee,Po-HsiangTsui,Yi-ChengChen,Chun-YenLinandDar-InTai InterpretationUSElastographyinChronicHepatitisBwithorwithoutAnti-HBVTherapy Reprintedfrom:AppliedSciences2017,7,1164,doi:10.3390/app7111164 . . . . . . . . . . . . . . . 22 MariuszŁucejkoandRobertFlisiak EffectofHCVCoreAntigenandRNAClearanceduringTherapywithDirectActingAntivirals onHepaticStiffnessMeasuredwithShearWaveElastographyinPatientswithChronicViral HepatitisC Reprintedfrom:AppliedSciences2018,8,198,doi:10.3390/app8020198. . . . . . . . . . . . . . . . 34 XuejunZhang,XiangrongZhou,TakeshiHaraandHiroshiFujita Non-InvasiveAssessmentofHepaticFibrosisbyElasticMeasurementofLiverUsingMagnetic ResonanceTaggingImages Reprintedfrom:AppliedSciences2018,8,437,doi:10.3390/app8030437. . . . . . . . . . . . . . . . 46 Sheng-HungChenandCheng-YuanPeng Ultrasound-BasedLiverStiffnessSurveillanceinPatientsTreatedforChronicHepatitisBorC Reprintedfrom:AppliedSciences2018,8,626,doi:10.3390/app8040626. . . . . . . . . . . . . . . . 59 KristenM.Meiburger,MassimoSalvi,MaurizioGiacchino,U.RajendraAcharya, MarcoA.Minetto,CristinaCaresioandFilippoMolinari Quantitative Analysis of Patellar Tendon Abnormality in Asymptomatic Professional “Pallapugno”Players:ATexture-BasedUltrasoundApproach Reprintedfrom:AppliedSciences2018,8,660,doi:10.3390/app8050660. . . . . . . . . . . . . . . . 69 ChristophF.Dietrich,RoxanaSirli,GiovannaFerraioli,AlinaPopescu,IoanSporea, CorinaPienar,ChristianKunze,HeikeTaut,SimoneSchrading,SimonaBota, DagmarSchreiber-DietrichandDongYi CurrentKnowledgeinUltrasound-BasedLiverElastographyofPediatricPatients Reprintedfrom:AppliedSciences2018,8,944,doi:10.3390/app8060944. . . . . . . . . . . . . . . . 82 SiuNgorFu,Hsing-KuoWangandChenHuang ANovelMethodforAssessingRegionalTendonStiffnessandItsSignificance Reprintedfrom:AppliedSciences2018,8,1156,doi:10.3390/app8071156 . . . . . . . . . . . . . . . 101 CatherinePayne,PeterWattandNickWebborn Shear Wave Elastography Measures of the Achilles Tendon: Influence of Time of Day, Leg DominanceandtheImpactofanAcute30-MinuteBoutofRunning Reprintedfrom:AppliedSciences2018,8,1170,doi:10.3390/app8071170 . . . . . . . . . . . . . . . 109 v RoaldFleslandHavre, JoErlingRiiseWaage, AnesaMulabecirovic, OddHelgeGiljaand LarsBirgerNesje StrainRatioasaQuantificationToolinStrainImaging Reprintedfrom:AppliedSciences2018,8,1273,doi:10.3390/app8081273 . . . . . . . . . . . . . . . 123 vi About the Special Issue Editor ChristophF.Dietrich,Prof. Dr.,MBA,isChiefofInternalMedicine2atCaritas-KrankenhausBad Mergentheim, Germany. He has also studied philosophy and history. He specializes in internal medicine, gastroenterology, hepatology, proctology, pneumology, hematology, oncology, palliative care,andgeriatricmedicine. HewasthePresidentofEFSUMBfrom2013to2015andofDGE-BVin 2013,andheiscurrentlytheVicePresidentofWFUMB(2017–2019). vii applied sciences Editorial Editorial on the Special Issue of Applied Sciences on the Topic of Elastography ChristophF.Dietrich1,2,*ID andJeffreyC.Bamber3 1 Sino-GermanTongji-CaritasResearchCenterofUltrasoundinMedicine,DepartmentofMedicalUltrasound, TongjiHospital,TongjiMedicalCollege,HuazhongUniversityofScienceandTechnology, Wuhan430030,China 