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Erschienen in: Hepatology International 3/2007

01.09.2007 | Original Paper

Assessing liver tumor stiffness by transient elastography

verfasst von: Ryota Masuzaki, Ryosuke Tateishi, Haruhiko Yoshida, Takahisa Sato, Takamasa Ohki, Tadashi Goto, Hideo Yoshida, Shinpei Sato, Yosuke Sugioka, Hitoshi Ikeda, Shuichiro Shiina, Takao Kawabe, Masao Omata

Erschienen in: Hepatology International | Ausgabe 3/2007

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Abstract

Background and aims

Transient elastography is a novel noninvasive method to assess liver fibrosis by measuring liver stiffness. This study is a first step toward the provision of a noninvasive measurement of hepatic tumor stiffness by transient elastography.

Patients and methods

Patients with liver tumor larger than 5 cm in diameter and located near the liver surface were enrolled between June 2004 and February 2005. Histology of each tumor was evaluated on ultrasound-guided liver biopsy specimens. Transient elastography (Fibroscan, Echosens, Paris) was used to measure tumor stiffness. Tumor stiffness was measured as follows. First, by using B-mode ultrasound, we searched for the optimal right intercostal position for tumor stiffness measurement while keeping the ultrasound probe and body surface at right angles. Then the vibrator for transient elastography was applied at the same position and angle, and stiffness was measured according to the manufacturer’s instruction.

Results

Tumor stiffness was measured in 40 patients, 17 with hepatocellular carcinoma (HCC), six with cholangiocellular carcinoma (CCC), 16 with metastatic tumors (mostly adenocarcinoma), and one with malignant lymphoma. The median value was 55 kPa in HCC, 75 kPa in CCC, 66.5 kPa in metastatic tumor, and 16.9 kPa in malignant lymphoma. The stiffness value of CCC was significantly higher than that of HCC and metastatic tumors (P = .049).

