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Concept
Elastography
Summary
Elastography is any of a class of medical imaging modalities that map the elastic properties and stiffness of soft tissue. The main idea is that whether the tissue is hard or soft will give diagnostic information about the presence or status of disease. For example, cancerous tumours will often be harder than the surrounding tissue, and diseased livers are stiffer than healthy ones.
The most prominent techniques use ultrasound or magnetic resonance imaging (MRI) to make both the stiffness map and an anatomical image for comparison.
Palpation is the practice of feeling the stiffness of a person's or animal's tissues with the health practitioner's hands. Manual palpation dates back at least to 1500 BC, with the Egyptian Ebers Papyrus and Edwin Smith Papyrus both giving instructions on diagnosis with palpation. In ancient Greece, Hippocrates gave instructions on many forms of diagnosis using palpation, including palpation of the breasts, wounds, bowels, ulcers, uterus, skin, and tumours. In the modern Western world, palpation became considered a respectable method of diagnosis in the 1930s. Since then, the practice of palpation has become widespread, and it is considered an effective method of detecting tumours and other pathologies.
Manual palpation has several important limitations: it is limited to tissues accessible to the physician's hand, it is distorted by any intervening tissue, and it is qualitative but not quantitative. Elastography, the measurement of tissue stiffness, seeks to address these challenges.
There are numerous elastographic techniques, in development stages from early research to extensive clinical application. Each of these techniques works in a different way. What all methods have in common is that they create a distortion in the tissue, observe and process the tissue response to infer the mechanical properties of the tissue, and then display the results to the operator, usually as an image. Each elastographic method is characterized by the way it does each of these things.
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