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Keywords:
Liver, Ultrasound, Elastography, Diagnostic procedure
Authors:
G. Ferraioli, L. Maiocchi, R. Lissandrin, C. Tinelli, C. Filice; Pavia/IT
DOI:
10.1594/ecr2016/B-1085
Methods and materials
This was a single center cross-sectional study.
From May to October 2015 consecutive individuals,
referred to the ultrasound unit of the infectious disease department of our institution for abdominal ultrasound examination,
were enrolled.
Liver stiffness measurements (LSM)s were performed with both QElaXto® and VCTE.
The LSMs with FibroScan device were performed following the procedure described elsewhere and only LSMs with 10 validated measurements and an interquantile range/median (IQR/M) < 30% for values higher than 7.1 kiloPascal (kPa) were considered reliable [1,2].
The LSMs with QElaXto® technique were performed in the right lobe of the liver,
through intercostal spaces,
with the subject lying supine with the right arm in maximal abduction.
Using a real time B-mode image,
the operator selected an area of liver parenchyma free of large vessels,
at least 1.5 cm below the Glisson’s capsule,
where the fixed sample box was placed by moving a trackball (Figure 1).
Patients were instructed to hold their breath while the operator launched the data acquisition.
The median value of 10 measurements was used for the statistical analysis.
The FibroScan and Twice ultrasound system were used in a random order. The study protocol was approved by the institutional Ethics Committee and informed written consent was obtained from all subjects for being included in the study.
For staging liver fibrosis we used the VCTE cutoffs of 7.0,
9.5 and 12.0 kPa,
respectively,
for significant fibrosis (F≥2),
advanced fibrosis (F≥3),
and liver cirrhosis (F=4) [3].
The diagnostic performance of QElaXto® was assessed by calculating the area under the receiver operating characteristic curve (AUROC).