title: Appropriate use of virtual touch quantification and FibroScan M and XL probes according to the skin capsular distance.
abstract: BACKGROUND
  Appropriate utilization of different diagnostic modalities is essential for the accurate liver stiffness measurements (LSM) in patients with chronic liver diseases. The aim of this study was to evaluate the efficacy of Virtual Touch Quantification (VTQ) and the FibroScan M and XL probes in term of accurate LSM and to identify factors associated with inadequate measurements in obese and non-obese Japanese patients.
  
  
  METHODS
  A total of 664 consecutive patients with chronic liver disease were prospectively enrolled. LSM were evaluated concurrently with VTQ and the FibroScan M and XL probes. LSM quality was categorized as inadequate (success rate <60% and/or interquartile range/median value of ≥30%) or adequate.
  
  
  RESULTS
  No significant differences in the rate of inadequate LSM were observed among the three diagnostic modalities. In multivariate analysis, skin capsule distance (SCD) was strongly associated with inadequate rates obtained with VTQ and the M probe [odds ratio (OR) 1.28, P < 0.0001 and OR 1.20, P < 0.0001, respectively]. Inadequate LSM rates with both VTQ and the M probe increased with longer SCD, with a significant difference between subgroups at an SCD of ≥22.5 mm (VTQ 54.0%; M probe 51.1%; XL probe 25.2%; P < 0.0001). The rates of inadequate LSM rates with VTQ were significantly lower than those with the XL probe at an SCD of <17.5 mm. A total of 15 liver biopsy specimens obtained from nonalcoholic fatty liver disease patients confirmed the diagnostic accuracy and high applicability of the XL probe.
  
  
  CONCLUSIONS
  Long SCD reduced the diagnostic performance of the FibroScan® M probe and VTQ. LSM modalities should be selected according to SCD.
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Chiba, Japan.|The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine at Kohnodai, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan.|Department of Gastroenterology, Juntendo University School of Medicine, Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Erina
authors.initials: E
authors.lastname: Kumagai
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Chiba, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Korenaga
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Chiba, Japan. dmkorenaga@hospk.ncgm.go.jp.|The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine at Kohnodai, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan. dmkorenaga@hospk.ncgm.go.jp.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Korenaga
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Chiba, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Imamura
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Chiba, Japan.|The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine at Kohnodai, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan.|Department of Gastroenterology, Juntendo University School of Medicine, Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Misuzu
authors.initials: M
authors.lastname: Ueyama
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Chiba, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Aoki
authors.affiliation: The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine at Kohnodai, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Sugiyama
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Chiba, Japan.|The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine at Kohnodai, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan.
authors.forename: Kazumoto
authors.initials: K
authors.lastname: Murata
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Chiba, Japan.|The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine at Kohnodai, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan.
authors.forename: Naohiko
authors.initials: N
authors.lastname: Masaki
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Chiba, Japan.|The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine at Kohnodai, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kanto
authors.affiliation: Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Ichikawa, Chiba, Japan.|The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine at Kohnodai, 1-7-1 Kohnodai, Ichikawa, Chiba, 272-8516, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Mizokami
authors.affiliation: Department of Gastroenterology, Juntendo University School of Medicine, Hongo, Bunkyo, Tokyo, Japan.
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001706:Biopsy; D002908:Chronic Disease; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D015203:Reproducibility of Results; D055815:Young Adult
keywords: Transient elastography; Virtual touch quantification; XL probe