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Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
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The impact of elastography with virtual touch quantification of future remnant liver before major hepatectomy
| Title: | The impact of elastography with virtual touch quantification of future remnant liver before major hepatectomy |
| Authors: | Shimada, Shingo Browse this author | | Kamiyama, Toshiya Browse this author | | Kakisaka, Tatsuhiko Browse this author | | Orimo, Tatsuya Browse this author | | Nagatsu, Akihisa Browse this author | | Asahi, Yoh Browse this author | | Sakamoto, Yuzuru Browse this author | | Kamachi, Hirofumi Browse this author | | Kudo, Yusuke Browse this author | | Nishida, Mutsumi Browse this author | | Taketomi, Akinobu Browse this author →KAKEN DB |
| Keywords: | Elastography | | virtual touch quantification (VTQ) | | future remnant liver (FRL) | | hepatectomy |
| Issue Date: | Jun-2021 |
| Publisher: | AME Publishing Company |
| Journal Title: | Quantitative imaging in medicine and surgery |
| Volume: | 11 |
| Issue: | 6 |
| Start Page: | 2572 |
| End Page: | 2585 |
| Publisher DOI: | 10.21037/qims-20-1073 |
| Abstract: | Background: Liver elastography with virtual touch quantification (VTQ) measures the velocity of the shear wave generated by a short-duration acoustic force impulse, with values expressed in units of velocity (m/s). VTQ can evaluate right or left hepatic lobes separately. VTQ might be appropriate for the evaluation of future remnant liver after hepatectomy. Methods: We analyzed 95 patients underwent liver elastography with VTQ and both future remnant liver and resected side before hepatectomy of more than two sections, except for central bisectionectomy. We divided the patients into a high VTQ group (>= 1.52 m/s, n=37, 39%) and a low VTQ group (<1.52 m/s, n=58, 61%) according to the VTQ of future remnant liver. Transient elastography could not be performed in 22 cases due to tumor size. We defined the group with liver stiffness measurement (LSM) >= 7.9 kPa as the high LSM group (n=29, 40%) and those with LSM <7.9 kPa as the low LSM group (n=44, 60%). We investigated the outcome after hepatectomy and the correlations between the VTQ of future remnant liver and other indicators for hepatic fibrosis. Results: The high VTQ group showed significantly higher postoperative ascites (19% vs. 3%; P=0.01), pathological fibrosis (19% vs. 5%; P=0.03), and rates of patients with postoperative T-bil >= 2.0 mg/dL (70% vs. 40%; P<0.01). The high LSM group showed no significant postoperative outcomes compared to the low LSM group. The high VTQ group showed a higher frequency of male gender (78% vs. 57%; P=0.03), higher indocyanine green retention rate at 15 min (ICGR15) (10.5% vs. 6.3%; P<0.01), hyaluronic acid (100 vs. 67 ng/mL; P=0.02), type IV collagen 7S (7.6 vs. 5.1 ng/mL; P<0.01), Mac-2 binding protein glycan isomer (M2BPGi) (1.19 vs. 1.00; P=0.01), Fibrosis-4 (FIB-4) index (2.25 vs. 1.76; P=0.01), and aspartate aminotransferase to platelet ratio index (APRI) score (0.64 vs. 0.41; P<0.01). We also observed an especially strong positive correlation between the high VTQ and hyaluronic acid or type IV collagen 7S. Conclusions: Elastography with VTQ for future remnant liver before major hepatectomy is an accurate and useful method as a preoperative evaluation. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/82061 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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