Abstract
Background and aims
Transient elastography is a novel noninvasive method to assess liver fibrosis by measuring liver stiffness. This study is a first step toward the provision of a noninvasive measurement of hepatic tumor stiffness by transient elastography.
Patients and methods
Patients with liver tumor larger than 5 cm in diameter and located near the liver surface were enrolled between June 2004 and February 2005. Histology of each tumor was evaluated on ultrasound-guided liver biopsy specimens. Transient elastography (Fibroscan, Echosens, Paris) was used to measure tumor stiffness. Tumor stiffness was measured as follows. First, by using B-mode ultrasound, we searched for the optimal right intercostal position for tumor stiffness measurement while keeping the ultrasound probe and body surface at right angles. Then the vibrator for transient elastography was applied at the same position and angle, and stiffness was measured according to the manufacturer’s instruction.
Results
Tumor stiffness was measured in 40 patients, 17 with hepatocellular carcinoma (HCC), six with cholangiocellular carcinoma (CCC), 16 with metastatic tumors (mostly adenocarcinoma), and one with malignant lymphoma. The median value was 55 kPa in HCC, 75 kPa in CCC, 66.5 kPa in metastatic tumor, and 16.9 kPa in malignant lymphoma. The stiffness value of CCC was significantly higher than that of HCC and metastatic tumors (P = .049).
Conclusion
We showed that stiffness of liver tumors could be measured with transient elastography. Improvements in the device, such as smaller and variable region of interest of measurement and real-time B-mode display, may ensure wider clinical application.
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Abbreviations
- CCC:
-
Cholangiocellular carcinoma
- CT:
-
Computed tomography
- HCC:
-
Hepatocellular carcinoma
- RFA:
-
Radiofrequency ablation
- ROI:
-
Region of interest
- TACE:
-
Transcatheter arterial chemoembolization
References
Eklund A, Bergh A, Lindahl OA. A catheter tactile sensor for measuring hardness of soft tissue: measurement in a silicone model and in an in vitro human prostate model. Med Biol Eng Comput 1999;37:618–24
Ophir J, Garra B, Kallel F, Konofagou E, Krouskop T, Righetti R, et al. Elastographic imaging. Ultrasound Med Biol 2000;26(Suppl 1):S23–9
Bercoff J, Chaffai S, Tanter M, Sandrin L, Catheline S, Fink M, et al. In vivo breast tumor detection using transient elastography. Ultrasound Med Biol 2003;29:1387–96
Kusaka K, Harihara Y, Torzilli G, Kubota K, Takayama T, Makuuchi M, et al. Objective evaluation of liver consistency to estimate hepatic fibrosis and functional reserve for hepatectomy. J Am Coll Surg 2000;191:47–53
Gao L, Parker KJ, Lerner RM, Levinson SF. Imaging of the elastic properties of tissue—a review. Ultrasound Med Biol 1996;22:959–77
Greenleaf JF, Fatemi M, Insana M. Selected methods for imaging elastic properties of biological tissues. Annu Rev Biomed Eng 2003;5:57–78
Thomas A, Fischer T, Frey H, Ohlinger R, Grunwald S, Blohmer JU, et al. Real-time elastography—an advanced method of ultrasound: first results in 108 patients with breast lesions. Ultrasound Obstet Gynecol 2006;28:335–40
Bosch FX, Ribes J, Diaz M, Cleries R. Primary liver cancer: worldwide incidence and trends. Gastroenterology 2004;127:S5–16
Parkin DM, Muir CS. Cancer incidence in five continents. Comparability and quality of data. IARC Sci Publ 1992:45–173
Llovet JM, Beaugrand M. Hepatocellular carcinoma: present status and future prospects. J Hepatol 2003;38(Suppl 1):S136–49
Castera L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 2005;128:343–50
Sandrin L, Fourquet B, Hasquenoph JM, Yon S, Fournier C, Mal F, et al. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol 2003;29:1705–13
Ziol M, Handra-Luca A, Kettaneh A, Christidis C, Mal F, Kazemi F, et al. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C. Hepatology 2005;41:48–54
Foucher J, Chanteloup E, Vergniol J, Castera L, Le Bail B, Adhoute X, et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study. Gut 2006;55:403–8
Torzilli G, Minagawa M, Takayama T, Inoue K, Hui AM, Kubota K, et al. Accurate preoperative evaluation of liver mass lesions without fine-needle biopsy. Hepatology 1999;30:889–93
Varghese T, Techavipoo U, Liu W, Zagzebski JA, Chen Q, Frank G, et al. Elastographic measurement of the area and volume of thermal lesions resulting from radiofrequency ablation: pathologic correlation. Am J Roentgenol 2003;181:701–7
Bharat S, Techavipoo U, Kiss MZ, Liu W, Varghese T. Monitoring stiffness changes in lesions after radiofrequency ablation at different temperatures and durations of ablation. Ultrasound Med Biol 2005;31:415–22
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Masuzaki, R., Tateishi, R., Yoshida, H. et al. Assessing liver tumor stiffness by transient elastography. Hepatol Int 1, 394–397 (2007). https://doi.org/10.1007/s12072-007-9012-7
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DOI: https://doi.org/10.1007/s12072-007-9012-7