New method for assessing liver fibrosis based on acoustic radiation force impulse: a special reference to the difference between right and left liver.
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.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. toshima@surg2.med.kyushu-u.ac.jp
Takeo
T
Toshima
Ken
K
Shirabe
Kazuki
K
Takeishi
Takashi
T
Motomura
Youhei
Y
Mano
Hideaki
H
Uchiyama
Tomoharu
T
Yoshizumi
Yuji
Y
Soejima
Akinobu
A
Taketomi
Yoshihiko
Y
Maehara
D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008107:Liver Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results
D015415:Biomarkers
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