Journal of Gastroenterology

, Volume 46, Issue 5, pp 705–711 | Cite as

New method for assessing liver fibrosis based on acoustic radiation force impulse: a special reference to the difference between right and left liver

  • Takeo ToshimaEmail author
  • Ken Shirabe
  • Kazuki Takeishi
  • Takashi Motomura
  • Youhei Mano
  • Hideaki Uchiyama
  • Tomoharu Yoshizumi
  • Yuji Soejima
  • Akinobu Taketomi
  • Yoshihiko Maehara
Original Article—Liver, Pancreas, and Biliary Tract



Virtual touch tissue quantification (VTTQ) based on acoustic radiation force impulse (ARFI) imaging has been developed as a noninvasive bedside method for the assessment of liver stiffness. In this study, we examined the diagnostic performance of ARFI imaging in 103 patients, focusing on the difference in VTTQ values between the right and left liver lobes.


We evaluated VTTQ values of the right and left lobes in 79 patients with chronic liver disease who underwent histological examination of liver fibrosis and in 24 healthy volunteers. The diagnostic accuracy of VTTQ was compared with several serum markers, including hyaluronic acid, type 4 collagen, and aspartate transaminase to platelet ratio index.


The VTTQ values (meters per second) in the right and left lobes were 1.61 ± 0.51 and 1.90 ± 0.68, respectively, and the difference was statistically significant (P < 0.0001). The VTTQ values in both liver lobes were correlated significantly with histological fibrosis grades (P < 0.001). The standard deviations of the VTTQ values in the right lobe were significantly lower than those in the left lobe (P < 0.001). The area under the receiver-operating characteristic curve for the diagnosis of fibrosis (F ≥ 3) using VTTQ values in both liver lobes was superior to serum markers, especially in the right lobe.


VTTQ is an accurate and reliable tool for the assessment of liver fibrosis. VTTQ of the right lobe was more accurate for diagnosing liver fibrosis than in the left lobe.


Virtual touch tissue quantification Acoustic radiation force impulse Liver fibrosis Transient elastography Chronic hepatitis 



Virtual Touch™ tissue quantification


Acoustic radiation force impulse


Receiver operating characteristic


Alanine aminotransferase


Living donor liver transplantation


Aspartate transaminase-to-platelet ratio index


Hepatitis C virus antibody


Hepatitis B virus surface antigen


Meters per second


Aspartate aminotransferase


Positive predictive value


Negative predictive value


Hepatitis B virus


Hepatitis C virus



The authors wish to thank Siemens Medical Solutions USA, Inc., for the use of the Acuson S2000 device, Mochida Siemens Medical Systems Co., Ltd., in Japan for assisting in the setup of the device, and Ms. Natsumi Yamashita for her valuable advice with the statistical analysis. We have no financial interests linked to this work.


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Copyright information

© Springer 2011

Authors and Affiliations

  • Takeo Toshima
    • 1
    Email author
  • Ken Shirabe
    • 1
  • Kazuki Takeishi
    • 1
  • Takashi Motomura
    • 1
  • Youhei Mano
    • 1
  • Hideaki Uchiyama
    • 1
  • Tomoharu Yoshizumi
    • 1
  • Yuji Soejima
    • 1
  • Akinobu Taketomi
    • 1
  • Yoshihiko Maehara
    • 1
  1. 1.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan

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