Assessment of re-implementation of liver shear wave elastography in a large clinical practice
Tuesday, April 9, 2024
9:18am – 9:25am
Location: 412
Authors: Zaiyang Long, Mayo Clinic Mike Olson, Mayo Clinic Rochester Dawn Boynton, Mayo Clinic Shannon Sheedy, Mayo Clinic Anil Kurup, Mayo Clinic John Knudsen, Mayo Clinic Nicholas Hangiandreou, Mayo Clinic Jaydev Dave, Mayo Clinic Kevin Brom, Mayo Clinic Scott Stekel, Mayo Clinic Donald Tradup, Mayo Clinic Rochester MN
Initial use of liver ultrasound shear wave elastography (SWE) in our clinical practice was halted due to a small percentage of patients showing false negative results for minimal risk of clinically significant fibrosis according to the vendor-specific Young’s modulus thresholds. After adopting the updated thresholds and interpretation strategy from the Society of Radiologists in Ultrasound (SRU) and staff training, liver SWE was resumed in September 2022 using a fleet of 35 GE LOGIQ E9 and E10 scanners operated by 80 sonographers. The targeted patient population was patients with elevated liver enzymes, hepatitis B, non-alcoholic fatty liver disease, and incidental fatty liver disease. There have been 2,355 completed or attempted liver SWE exams to date. A custom quality control (QC) tool was utilized to automatically check acquisition factors such as probe selection, color filling, and elastography gain. Output from the QC tool was used to provide periodic sonographer feedback initially weekly and later monthly. The technical success rate of liver SWE was 70.0% in the first month, which grew to 81.4% with an average of 76.3%. No false negative result was observed in the re-implementation as previously noted. Re-implementation of liver SWE was considered successful with robust QC and sonographer feedback.