Usefulness of virtual touch quantification for staging liver fibrosis in patients with hepatitis C, and factors affecting liver stiffness measurement failure compared with liver biopsy

Tsukano, Natsumi; Miyase, Shiho; Saeki, Tatsuhiko; Mizobe, Keiko; Iwashita, Hirofumi; Arima, Nobuyuki; Fujiyama, Shigetoshi

doi:10.1111/hepr.13041

Cited by 8 publications

(10 citation statements)

References 69 publications

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“…These results indicate that the median liver stiffness generally increased with the severity of fibrosis (F0-F4), but between immediately adjacent stages there were no significant differences, except for F2 versus F3. This observation suggests that SWV measurements cannot differentiate fine differences between different fibrosis stages, which is similar to the results presented by Jain et al [23], but is inconsistent with the study by Zheng et al [5], who found patients in each fibrosis stage to have significantly higher median liver stiffness than those with less fibrosis, as well as similar findings reported by Ozkan et al [12] and Tsukano et al [24]. The SWV of the liver showed no significant difference between patients with a normal liver and inactive HBV carriers, suggesting that if inactive HBV carriers do not suffer continuous or repeated active inflammation, their livers are likely to generate slight stiffness (with minimal to no fibrosis).…”

Section: Discussioncontrasting

confidence: 74%

Patchy echogenicity of the liver in patients with chronic hepatitis B does not indicate poorer elasticity

Xiong

2019

Ultrasonography

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PurposeThis study was conducted to investigate whether the presence of patchy echogenicity in the liver of patients with chronic hepatitis B (CHB) is predictive of liver stiffness.MethodsA total of 200 CHB patients with and without patchy echogenicity of the liver were assigned to two groups, with 100 patients in each group, and 32 of them underwent liver biopsy. Additionally, 80 healthy subjects, 100 inactive HBV carriers, and 100 patients with decompensated hepatic cirrhosis were assigned to the control groups. Laboratory tests and clinical data were collected, and shear wave velocity (SWV) of the liver was measured for all 480 subjects.ResultsThe median SWV in patients with a normal liver, inactive hepatitis B virus carriers, CHB patients with and without patchy echogenicity, and decompensated hepatic cirrhosis were 1.07 m/sec, 1.08 m/sec, 1.16 m/sec, 1.16 m/sec, and 2.02 m/sec, respectively; there was no significant difference in SWV values between CHB patients with patchy echogenicity and those without patchy echogenicity. Furthermore, among CHB patients with and without patchy echogenicity, no significant difference in SWV was found according to fibrosis stage.ConclusionThe presence of patchy echogenicity of the liver does not indicate a higher degree of liver stiffness.

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Section: Discussioncontrasting

confidence: 74%

Patchy echogenicity of the liver in patients with chronic hepatitis B does not indicate poorer elasticity

Xiong

2019

Ultrasonography

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“…That is, the CHC cohort manifested higher age compared with the CHB cohort (median age 49 years in the CHB cohort and 63 years in the CHC cohort; P < 0.0001). The Fib‐4 index includes age and Japanese CHC patients are aging . Individual cut‐off values of LF markers in each etiology of CLD for the severity of LF should thus be in use in the clinical settings.…”

Section: Discussionmentioning

confidence: 99%

“…Much research has focused on the evaluation of non‐invasive assessment methods for the severity of LF. Currently, one of the major ultrasound‐based assessment methods for LF using shear wave velocity is acoustic radiation force impulse (ARFI) . Several meta‐analyses and systematic reviews confirmed clinical utility of ARFI for the evaluation of the severity of LF .…”

Section: Introductionmentioning

confidence: 99%

Liver fibrosis markers as assessed by ultrasound elastography and serum samples: A large comparative study in hepatitis virus B and C liver diseases

