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World J Radiol. May 28, 2020; 12(5): 76-86
Published online May 28, 2020. doi: 10.4329/wjr.v12.i5.76
Diagnostic problems in two-dimensional shear wave elastography of the liver
Hiroko Naganuma, Hideaki Ishida, Atsushi Uno, Hiroshi Nagai, Hidekatsu Kuroda, Masahiro Ogawa
Hiroko Naganuma, Department of Gastroenterology, Yokote Municipal Hospital, Yokote 0138602, Akita, Japan
Hideaki Ishida, Department of Gastroenterology, Akita Red Cross Hospital, Kamikitatesaruta 0101495, Akita, Japan
Atsushi Uno, Department of Gastroenterology, Oomori Municipal Hospital, Yokote 0130525, Akita, Japan
Hiroshi Nagai, New Generation Imaging Laboratory, Tokyo 1680065, Japan
Hidekatsu Kuroda, Division of Gastroenterology and Hepatology, Iwate Medical University, Morioka 0200023, Iwate, Japan
Masahiro Ogawa, Department of Gastroenterology and Hepatology, Nihon University Hospital, Chiyoda 1018309, Tokyo, Japan
Author contributions: Naganuma H designed the report, collected the patient’s clinical data, and generated the figures; Ishida H designed the report and wrote the paper; Uno A performed the computer simulation; Nagai H generated the figures; Kuroda H and Ogawa M collected the patient’s clinical data.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hiroko Naganuma, MD, PhD, Doctor, Department of Gastroenterology, Yokote Municipal Hospital, 5-31 Negishi-cho, Yokote 0138602, Akita, Japan. hiron@vesta.ocn.ne.jp
Received: February 25, 2020
Peer-review started: February 25, 2020
First decision: April 7, 2020
Revised: April 19, 2020
Accepted: May 12, 2020
Article in press: May 12, 2020
Published online: May 28, 2020
Processing time: 91 Days and 18.8 Hours
Core Tip

Core tip: Two-dimensional shear wave elastography is the most widely used diagnostic tool for liver but has many ultrasound artifact-related problems. Our computer simulation model suggests the following ways to minimize them: (1) In patients with chronic hepatic disease, especially liver cirrhosis, measure shear wave values through the least irregular hepatic surface; (2) The most useful application in patients with focal lesions is detecting lesions poorly visible on B-mode ultrasound and differentiating true tumors from pseudo-tumors (e.g., irregular fatty change); and (3) Measurement of shear wave values in the area posterior to a focal lesion must be avoided.