2 DepartmentofInternalMedicine2,MedizinischeKlinik2,CaritasKrankenhausBadMergentheim, Uhlandstraße7,97980BadMergentheim,Germany 3 JointDepartmentofPhysicsandCancerResearchUKImagingCentre,TheInstituteofCancerResearchand TheRoyalMarsdenHospital,CotswoldRoad,Sutton,LondonSM25NG,UK;[email protected] * Correspondence:[email protected];Tel.:+49-7931-58-2201;Fax:+49-7931-58-2290 Received:20June2018;Accepted:17July2018;Published:26July2018 Keywords:guideline;EFSUMB;WFUMB;elastography;contrastenhancedultrasound;pointofcare ultrasound;healthcare Elastographyisthescienceofcreatingnoninvasiveimagesofthemechanicalcharacteristicsof tissues.Thebasicprinciplesofelastographyhavebeendescribedsomeyearsagoandhaveremained unchangedsincetheywereoutlinedintheEuropeanFederationofSocietiesforUltrasoundinMedicine andBiology(EFSUMB)guidelines[1,2].Thefirstelastographyguidelinesworldwidewereintroduced andpublishedbyEFSUMBinApril2013[1,2],wereupdatedin2017fortheliver[3,4],andwere followedbytheJapaneseSocietyofUltrasoundinMedicine(JSUM)[5]andtheWorldFederationfor UltrasoundinMedicineandBiology(WFUMB)guidelinesonbasicprinciples[6]andapplicationsin variousorgans[7–14].Thementionedguidelinesprovideanintroductiontothephysicalprinciples andtechnologyonwhichallformsofcurrentcommerciallyavailableultrasoundelastographyare based.Thepracticaladvantagesanddisadvantagesthatareassociatedwitheachofthetechniques aredescribed,andguidanceisprovidedontheoptimisationofscanningtechnique,imagedisplay, imageinterpretation,andsomeoftheknownimageartefacts.TheEFSUMBandtheWFUMBguideline articlescanbefreelydownloadedfromtheEFSUMBwebsite(www.efsumb.org)[15]andtheWFUMB website(www.wfumb.org). Asdescribedin[1],ultrasoundelastographyusesultrasonicechoestoobservetissuedisplacement asafunctionoftimeandspaceafterapplyingaforcethatiseitherdynamic(e.g., bythumping orvibrating)orvaryingitsoslowlythatitisconsidered“quasi-static”(e.g.,byprobepalpation). Thecommerciallyavailabletechnologiescanbeclassifiedaccordingtowhetherthistissuedisplacement is(a)displayeddirectlyastheimagedquantity,asinthemethodthatisknownasacousticradiation forceimpulse(ARFI)imaging;(b)usedtocalculateanddisplaystrain,producingwhatistermed strainelastography(SE);or(c)usedtocalculateanddisplayanimageofshearwavespeed.Thelast oftheseisanimagethatis,inprinciple,quantitativeforatissuepropertyandistheonlyonethat requiresthecreationofashearwave,whichinturnrequirestheuseofadynamicforce.Theothers mayuseadynamicforcebutcanalsoworkwithastaticornearlystaticforce[1].However,eventhe measurementofshearwavespeedisdependentonsystemparameterssuchastheappliedshearforce andthefrequencyoftheshearwave.Elastographymaybeconsideredasatypeofremotepalpation thatallowsthemeasurementanddisplayofbiomechanicalpropertiesthatareassociatedwiththe elasticrestoringforcesinthetissuethatactagainstsheardeformation.Thisviewunifiesthedifferent typesofelastography,namelySE,ARFIimaging,andSWE,andexplainswhytheyalldisplayimages withcontrastforthesameunderlyinginformation,whichisassociatedwiththeshearelasticmodulus. Appl.Sci.2018,8,1232;doi:10.3390/app8081232 1 www.mdpi.com/journal/applsci