Shear wave elastography (SWE) of the liver is a new technology that has been shown to be useful for distinguishing early from advanced liver fibrosis. At present, interobserver variability limits the use of shear wave elastography for precise staging and serial monitoring of the progression of diffuse liver disease. The broad research goal of this proposal is to reduce shear wave elastography variability. The research has two specific aims. [Aim 1 is to create a new system - hardware and algorithms - by (1) integrating two previously developed systems: (a) a force-measurement (FM) ultrasound probe system, which measures and displays applied transducer force (preload) in real-time, permitting the operator to precisely control applied preload, and (b) an optical tracking system (OTS), which precisely localizes a transducer relative to skin markings, facilitating precise software-based co-registration of shear wave elastograms, and (2) creating new algorithms to process data generated by the integrated FM/OTS device.] In Aim 2 Dr. Samir will perform a clinical trial in thirty human subjects testing the performance of FM/OTS enhanced SWE against the reference standard of histopathologically staged liver fibrosis. Career development goals: Immediate and long-term. Dr. Samir's short-term goal is to acquire additional technical skills and advanced clinical trial skills through the combination of device design, fabrication, and software development under the guidance of MED- RC faculty, particularly Dr. Brian Anthony, and advanced clinical trial skills under the supervision of Raymond Chung MD, who is an expert in Hepatology research. Dr. Ralph Weissleder MD PhD and Dr. Bruce Rosen MD PhD, both well-known experts in Radiology research, will mentor Dr. Samir throughout his training program in order to facilitate his long-term objective, which is to become an independently funded investigator leading a laboratory focused on rapid development and translation of medical ultrasound technology.

Public Health Relevance

This project aims to reduce variability in shear wave elastography estimates of liver stiffness by integrating two variability-reducing systems into a new elastogram acquisition device. If successful, less variable shear wave elastogram measurements would allow more accurate diagnosis and follow-up of liver fibrosis, potentially reducing the number of liver biopsies performed for this purpose, and facilitating the administration of treatment to patients most likely to benefit.

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
1K23EB020710-01A1
Application #
9109220
Study Section
Special Emphasis Panel (ZEB1-OSR-E (J1)S)
Program Officer
Erim, Zeynep
Project Start
2016-07-01
Project End
2020-06-30
Budget Start
2016-07-01
Budget End
2017-06-30
Support Year
1
Fiscal Year
2016
Total Cost
$197,424
Indirect Cost
$14,624
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02114
Dhyani, Manish; Xiang, Feixiang; Li, Qian et al. (2018) Ultrasound Shear Wave Elastography: Variations of Liver Fibrosis Assessment as a Function of Depth, Force and Distance from Central Axis of the Transducer with a Comparison of Different Systems. Ultrasound Med Biol 44:2209-2222
Ozturk, Arinc; Grajo, Joseph R; Dhyani, Manish et al. (2018) Principles of ultrasound elastography. Abdom Radiol (NY) 43:773-785
Brattain, Laura J; Telfer, Brian A; Dhyani, Manish et al. (2018) Machine learning for medical ultrasound: status, methods, and future opportunities. Abdom Radiol (NY) 43:786-799
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Ozturk, Arinc; Grajo, Joseph R; Gee, Michael S et al. (2018) Quantitative Hepatic Fat Quantification in Non-alcoholic Fatty Liver Disease Using Ultrasound-Based Techniques: A Review of Literature and Their Diagnostic Performance. Ultrasound Med Biol 44:2461-2475
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Dhyani, Manish; Grajo, Joseph R; Bhan, Atul K et al. (2017) Validation of Shear Wave Elastography Cutoff Values on the Supersonic Aixplorer for Practical Clinical Use in Liver Fibrosis Staging. Ultrasound Med Biol 43:1125-1133
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