Assessment of liver fibrosis by ultrasound elastography and contrast-enhanced ultrasound: a randomized prospective animal study

Qiu, Tingting; Wang, Hong; Song, Jinzhen; Ling, Wenwu; Shi, Yujun; Guo, Gang; Luo, Yan

doi:10.1538/expanim.17-0098

Cited by 10 publications

(4 citation statements)

References 28 publications

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“…Over the years, CEUS has also been used to investigate the presence of oesophageal varices (EV) based on time–intensity curves [ 31 , 32 ], and the results show that CEUS can predict EV. CEUS has also been used in animal models to investigate liver fibrosis [ 33 , 34 ], and it was concluded that this method has diagnostic performance for liver fibrosis, similar to our study.…”

Section: Discussionsupporting

confidence: 88%

Contrast-Enhanced Ultrasonography with Arrival Time Parametric Imaging as a Non-Invasive Diagnostic Tool for Liver Cirrhosis

Lupușoru

Sporea²,

Raţiu³

et al. 2022

Diagnostics

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Liver biopsy is the gold standard method for staging liver fibrosis, but it is an invasive procedure that is associated with some complications. There are also non-invasive techniques for assessing liver fibrosis, such as elastography and biological tests, but these techniques can fail in detection or generate false measurements depending on the subject’s condition. This study aimed to determine whether liver fibrosis can be evaluated using contrast-enhanced ultrasonography with arrival time parametric imaging using the ultrasound machine’s parametric image software, the method being called (CEUS-PAT). CEUS-PAT was performed on each subject using SonoVue as a contrast agent, and images showing liver parenchyma and the right kidney on a single screen were used for analysis in parametric imaging, which was performed using the proprietary software of the ultrasound system. The ratio between the kidney and liver arrival times was calculated. The study included 64 predominantly male (56.3%) subjects, 37 cirrhotic patients, and 27 healthy volunteers, with a mean age of 58.98 ± 8.90 years. Significant differences were found between the liver cirrhosis and healthy groups regarding CEUS-PAT, 0.83 ± 0.09 vs. 0.49 ± 0.11, p < 0.0001. The correlation between CEUS-PAT and VCTE was r = 0.81. The optimal cut-off value for detecting liver cirrhosis was >0.7, with an AUC of 0.98, p < 0.001, Se = 89.19%, Sp = 100%, PPV = 100%, and NPV = 87.1%. We demonstrate that CEUS-PAT achieves excellent performance in diagnosing liver cirrhosis and is a fast method for diagnosing liver cirrhosis that can even be applied in situations where the use of other methods is excluded.

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Section: Discussionsupporting

confidence: 88%

Contrast-Enhanced Ultrasonography with Arrival Time Parametric Imaging as a Non-Invasive Diagnostic Tool for Liver Cirrhosis

Lupușoru

Sporea²,

Raţiu³

et al. 2022

Diagnostics

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“…In a previous study of rabbit liver tumors, the median LSV on SWE were 7.0 kPa (6.0, 8.3) for fibrosis stages F0-F1, 9.5 kPa (7.8, 11.4) for stage F2, 13.0 kPa (10.4, 16.7) for stage F3, and 25.8 kPa (21.7, 34.5) for stage F4 ( Guibal et al, 2016 ). In a carbon tetrachloride-induced rabbit liver fibrosis model, the areas under the ROC curve for LSV in diagnosing stages ≥ F1, ≥F2, ≥F3, and ≥F4 were 0.874, 0.956, 0.954, and 0.933, respectively ( Qiu et al, 2018 ). These previous results are similar to our findings.…”

Section: Discussionmentioning

confidence: 99%

Intravoxel incoherent motion diffusion-weighted imaging and shear wave elastography for evaluating peritumoral liver fibrosis after transarterial chemoembolization in a VX2 rabbit liver tumor model

Cheng

Yang

et al. 2022

Front. Physiol.

