Theranostics 2017; 7(5):1303-1329. doi:10.7150/thno.18650


Ultrasound Elastography: Review of Techniques and Clinical Applications

Rosa M.S. Sigrist1, Joy Liau1, Ahmed El Kaffas1, Maria Cristina Chammas2, Juergen K. Willmann1✉

1. Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, School of Medicine, Stanford, CA, USA.
2. Department of Ultrasound, Institute of Radiology, Hospital das Clínicas, Medical School of University of São Paulo


Elastography-based imaging techniques have received substantial attention in recent years for non-invasive assessment of tissue mechanical properties. These techniques take advantage of changed soft tissue elasticity in various pathologies to yield qualitative and quantitative information that can be used for diagnostic purposes. Measurements are acquired in specialized imaging modes that can detect tissue stiffness in response to an applied mechanical force (compression or shear wave). Ultrasound-based methods are of particular interest due to its many inherent advantages, such as wide availability including at the bedside and relatively low cost. Several ultrasound elastography techniques using different excitation methods have been developed. In general, these can be classified into strain imaging methods that use internal or external compression stimuli, and shear wave imaging that use ultrasound-generated traveling shear wave stimuli. While ultrasound elastography has shown promising results for non-invasive assessment of liver fibrosis, new applications in breast, thyroid, prostate, kidney and lymph node imaging are emerging.

Here, we review the basic principles, foundation physics, and limitations of ultrasound elastography and summarize its current clinical use and ongoing developments in various clinical applications.

Keywords: Elastography, Ultrasound, Strain Imaging, Shear Wave Imaging, Liver, Breast, Thyroid, Kidney, Prostate, Lymph nodes.

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How to cite this article:
Sigrist RMS, Liau J, Kaffas AE, Chammas MC, Willmann JK. Ultrasound Elastography: Review of Techniques and Clinical Applications. Theranostics 2017; 7(5):1303-1329. doi:10.7150/thno.18650. Available from