Real-time sonoelastography using an external reference material: test–retest reliability of healthy Achilles tendons

Alessandro Schneebeli; Filippo Del Grande; Gabriele Vincenzo; Corrado Cescon; Ron Clijsen; Fulvio Biordi; Marco Barbero

doi:10.1007/s00256-016-2382-y

Real-time sonoelastography using an external reference material: test–retest reliability of healthy Achilles tendons

Alessandro Schneebeli, Filippo Del Grande, Gabriele Vincenzo, Corrado Cescon, Ron Clijsen, Fulvio Biordi, Marco Barbero

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To establish the test–retest reliability of sonoelastography (SE) on healthy Achilles tendons in contracted and relaxed states using an external reference system. Materials and Methods: Forty-eight Achilles tendons from 24 healthy volunteers were assessed using ultrasound and real-time SE with an external reference material. Tendons were analyzed under relaxed and contracted conditions. Strain ratios between the tendons and the reference material were calculated. The intraclass correlation coefficient (ICC_2.k) and Bland–Altman plot were used to assess test–retest reliability. Results: The reliability of SE measurements under relaxed conditions ranged from high to very high, with an ICC_2.k of 0.84 (95 % CI: 0.64–0.92) for reference material, 0.91 (95 % CI: 0.83–0.95) for Achilles tendons and 0.95 (95 % CI: 0.91–0.97) for Kager fat pads (KFP). The ICC_2.k value for skin was 0.30 (95 % CI: –0.26 to 0.61). Reliability for measurements in the contracted state ranged from high to very high, with an ICC_2.k of 0.93 (95 % CI: 0.87–0.96) for reference material, 0.72 (95 % CI: 0.50–0.84) for skin, 0.93 (95 % CI: 0.87–0.96) for Achilles tendons, and 0.81 (95 % CI: 0.66–0.89) for KFP. Reliability of the strain ratio (tendon/reference) under relaxed conditions was high with an ICC_2.k of 0.87 (95 % CI: 0.75–0.93), and in the contracted state, it was very high with an ICC_2.k of 0.94 (95 % CI: 0.90–0.97). Conclusion: Sonoelastography using an external reference material is a reliable and simple technique for the assessment of the elasticity of healthy Achilles tendons. The use of an external material as a reference, along with strain ratios, could provide a quantitative measure of elasticity.

Original language	English (US)
Pages (from-to)	1045-1052
Number of pages	8
Journal	Skeletal Radiology
Volume	45
Issue number	8
DOIs	https://doi.org/10.1007/s00256-016-2382-y
State	Published - Aug 1 2016
Externally published	Yes

Keywords

Achilles tendon
Reliability
Sonoelastography

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

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10.1007/s00256-016-2382-y

Cite this

Real-time sonoelastography using an external reference material : test–retest reliability of healthy Achilles tendons. / Schneebeli, Alessandro; Del Grande, Filippo; Vincenzo, Gabriele; Cescon, Corrado; Clijsen, Ron; Biordi, Fulvio; Barbero, Marco.

In: Skeletal Radiology, Vol. 45, No. 8, 01.08.2016, p. 1045-1052.

Research output: Contribution to journal › Article › peer-review

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title = "Real-time sonoelastography using an external reference material: test–retest reliability of healthy Achilles tendons",

abstract = "Objective: To establish the test–retest reliability of sonoelastography (SE) on healthy Achilles tendons in contracted and relaxed states using an external reference system. Materials and Methods: Forty-eight Achilles tendons from 24 healthy volunteers were assessed using ultrasound and real-time SE with an external reference material. Tendons were analyzed under relaxed and contracted conditions. Strain ratios between the tendons and the reference material were calculated. The intraclass correlation coefficient (ICC2.k) and Bland–Altman plot were used to assess test–retest reliability. Results: The reliability of SE measurements under relaxed conditions ranged from high to very high, with an ICC2.k of 0.84 (95 % CI: 0.64–0.92) for reference material, 0.91 (95 % CI: 0.83–0.95) for Achilles tendons and 0.95 (95 % CI: 0.91–0.97) for Kager fat pads (KFP). The ICC2.k value for skin was 0.30 (95 % CI: –0.26 to 0.61). Reliability for measurements in the contracted state ranged from high to very high, with an ICC2.k of 0.93 (95 % CI: 0.87–0.96) for reference material, 0.72 (95 % CI: 0.50–0.84) for skin, 0.93 (95 % CI: 0.87–0.96) for Achilles tendons, and 0.81 (95 % CI: 0.66–0.89) for KFP. Reliability of the strain ratio (tendon/reference) under relaxed conditions was high with an ICC2.k of 0.87 (95 % CI: 0.75–0.93), and in the contracted state, it was very high with an ICC2.k of 0.94 (95 % CI: 0.90–0.97). Conclusion: Sonoelastography using an external reference material is a reliable and simple technique for the assessment of the elasticity of healthy Achilles tendons. The use of an external material as a reference, along with strain ratios, could provide a quantitative measure of elasticity.",

keywords = "Achilles tendon, Reliability, Sonoelastography",

author = "Alessandro Schneebeli and {Del Grande}, Filippo and Gabriele Vincenzo and Corrado Cescon and Ron Clijsen and Fulvio Biordi and Marco Barbero",

note = "Funding Information: We thank the staff and students at the University of Applied Sciences and Arts of Southern Switzerland (SUPSI) for taking part in the study. We especially thank the Thim van der Laan Foundation, Landquart, Switzerland for financial support. Publisher Copyright: {\textcopyright} 2016, ISS.",