Conclusion

We showed that stiffness of liver tumors could be measured with transient elastography. Improvements in the device, such as smaller and variable region of interest of measurement and real-time B-mode display, may ensure wider clinical application.
Literatur
1.
Zurück zum Zitat Eklund A, Bergh A, Lindahl OA. A catheter tactile sensor for measuring hardness of soft tissue: measurement in a silicone model and in an in vitro human prostate model. Med Biol Eng Comput 1999;37:618–24PubMedCrossRef Eklund A, Bergh A, Lindahl OA. A catheter tactile sensor for measuring hardness of soft tissue: measurement in a silicone model and in an in vitro human prostate model. Med Biol Eng Comput 1999;37:618–24PubMedCrossRef
2.
Zurück zum Zitat Ophir J, Garra B, Kallel F, Konofagou E, Krouskop T, Righetti R, et al. Elastographic imaging. Ultrasound Med Biol 2000;26(Suppl 1):S23–9PubMedCrossRef Ophir J, Garra B, Kallel F, Konofagou E, Krouskop T, Righetti R, et al. Elastographic imaging. Ultrasound Med Biol 2000;26(Suppl 1):S23–9PubMedCrossRef
3.
Zurück zum Zitat Bercoff J, Chaffai S, Tanter M, Sandrin L, Catheline S, Fink M, et al. In vivo breast tumor detection using transient elastography. Ultrasound Med Biol 2003;29:1387–96PubMedCrossRef Bercoff J, Chaffai S, Tanter M, Sandrin L, Catheline S, Fink M, et al. In vivo breast tumor detection using transient elastography. Ultrasound Med Biol 2003;29:1387–96PubMedCrossRef
4.
Zurück zum Zitat Kusaka K, Harihara Y, Torzilli G, Kubota K, Takayama T, Makuuchi M, et al. Objective evaluation of liver consistency to estimate hepatic fibrosis and functional reserve for hepatectomy. J Am Coll Surg 2000;191:47–53PubMedCrossRef Kusaka K, Harihara Y, Torzilli G, Kubota K, Takayama T, Makuuchi M, et al. Objective evaluation of liver consistency to estimate hepatic fibrosis and functional reserve for hepatectomy. J Am Coll Surg 2000;191:47–53PubMedCrossRef
5.
Zurück zum Zitat Gao L, Parker KJ, Lerner RM, Levinson SF. Imaging of the elastic properties of tissue—a review. Ultrasound Med Biol 1996;22:959–77PubMedCrossRef Gao L, Parker KJ, Lerner RM, Levinson SF. Imaging of the elastic properties of tissue—a review. Ultrasound Med Biol 1996;22:959–77PubMedCrossRef
6.
Zurück zum Zitat Greenleaf JF, Fatemi M, Insana M. Selected methods for imaging elastic properties of biological tissues. Annu Rev Biomed Eng 2003;5:57–78PubMedCrossRef Greenleaf JF, Fatemi M, Insana M. Selected methods for imaging elastic properties of biological tissues. Annu Rev Biomed Eng 2003;5:57–78PubMedCrossRef
7.
Zurück zum Zitat Thomas A, Fischer T, Frey H, Ohlinger R, Grunwald S, Blohmer JU, et al. Real-time elastography—an advanced method of ultrasound: first results in 108 patients with breast lesions. Ultrasound Obstet Gynecol 2006;28:335–40PubMedCrossRef Thomas A, Fischer T, Frey H, Ohlinger R, Grunwald S, Blohmer JU, et al. Real-time elastography—an advanced method of ultrasound: first results in 108 patients with breast lesions. Ultrasound Obstet Gynecol 2006;28:335–40PubMedCrossRef
8.
Zurück zum Zitat Bosch FX, Ribes J, Diaz M, Cleries R. Primary liver cancer: worldwide incidence and trends. Gastroenterology 2004;127:S5–16PubMedCrossRef Bosch FX, Ribes J, Diaz M, Cleries R. Primary liver cancer: worldwide incidence and trends. Gastroenterology 2004;127:S5–16PubMedCrossRef
9.
Zurück zum Zitat Parkin DM, Muir CS. Cancer incidence in five continents. Comparability and quality of data. IARC Sci Publ 1992:45–173 Parkin DM, Muir CS. Cancer incidence in five continents. Comparability and quality of data. IARC Sci Publ 1992:45–173
10.
Zurück zum Zitat Llovet JM, Beaugrand M. Hepatocellular carcinoma: present status and future prospects. J Hepatol 2003;38(Suppl 1):S136–49PubMedCrossRef Llovet JM, Beaugrand M. Hepatocellular carcinoma: present status and future prospects. J Hepatol 2003;38(Suppl 1):S136–49PubMedCrossRef
11.
Zurück zum Zitat Castera L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 2005;128:343–50PubMedCrossRef Castera L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 2005;128:343–50PubMedCrossRef
12.
Zurück zum Zitat Sandrin L, Fourquet B, Hasquenoph JM, Yon S, Fournier C, Mal F, et al. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol 2003;29:1705–13PubMedCrossRef Sandrin L, Fourquet B, Hasquenoph JM, Yon S, Fournier C, Mal F, et al. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol 2003;29:1705–13PubMedCrossRef
13.
Zurück zum Zitat Ziol M, Handra-Luca A, Kettaneh A, Christidis C, Mal F, Kazemi F, et al. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C. Hepatology 2005;41:48–54PubMedCrossRef Ziol M, Handra-Luca A, Kettaneh A, Christidis C, Mal F, Kazemi F, et al. Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis C. Hepatology 2005;41:48–54PubMedCrossRef
14.
Zurück zum Zitat Foucher J, Chanteloup E, Vergniol J, Castera L, Le Bail B, Adhoute X, et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study. Gut 2006;55:403–8PubMedCrossRef Foucher J, Chanteloup E, Vergniol J, Castera L, Le Bail B, Adhoute X, et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study. Gut 2006;55:403–8PubMedCrossRef
15.
Zurück zum Zitat Torzilli G, Minagawa M, Takayama T, Inoue K, Hui AM, Kubota K, et al. Accurate preoperative evaluation of liver mass lesions without fine-needle biopsy. Hepatology 1999;30:889–93PubMedCrossRef Torzilli G, Minagawa M, Takayama T, Inoue K, Hui AM, Kubota K, et al. Accurate preoperative evaluation of liver mass lesions without fine-needle biopsy. Hepatology 1999;30:889–93PubMedCrossRef
16.
Zurück zum Zitat Varghese T, Techavipoo U, Liu W, Zagzebski JA, Chen Q, Frank G, et al. Elastographic measurement of the area and volume of thermal lesions resulting from radiofrequency ablation: pathologic correlation. Am J Roentgenol 2003;181:701–7 Varghese T, Techavipoo U, Liu W, Zagzebski JA, Chen Q, Frank G, et al. Elastographic measurement of the area and volume of thermal lesions resulting from radiofrequency ablation: pathologic correlation. Am J Roentgenol 2003;181:701–7
17.
Zurück zum Zitat Bharat S, Techavipoo U, Kiss MZ, Liu W, Varghese T. Monitoring stiffness changes in lesions after radiofrequency ablation at different temperatures and durations of ablation. Ultrasound Med Biol 2005;31:415–22PubMedCrossRef Bharat S, Techavipoo U, Kiss MZ, Liu W, Varghese T. Monitoring stiffness changes in lesions after radiofrequency ablation at different temperatures and durations of ablation. Ultrasound Med Biol 2005;31:415–22PubMedCrossRef
Metadaten
Titel
Assessing liver tumor stiffness by transient elastography
verfasst von
Ryota Masuzaki
Ryosuke Tateishi
Haruhiko Yoshida
Takahisa Sato
Takamasa Ohki
Tadashi Goto
Hideo Yoshida
Shinpei Sato
Yosuke Sugioka
Hitoshi Ikeda
Shuichiro Shiina
Takao Kawabe
Masao Omata
Publikationsdatum
01.09.2007
Verlag
Springer-Verlag
Erschienen in
Hepatology International / Ausgabe 3/2007
Print ISSN: 1936-0533
Elektronische ISSN: 1936-0541
DOI
https://doi.org/10.1007/s12072-007-9012-7

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