Abstract
Purpose: Objective Shear wave elastography (SWE)
enabled living tissue assessment of stiffness. This is
routinely used for breast, thyroid and liver diseases,
but there is currently no data for the brain.
We aim to characterize elasticity of normal brain
parenchyma and brain tumors using SWE.
Materials and Methods: Patients with scheduled
brain tumor removal were included in this study.
In addition to standard ultrasonography, intraoperative
SWE using an ultrafast ultrasonic device
was used to measure the elasticity of each tumor
and its surrounding normal brain. Data were collected
by an investigator blinded to the diagnosis.
Descriptive statistics, box plot analysis as well as
intraoperator and interoperator reproducibility
analysis were also performed.
Results: 63 patients were included and classified
into four main types of tumor: meningiomas,
low-grade gliomas, high-grade gliomas and metastasis.
Young’s Modulus measured by SWE has
given new insight to differentiate brain tumors:
33.1 ± 5.9 kPa, 23.7 ± 4.9 kPa, 11.4 ± 3.6 kPa and
16.7 ± 2.5 kPa, respectively, for the four subgroups.
Normal brain tissue has been characterized
by a reproducible mean stiffness of 7.3 ± 2.1
kPa. Moreover, low-grade glioma stiffness is different
from high-grade glioma stiffness (p = 0.01)
and normal brain stiffness is very different from
low-grade gliomas stiffness (p under 0.01).
Conclusion: This study demonstrates that there
are significant differences in elasticity among the
most common types of brain tumors. With intraoperative
SWE, neurosurgeons may have innovative
information to predict diagnosis and guide
their resection.