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doi = "10.1007/s00256-016-2382-y",

language = "English (US)",

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T1 - Real-time sonoelastography using an external reference material

T2 - test–retest reliability of healthy Achilles tendons

AU - Schneebeli, Alessandro

AU - Del Grande, Filippo

AU - Vincenzo, Gabriele

AU - Cescon, Corrado

AU - Clijsen, Ron

AU - Biordi, Fulvio

AU - Barbero, Marco

N1 - Funding Information: We thank the staff and students at the University of Applied Sciences and Arts of Southern Switzerland (SUPSI) for taking part in the study. We especially thank the Thim van der Laan Foundation, Landquart, Switzerland for financial support. Publisher Copyright: © 2016, ISS.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Objective: To establish the test–retest reliability of sonoelastography (SE) on healthy Achilles tendons in contracted and relaxed states using an external reference system. Materials and Methods: Forty-eight Achilles tendons from 24 healthy volunteers were assessed using ultrasound and real-time SE with an external reference material. Tendons were analyzed under relaxed and contracted conditions. Strain ratios between the tendons and the reference material were calculated. The intraclass correlation coefficient (ICC2.k) and Bland–Altman plot were used to assess test–retest reliability. Results: The reliability of SE measurements under relaxed conditions ranged from high to very high, with an ICC2.k of 0.84 (95 % CI: 0.64–0.92) for reference material, 0.91 (95 % CI: 0.83–0.95) for Achilles tendons and 0.95 (95 % CI: 0.91–0.97) for Kager fat pads (KFP). The ICC2.k value for skin was 0.30 (95 % CI: –0.26 to 0.61). Reliability for measurements in the contracted state ranged from high to very high, with an ICC2.k of 0.93 (95 % CI: 0.87–0.96) for reference material, 0.72 (95 % CI: 0.50–0.84) for skin, 0.93 (95 % CI: 0.87–0.96) for Achilles tendons, and 0.81 (95 % CI: 0.66–0.89) for KFP. Reliability of the strain ratio (tendon/reference) under relaxed conditions was high with an ICC2.k of 0.87 (95 % CI: 0.75–0.93), and in the contracted state, it was very high with an ICC2.k of 0.94 (95 % CI: 0.90–0.97). Conclusion: Sonoelastography using an external reference material is a reliable and simple technique for the assessment of the elasticity of healthy Achilles tendons. The use of an external material as a reference, along with strain ratios, could provide a quantitative measure of elasticity.

AB - Objective: To establish the test–retest reliability of sonoelastography (SE) on healthy Achilles tendons in contracted and relaxed states using an external reference system. Materials and Methods: Forty-eight Achilles tendons from 24 healthy volunteers were assessed using ultrasound and real-time SE with an external reference material. Tendons were analyzed under relaxed and contracted conditions. Strain ratios between the tendons and the reference material were calculated. The intraclass correlation coefficient (ICC2.k) and Bland–Altman plot were used to assess test–retest reliability. Results: The reliability of SE measurements under relaxed conditions ranged from high to very high, with an ICC2.k of 0.84 (95 % CI: 0.64–0.92) for reference material, 0.91 (95 % CI: 0.83–0.95) for Achilles tendons and 0.95 (95 % CI: 0.91–0.97) for Kager fat pads (KFP). The ICC2.k value for skin was 0.30 (95 % CI: –0.26 to 0.61). Reliability for measurements in the contracted state ranged from high to very high, with an ICC2.k of 0.93 (95 % CI: 0.87–0.96) for reference material, 0.72 (95 % CI: 0.50–0.84) for skin, 0.93 (95 % CI: 0.87–0.96) for Achilles tendons, and 0.81 (95 % CI: 0.66–0.89) for KFP. Reliability of the strain ratio (tendon/reference) under relaxed conditions was high with an ICC2.k of 0.87 (95 % CI: 0.75–0.93), and in the contracted state, it was very high with an ICC2.k of 0.94 (95 % CI: 0.90–0.97). Conclusion: Sonoelastography using an external reference material is a reliable and simple technique for the assessment of the elasticity of healthy Achilles tendons. The use of an external material as a reference, along with strain ratios, could provide a quantitative measure of elasticity.

KW - Achilles tendon

KW - Reliability

KW - Sonoelastography

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Real-time sonoelastography using an external reference material: test–retest reliability of healthy Achilles tendons

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