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## Meet the editor

Monica Lupşor-Platon MD, PhD is an Associate Professor of Medical Imaging at the Iuliu-Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. She is currently working in the Department of Ultrasonography and Elastography of the Institute of Gastroenterology and Hepatology in Cluj. She is involved in the medical education of students and residents and she teaches postgraduate courses in abdominal ultrasonography

and elastography. She has carried out important research activity, especially in the field of non-invasive evaluation of fibrosis and steatosis in diffuse liver diseases using ultrasonographic and elastographic methods, resulting in several scientific papers, with currently over 3000 citations and many national and international awards. She is the author of 3 books and 16 chapters. She is a member of many Romanian and European scientific societies.

Contents

**Section 1**

Techniques

*by Monica Lupsor-Platon*

**Preface III**

Liver Elastography **1**

**Chapter 1 3**

**Chapter 2 21**

**Chapter 3 37**

**Chapter 4 49**

**Chapter 5 61**

**Chapter 6 71**

Breast Elastography **79**

**Chapter 7 81**

Noninvasive Assessment of Diffuse Liver Diseases Using Vibration-Controlled Transient Elastography (VCTE)

Liver Fibrosis Assessment by Point Shear-Wave Elastography

2D Shear Wave Elastography for Liver Fibrosis Evaluation

Elastometry Indices of Unchanged Liver in Healthy Children *by Mikhail Pykov, Natalia Kuzmina, Nikolay Rostovtsev* 

*by Angelica Rita Chiorean, Roxana Pintican, Diana Feier, Dan Eniu* 

Strain Elastography in Invasive Lobular Carcinoma

*by Roxana Șirli, Alina Popescu and Ioan Sporea*

*by Alina Popescu, Roxana Şirli and Ioan Sporea*

*by Ioan Sporea, Roxana Șirli and Alina Popescu*

Elastography in Chronic Liver Diseases *by Samuel N. Gitau and Issa K. Menge*

Quantification of Liver Steatosis

*and Alexander Kinzersky*

*and Maria Magdalena Duma*

**Section 2**

## Contents



Preface

characteristics of tissues, has been rapidly evolving in recent years. The advantage of this technique is its ability to rapidly detect and quantify the changes in soft tissue stiffness resulting from specific pathological or physiological processes. Ultrasound elastography is nowadays applied especially on the liver and breast, but the technique has been increasingly used for other tissues including the thyroid, lymph nodes, spleen, pancreas, gastrointestinal tract, kidney, prostate, and the

This book presents some of the applications of strain and shear-wave ultrasound elastography in hepatic, pancreatic, breast and musculoskeletal conditions.

Most of the book is focused on diffuse liver conditions, since the evaluation of diffuse liver disease is the best validated application of ultrasound elastography and has been widely adopted for non-invasive detection and staging of liver fibrosis and steatosis, for the diagnosis of cirrhosis and its complications, as well as for monitoring disease progression. The main elastographic techniques in these conditions are reviewed, namely Vibration Controlled Transient Elastography (VCTE), point-Shear Waves Elastography, and 2D Share Wave Elastography.

The use of elastography in breast conditions is also discussed; specifically, the technique is used for differentiating benign focal lesions from suspicious focal lesions (in general, benign lesions have low stiffness, while malignant lesions have high stiffness). Both strain and shear-wave methods have been evaluated for improving the generally high sensitivity and specificity of the Breast Imaging Reporting and Data System (BIRADS) and it is recommended that they are used to

Another chapter reviews pancreatic elastography, a challenging new procedure used for inflammatory and tumoral conditions. Certain technical difficulties, such as the deep location of the organ, impede the accurate assessment of pancreatic stiffness, but the new software for both conventional and endoscopic ultrasound offer promise for the differential diagnosis between malignant tumors and different

The last chapter includes some preliminary data on the strain-based elastography

Evidently, further research with unbiased large-scale studies is still required, but ultrasound elastography holds immense potential for various clinical applications, and its continued development will warrant its widespread clinical use in the

Elastography, the science of creating noninvasive images of mechanical

musculoskeletal and vascular systems.

enhance the usual ultrasound examination.

assessment of patients with De Quervain tenosynovitis.

forms of chronic pancreatitis.

upcoming years.
