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, 14 (7), e0219621

Accuracy and Precision of Ultrasound Shear Wave Elasticity Measurements According to Target Elasticity and Acquisition Depth: A Phantom Study


Accuracy and Precision of Ultrasound Shear Wave Elasticity Measurements According to Target Elasticity and Acquisition Depth: A Phantom Study

Chong Hyun Suh et al. PLoS One.


Objective: To investigate the accuracy and precision of ultrasound shear wave elasticity measurements as a function of target elasticity and acquisition depth.

Materials and methods: Using five ultrasound systems (VTQ, VTIQ, EPIQ 5, Aixplorer, and Aplio 500), two operators independently measured shear wave elasticities in two phantoms containing five different target elasticities (8±3, 14±4, 25±6, 45±8, and 80±12 kPa) at depths of 15, 30, 35, and 60 mm. Accuracy was assessed by evaluating measurement errors and the proportions of outliers, while factors affecting accuracy were assessed using logistic regression analysis. Measurement errors were defined as differences between the measured values and 1) the margins of the target elasticity, and 2) the median values of the target elasticity. Outliers were defined as measured values outside the margins of the target elasticity. Precision was assessed by calculating the reproducibility of measurements using the within-subject coefficient of variation (wCV).

Results: Mean measurement errors and the proportions of outliers were higher for high than for low target elasticities (p<0.001), but did not differ in relation to acquisition depth, either within an elastography system or across the different systems. Logistic regression analysis showed that target elasticity (p<0.001) significantly affected accuracy, whereas acquisition depth (p>0.05) did not. The wCV for the 80±12 kPa target (31.33%) was significantly higher than that for lower elasticity targets (6.96-10.43 kPa; p<0.001). The wCV did not differ across acquisition depths. The individual elastography systems showed consistent results.

Conclusions: Targets with high elasticity showed lower accuracy and lower precision than targets with low elasticity, while acquisition depth did not show consistent patterns in either accuracy or precision.

Conflict of interest statement

The authors have declared that no competing interests exist.


Fig 1
Fig 1. Measurements of shear wave elasticities in a target of 8 ± 3 kPa using four different machines.
(A and B) A linear transducer and the VTQ system and a linear transducer and the VTIQ system (ACUSON S2000, Siemens Healthcare, Erlangen, Germany) at depths of 15 mm, (C) a curved transducer and the Aixplorer system (Supersonic Imagine, Aix Provence, France) at a depth of 60 mm, (D) a linear transducer and the Aplio 500 system (Toshiba Medical Systems, Tochigi-ken, Japan) at a depth of 30 mm, and (E) a curved transducer and the EPIQ 5 system (Philips Medical System, Best, the Netherlands) at a depth of 60 mm.

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Grant support

This work was supported by the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea, grant no. 2016-719 to SCJ ( The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.