Liver reserve function assessment by acoustic radiation force impulse imaging.
OBJECTIVE
To evaluate the utility of liver reserve function by acoustic radiation force impulse (ARFI) imaging in patients with liver tumors.


METHODS
Seventy-six patients with liver tumors were enrolled in this study. Serum biochemical indexes, such as aminotransferase (ALT), aspartate aminotransferase (AST), serum albumin (ALB), total bilirubin (T-Bil), and other indicators were observed. Liver stiffness (LS) was measured by ARFI imaging, measurements were repeated 10 times, and the average value of the results was taken as the final LS value. Indocyanine green (ICG) retention was performed, and ICG-K and ICG-R15 were recorded. Child-Pugh (CP) scores were carried out based on patient's preoperative biochemical tests and physical condition. Correlations among CP scores, ICG-R15, ICG-K and LS values were observed and analyzed using either the Pearson correlation coefficient or the Spearman rank correlation coefficient. Kruskal-Wallis test was used to compare LS values of CP scores, and the receiver-operator characteristic (ROC) curve was used to analyze liver reserve function assessment accuracy.


RESULTS
LS in the ICG-R15 10%-20% group was significantly higher than in the ICG-R15 < 10% group; and the difference was statistically significant (2.19 ± 0.27 vs 1.59 ± 0.32, P < 0.01). LS in the ICG-R15 > 20% group was significantly higher than in the ICG-R15 < 10% group; and the difference was statistically significant (2.92 ± 0.29 vs 1.59 ± 0.32, P < 0.01). The LS value in patients with CP class A was lower than in patients with CP class B (1.57 ± 0.34 vs 1.86 ± 0.27, P < 0.05), while the LS value in patients with CP class B was lower than in patients with CP class C (1.86 ± 0.27 vs 2.47 ± 0.33, P < 0.01). LS was positively correlated with ICG-R15 (r = 0.617, P < 0.01) and CP score (r = 0.772, P < 0.01). Meanwhile, LS was negatively correlated with ICG-K (r = -0.673, P < 0.01). AST, ALT and T-Bil were positively correlated with LS, while ALB was negatively correlated with LS (P < 0.05). The ROC curve revealed that the when the LS value was 2.34 m/s, the Youden index was at its highest point, sensitivity was 69.2% and specificity was 92.1%.


CONCLUSIONS
For patients with liver tumors, ARFI imaging is a useful tool for assessing liver reserve function.
Xiao-Lan Sun, Department of Ultrasound in Medicine, Shanghai Shidong Hospital, Shanghai 200438, China.
Xiao-Lan
XL
Sun
Xiao-Lan Sun, Department of Ultrasound in Medicine, Shanghai Shidong Hospital, Shanghai 200438, China.
Li-Wei
LW
Liang
Xiao-Lan Sun, Department of Ultrasound in Medicine, Shanghai Shidong Hospital, Shanghai 200438, China.
Hui
H
Cao
Xiao-Lan Sun, Department of Ultrasound in Medicine, Shanghai Shidong Hospital, Shanghai 200438, China.
Qiong
Q
Men
Xiao-Lan Sun, Department of Ultrasound in Medicine, Shanghai Shidong Hospital, Shanghai 200438, China.
Ke-Zhu
KZ
Hou
Xiao-Lan Sun, Department of Ultrasound in Medicine, Shanghai Shidong Hospital, Shanghai 200438, China.
Zhen
Z
Chen
Xiao-Lan Sun, Department of Ultrasound in Medicine, Shanghai Shidong Hospital, Shanghai 200438, China.
Ya-E
YE
Zhao
D000328:Adult; D000368:Aged; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood; D017115:Catheter Ablation; D054459:Elasticity Imaging Techniques; D004621:Embolization, Therapeutic; D005260:Female; D005456:Fluorescent Dyes / Q000008:administration & dosage; D006498:Hepatectomy; D006801:Humans; D007208:Indocyanine Green / Q000008:administration & dosage; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results
D014408:Biomarkers, Tumor; D005456:Fluorescent Dyes; D007208:Indocyanine Green
Acoustic radiation force impulse; Liver reserve function; Liver tumor; Receiver-operator characteristic