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In this study, we sought to evaluate changes in peritumoral fibrosis after transarterial chemoembolization (TACE) in a rabbit VX2 liver tumor model using intravoxel incoherent motion diffusion-weighted imaging (IVIM DWI) and ultrasound shear wave elastography (SWE). A total of 20 rabbits underwent implantation of VX2 tumor tissues in the left lobe of the liver. The rabbits were randomly divided into an experimental group (n = 10) or a control group (n = 10). Those in the experimental group were treated with an emulsion of lipiodol and pirarubicin through a microcatheter 2–3 weeks after implantation; those in the control group were treated with sterile water. Compared with the control group, the true diffusion coefficient (D) and pseudodiffusion coefficient (D*) values in liver tissues were significantly lower (p < 0.05 for all) and liver stiffness values (LSV) (10.58 ± 0.89 kPa) were higher in the experimental group (7.65 ± 0.86 kPa; p < 0.001). The median stage of liver fibrosis based on METAVIR scores was 1 (1,1) in the control group and 2 (2,3) in the experimental group (Z = 4.15, p < 0.001). D, D*, and LSV were significantly correlated with pathologic staining in the assessment of liver fibrosis (r = −0.54 p = 0.015; r = −0.50, p = 0.025; r = 0.91, p < 0.001; respectively). These data suggest that TACE aggravates liver injury and liver fibrosis, especially surrounding the tumor, in a rabbit VX2 liver tumor model. IVIM DWI and SWE can be used to evaluate the change in liver fibrosis.

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“…SE is regarded as a promising technique capable of noninvasively evaluating and staging liver fibrosis with high diagnostic accuracy. Meng and colleagues performed SE and liver biopsy in 166 patients with chronic hepatitis B, and they found the diagnostic accuracy of SE was similar to that of TE; the elasticity index and liver stiffness were 0.880 and 0.909 (≥F2), 0,868 and 0.874 (≥F3), and 0.752 and 0.815 (F4), respectively for predicting substantial fibrosis [68]. A study was conducted by Tajiri and colleagues using SE in 598 patients with chronic liver disease and they found that the elasticity index was significantly different between mild (F1–2) and advanced fibrosis (F3–4) [69].…”

Section: Evaluation Of Liver Fibrosis By Mri Us and Ctmentioning

confidence: 99%

Liver Fibrosis Conventional and Molecular Imaging Diagnosis Update

Li¹,

Sun²,

Chen³

et al. 2019

J Liver

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Liver fibrosis is a serious, life-threatening disease with high morbidity and mortality that result from diverse causes. Liver biopsy, considered the “gold standard” to diagnose, grade, and stage liver fibrosis, has limitations in terms of invasiveness, cost, sampling variability, inter-observer variability, and the dynamic process of fibrosis. Compelling evidence has demonstrated that all stages of fibrosis are reversible if the injury is removed. There is a clear need for safe, effective, and reliable non-invasive assessment modalities to determine liver fibrosis in order to manage it precisely in personalized medicine. However, conventional imaging methods used to assess morphological and structural changes related to liver fibrosis, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), are only useful in assessing advanced liver disease, including cirrhosis. Functional imaging techniques, including MR elastography (MRE), US elastography, and CT perfusion are useful for assessing moderate to advanced liver fibrosis. MRE is considered the most accurate noninvasive imaging technique, and US elastography is currently the most widely used noninvasive means. However, these modalities are less accurate in early-stage liver fibrosis and some factors affect the accuracy of these techniques. Molecular imaging is a target-specific imaging mechanism that has the potential to accurately diagnose early-stage liver fibrosis. We provide an overview of recent advances in molecular imaging for the diagnosis and staging of liver fibrosis which will enable clinicians to monitor the progression of disease and potentially reverse liver fibrosis. We compare the promising technologies with conventional and functional imaging and assess the utility of molecular imaging in precision and personalized clinical medicine in the early stages of liver fibrosis.

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Assessment of liver fibrosis by ultrasound elastography and contrast-enhanced ultrasound: a randomized prospective animal study

Cited by 10 publications

References 28 publications

Contrast-Enhanced Ultrasonography with Arrival Time Parametric Imaging as a Non-Invasive Diagnostic Tool for Liver Cirrhosis

Contrast-Enhanced Ultrasonography with Arrival Time Parametric Imaging as a Non-Invasive Diagnostic Tool for Liver Cirrhosis

Intravoxel incoherent motion diffusion-weighted imaging and shear wave elastography for evaluating peritumoral liver fibrosis after transarterial chemoembolization in a VX2 rabbit liver tumor model

Liver Fibrosis Conventional and Molecular Imaging Diagnosis Update

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