WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 1: Basic principles and terminology

Tsuyoshi Shiina, Kathryn R. Nightingale, Mark L. Palmeri, Timothy J. Hall, Jeffrey C. Bamber, Richard G. Barr, Laurent Castera, Byung Ihn Choi, Yi Hong Chou, David Cosgrove, Christoph F. Dietrich, Hong Ding, Dominique Amy, Andre Farrokh, Giovanna Ferraioli, Carlo Filice, Mireen Friedrich-Rust, Kazutaka Nakashima, Fritz Schafer, Ioan SporeaShinichi Suzuki, Stephanie Wilson, Masatoshi Kudo

Research output: Contribution to journalArticlepeer-review

589 Citations (Scopus)


Conventional diagnostic ultrasound images of the anatomy (as opposed to blood flow) reveal differences in the acoustic properties of soft tissues (mainly echogenicity but also, to some extent, attenuation), whereas ultrasound-based elasticity images are able to reveal the differences in the elastic properties of soft tissues (e.g., elasticity and viscosity). The benefit of elasticity imaging lies in the fact that many soft tissues can share similar ultrasonic echogenicities but may have different mechanical properties that can be used to clearly visualize normal anatomy and delineate pathologic lesions. Typically, all elasticity measurement and imaging methods introduce a mechanical excitation and monitor the resulting tissue response. Some of the most widely available commercial elasticity imaging methods are 'quasi-static' and use external tissue compression to generate images of the resulting tissue strain (or deformation). In addition, many manufacturers now provide shear wave imaging and measurement methods, which deliver stiffness images based upon the shear wave propagation speed. The goal of this review is to describe the fundamental physics and the associated terminology underlying these technologies. We have included a questions and answers section, an extensive appendix, and a glossary of terms in this manuscript. We have also endeavored to ensure that the terminology and descriptions, although not identical, are broadly compatible across the WFUMB and EFSUMB sets of guidelines on elastography (Bamber etal. 2013; Cosgrove etal. 2013).

Original languageEnglish
Pages (from-to)1126-1147
Number of pages22
JournalUltrasound in Medicine and Biology
Issue number5
Publication statusPublished - 2015 May 1
Externally publishedYes


  • Acoustic radiation force
  • Elasticity
  • Elastogram
  • Elastography
  • Shear wave
  • Stiffness
  • Strain
  • Transient elastography
  • Ultrasonography

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Biophysics
  • Acoustics and Ultrasonics


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