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The impact of elastography with virtual touch quantification of future remnant liver before major hepatectomy

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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)
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
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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