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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

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

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

Abbreviations

VTTQ

Virtual Touch™ tissue quantification

ARFI

Acoustic radiation force impulse

ROC

Receiver operating characteristic

ALT

Alanine aminotransferase

LDLT

Living donor liver transplantation

APRI

Aspartate transaminase-to-platelet ratio index

HCVAb

Hepatitis C virus antibody

HBsAg

Hepatitis B virus surface antigen

m/s

Meters per second

AST

Aspartate aminotransferase

PPV

Positive predictive value

NPV

Negative predictive value

HBV

Hepatitis B virus

HCV

Hepatitis C virus

Notes

Acknowledgments

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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