Helen M DeJong1,2,3, Steven Abbott4, Marilyn Zelesco4, Brendan F Kennedy3,5, Mel R Ziman2, Fiona M Wood6,7,8,9. 1. Perth Scar and Pain ClinicMount Pleasant, Western Australia, 6153, Australia. 2. School of Medical and Health Science, Edith Cowan UniversityJoondalup, Western Australia, 6027, Australia. 3. BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre Nedlands and Centre for Medical Research, The University of Western AustraliaCrawley, Western Australia, 6009, Australia. 4. Department of Medical Imaging, Fiona Stanley HospitalMurdoch, Western Australian, 6150, Australia. 5. School of Electrical, Electronic and Computer Engineering, The University of Western Australia Crawley6009, Western Australia. 6. Burn Injury Research Unit, The University of Western Australia CrawleyWestern Australia, 6009, Australia. 7. Burn Service of Western Australia, Fiona Stanley HospitalMurdoch, Western Australian, 6150, Australia. 8. Child and Adolescent Health Service of Western Australia, Princess Margaret HospitalSubiaco, Western Australia, 6008, Australia. 9. Fiona Wood Foundation Fiona Stanley HospitalMurdoch, Western Australian, 6150, Australia.
Abstract
BACKGROUND: Ultrasound elastography is an imaging technology which can objectively and non-invasively assess tissue stiffness. It is emerging as a useful marker for disease diagnosis, progression and treatment efficacy. OBJECTIVE: To examine current, published research evaluating the use of ultrasound elastography for the measurement of cutaneous or subcutaneous stiffness and to determine the level of validity and reliability, recommended methodologies and limitations. METHODS: MEDLINE, Web of science and Scopus were systematically searched in August 2016 to identify original articles evaluating the use of ultrasound elastography to assess cutaneous stiffness. Relevant studies were then quality evaluated using the Quality Assessment of Diagnostic Accuracy Studies v 2 (QUADAS-2) tool and the Quality Appraisal of Reliability Studies (QAREL). RESULTS: From a total of 688 articles, 14 met the inclusion criteria for full review. Within the 14 studies, elastography was used to evaluate tumors, systemic sclerosis, lymphedema, abscess, and post-radiation neck fibrosis. Only three robust studies demonstrated good interrater reliability, whereas all validity studies had low sample sizes and demonstrated risks of bias. CONCLUSION: Robust evidence supporting the use of ultrasound elastography as a diagnostic tool in cutaneous conditions is low, however, initial indicators support further research to establish the utility of ultrasound elastography in dermatology.
BACKGROUND: Ultrasound elastography is an imaging technology which can objectively and non-invasively assess tissue stiffness. It is emerging as a useful marker for disease diagnosis, progression and treatment efficacy. OBJECTIVE: To examine current, published research evaluating the use of ultrasound elastography for the measurement of cutaneous or subcutaneous stiffness and to determine the level of validity and reliability, recommended methodologies and limitations. METHODS: MEDLINE, Web of science and Scopus were systematically searched in August 2016 to identify original articles evaluating the use of ultrasound elastography to assess cutaneous stiffness. Relevant studies were then quality evaluated using the Quality Assessment of Diagnostic Accuracy Studies v 2 (QUADAS-2) tool and the Quality Appraisal of Reliability Studies (QAREL). RESULTS: From a total of 688 articles, 14 met the inclusion criteria for full review. Within the 14 studies, elastography was used to evaluate tumors, systemic sclerosis, lymphedema, abscess, and post-radiation neck fibrosis. Only three robust studies demonstrated good interrater reliability, whereas all validity studies had low sample sizes and demonstrated risks of bias. CONCLUSION: Robust evidence supporting the use of ultrasound elastography as a diagnostic tool in cutaneous conditions is low, however, initial indicators support further research to establish the utility of ultrasound elastography in dermatology.
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