Nishimura

Iijima

Nishikawa

et al. 2019

Hepatology Research

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Aim We aimed to compare the well‐established liver fibrosis (LF) markers in Japanese patients with chronic hepatitis B (CHB, n = 331) and chronic hepatitis C (CHC, n = 886) and to discuss possible causes of differences in results between CHB patients and CHC patients. Methods Virtual touch quantification (VTQ) in acoustic radiation force impulse, Fibrosis‐4 (Fib‐4) index, aspartate aminotransferase to platelet ratio index (APRI), and hyaluronic acid (HA) were compared between the two cohorts. As an additional investigation, total collagen proportional area (TCPA, %) was tested using liver pathological samples (n = 83). Results Significant LF (F2 or greater) and advanced LF (F3 or greater) were identified in 153 (46.2%) and 76 (23.0%) patients in the CHB cohort and 579 (65.3%) and 396 (44.7%) patients in the CHC cohort. The median VTQ, Fib‐4 index, APRI, and HA values in the CHB cohort were 1.20 m/s, 1.36, 0.44, and 25 ng/mL; those in the CHC cohort were 1.32 m/s, 2.60, 0.74, and 65.5 ng/mL (P‐values, all <0.0001). Similar tendencies were noted by F stage‐based stratification. The median TCPA in the CHB cohort and the CHC cohort were 8.5% and 12.7% (P < 0.0006). The TCPA values in the CHC cohort were higher than those in the CHB cohort regardless of LF stage. Conclusion Values of LF markers in CHB patients can differ from those in CHC patients even in the same LF stage. Difference in total amount of collagen fiber in CHB and CHC appears to be linked to the difference.

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“…Virtual Touch™ Quantification is a new software which represents an application of acoustic radiation force impulse technology [18] that can be used to diagnose and monitor the evolution of liver fibrosis [19]. It can more accurately estimate liver fibrosis versus aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index.…”

Section: Attempts To Assess Liver Fibrosis By Imaging Meansmentioning

confidence: 99%

“…It can more accurately estimate liver fibrosis versus aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index. Discrepancies between the pathological fibrosis stage and the liver stiffness values estimated by virtual touch quantification may exist when the distance between the skin and the liver capsule is over 17.5 mm [18]. It has slightly higher sensitivity and specificity on significant fibrosis assessment versus transient elastography, according to the results of a metaanalysis that included patients with chronic hepatitis B or C virus infection.…”

Section: Attempts To Assess Liver Fibrosis By Imaging Meansmentioning

confidence: 99%

Liver stiffness in chronic hepatitis C virus infection

Mihăilă

2019

Romanian Journal of Internal Medicine

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Introduction. The severity of liver fibrosis can be assessed noninvasively today by liver stiffness measurements. Vibration-controlled transient elastography, shear wave elastography or magnetic resonance elastography are techniques increasingly used for this purpose. Methods. This article presents the recent advances in the use of new techniques for liver fibrosis assessment in chronic hepatitis C: the correlation between liver stiffness values and liver fibrosis estimated by liver biopsies, the prognosis role of liver stiffness values, their usefulness in monitoring the treatment response, in assessing the severity of portal hypertension and in estimating the presence of esophageal varices. Scientific articles from January 2017 to January 2018 were searched in PubMed and PubMed Central databases, using the terms “liver stiffness” and “hepatitis C”. Results. The median liver stiffness values measured with different techniques are not identical, so that FibroScan thresholds cannot be used on any other elastographic machine. The higher the liver’s stiffness measurement, the higher the liver-related events in patients with chronic hepatitis C. A liver stiffness measurement over 17 kPa could be an independent predictor for the presence of esophageal varices as well as a spleen with a longitudinal span ≥ 15 cm for patients with a value of liver stiffness < 17 kPa. A progressive and persistent decrease in liver stiffness is dependent on sustained virological response achievement. The lack of liver stiffness decrease has been associated with relapsers and a low value of liver stiffness at baseline. Conclusion. Liver stiffness provides clues about the severity and evolution of liver disease.

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Usefulness of virtual touch quantification for staging liver fibrosis in patients with hepatitis C, and factors affecting liver stiffness measurement failure compared with liver biopsy

Abstract: Virtual touch quantification is a non-invasive, simple method that is more accurate for staging liver fibrosis than the FIB-4 index and APRI. However, when the SCD is longer than 17.5 mm, there may be measurement failures.

Cited by 8 publications

References 69 publications

Patchy echogenicity of the liver in patients with chronic hepatitis B does not indicate poorer elasticity

Patchy echogenicity of the liver in patients with chronic hepatitis B does not indicate poorer elasticity

Liver fibrosis markers as assessed by ultrasound elastography and serum samples: A large comparative study in hepatitis virus B and C liver diseases

Liver stiffness in chronic hepatitis C virus infection

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