Multimodal ultrasound-based localization of surgical mesh using Nakagami parametric imaging and shear wave elastography—An in vitro and ex vivo study

Surgical mesh is widely used in soft tissue reinforcement treatments as it results in a lower recurrence rate of complications. However, there is a possibility of abnormalities after mesh implantation. These problems can result in chronic discomfort and demand further surgical procedures and postoperative monitoring. Hence, mesh visualization and detection are essential for understanding postoperative outcomes and surgical planning. However, using traditional imaging modalities, these meshes are difficult to visualize after implantation against surrounding tissues. Therefore, it is challenging to locate the implanted mesh accurately. The hypothesis for this work was that ultrasound shear wave elastography (SWE) and Nakagami parametric imaging could be useful methods for localizing and assessing the implanted mesh, as the mesh differs in mechanical stiffness, along with its echogenicity and the statistical distribution of backscattered signals compared to the surrounding tissue. This study demonstrates the potential of Nakagami imaging and SWE for accurately localizing surgical meshes. While both methods allowed for accurate mesh location recognition, Nakagami imaging provided better localization for meshes located at larger depths. According to these findings, this method could especially be helpful for patients with thick abdominal walls. This could enhance the clinical evaluation of hernia mesh implantation and improve diagnostic accuracy.