title: Comparison of contrast-enhanced ultrasonography with virtual touch tissue quantification in the evaluation of focal liver lesions.
abstract: OBJECTIVE
  To evaluate the diagnostic efficacy of virtual touch tissue quantification (VTQ) and contrast-enhanced ultrasonography (CEUS), separately and in combination, in diagnosing malignant focal liver lesions (FLLs).
  
  
  METHODS
  Forty-six patients with 55 FLLs (28 benign and 27 malignant) underwent both VTQ and CEUS. The diagnostic values of VTQ and CEUS, alone and in combination, were compared.
  
  
  RESULTS
  The diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of CEUS were 92.6% (25/27), 96.4% (27/28), 94.5% (52/55), 96.2% (25/26), and 93.1% (27/29), respectively. The diagnostic sensitivity, specificity, accuracy, PPV, and NPV of VTQ with a cutoff of 2.22 m/s were 51.9% (14/27), 85.7% (24/28), 69.1% (38/55), 77.8% (14/18), and 64.9% (24/37), respectively. The diagnostic sensitivity, specificity, accuracy, PPV, and NPV of VTQ and CEUS combined were 96.3% (26/27), 82.1% (23/28), 89.1% (49/55), 83.9% (26/31), and 95.8% (23/24), respectively. Comparing the accuracies of the three methods, the diagnostic values of CEUS and of the combination of CEUS with VTQ were significantly higher than those of VTQ alone (p ≤ 0.01). There was no significant difference between the combination of CEUS with VTQ and CEUS (p = 0.49).
  
  
  CONCLUSIONS
  CEUS is superior to VTQ in diagnosing malignant FLLs. Adding VTQ to CEUS did not improve the diagnosis of FLLs. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:347-353, 2016.
authors.affiliation: Department of Ultrasonography, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Jing-Ping
authors.initials: JP
authors.lastname: Wu
authors.affiliation: Department of Ultrasonography, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Shu
authors.affiliation: Department of Ultrasonography, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Yu-Zhen
authors.initials: YZ
authors.lastname: Zhao
authors.affiliation: Department of Radiology, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Guo-Lin
authors.initials: GL
authors.lastname: Ma
authors.affiliation: Department of Ultrasonography, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xue
authors.affiliation: Department of Ultrasonography, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Qi-Jia
authors.initials: QJ
authors.lastname: He
authors.affiliation: Department of Ultrasonography, China-Japan Friendship Hospital, Beijing, China.
authors.forename: Mei-Na
authors.initials: MN
authors.lastname: Hao
authors.affiliation: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Yawu
authors.initials: Y
authors.lastname: Liu
mesh_terms: D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: acoustic radiation force impulse; contrast-enhanced ultrasonography; focal liver lesions; shear-wave elastography