ACUSON Sequoia™ 3.5 VB30 VT Liver Elastography Poster

Liver Health WFUMB Guidance for Liver Stiffness Measurements siemens-healthineers.com/ultrasound Liver assessment using ultrasound gray scale findings alone can be difficult when determining relative tissue stiffness. The detection of compensated Advanced Chronic Liver Disease (cACLD) is of important clinical relevance, leading to 2 7 8 4a the development of new guidelines by the World Federation 1 3 of Ultrasound in Medicine and Biology (WFUMB) for 4b interpreting ARFI-based/SWE liver stiffness measurements. 6 5 The guidelines introduce a vendor-neutral ‘rule of four’ based on the probability of cACLD for given stiffness values. World Federation of Ultrasound in Medicine and Biology (WFUMB) Vendor-Neutral Guidelines on Liver Ultrasound Elastography using ARFI-SWE Techniques (rule of four)1 Liver Stiffness Value Value Interpretation ≤5 kPa (1.3 m/sec) High probability of being normal <9 kPa (1.7 m/sec) In the absence of other known clinical signs, rules out cACLD. If there are known clinical signs, further testing may be needed for confirmation. 9–13 kPa (1.7–2.1 m/sec) Suggestive of cACLD but further testing is required for confirmation >13 kPa (2.1 m/sec) Rules in cACLD >17 kPa (2.4 m/sec) Suggestive of CSPH >21 kPa (2.6 m/sec) High probability of CSPH ARFI = Acoustic Radiation Force Impulse, SWE = Shear Wave Elastography, cACLD = compensated Advanced Chronic Liver Disease, CSPH = Clinically Significant Portal Hypertension For pSWE, 5−10 acquisitions are recommended. For 2D SWE, 3−5 independent measurements should be obtained. However, beginners should consider performing a minimum of 10 acquisitions with pSWE and 5 with 2D SWE, and then reduce the number of acquisitions as the operator gains expertise, per guideline recommendations. The interquartile range-to-median ratio (IQR/M), which assesses the variability between consecutive liver stiffness measurements, is an important quality indicator. For accurate pSWE measurements in kPa, the IQR/M should be ≤30%, and for measurements in m/s, it should be ≤15%.1 Acquisition Method IQR/M Ratio Criteria pSWE ≤ 15% for 5-10 consecutive measurements in (m/s)1 ≤ 30% for 5-10 consecutive measurements in (kPa)1 ≤ 15% for 3-5 consecutive measurements in (m/s)1 2D SWE ≤ 30% for 3-5 consecutive measurements in (kPa)1 Auto pSWE ≤ 30% for 12-15 simultaneous measurements in (m/s)* ≤ 60% for 12-15 simultaneous measurements in (kPa)* IQR = Interquartile Range, M = Median With ACUSON Sequoia Auto pSWE, stiffness values can be collected for up to 15 individually regions of interest (ROIs) with a single button press.* For ACUSON Sequoia Auto pSWE, 1 acquisition (12-15 simultaneous measurements) is recommended if IQR/Median ratios are valid.* For more information, please visit siemens-healthineers.com/ultrasound or contact your local Siemens Healthineers sales representative. H. 1 Ferraioli G, et al., WFUMB Guideline/Guidance on Liver Multiparametric Ultrasound: Part 1. Update to 2018 Guidelines on Liver Ultrasound Elastography, Ultrasound in Medicine & Biology (2024), doi.org/10.1016/j.ultrasmedbio.2024.03.013 *Data on file. 15364 0724 · QR700011087 · ©Siemens Medical Solutions USA, Inc., 2024 SIEMENS Healthineers