Prospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2019; 7(21): 3463-3473
Published online Nov 6, 2019. doi: 10.12998/wjcc.v7.i21.3463
Normal values of shear wave velocity in liver tissue of healthy children measured using the latest acoustic radiation force impulse technology
Pei-Xuan Sun, Yu-Yang Tong, Jing Shi, Huan Zhang, Shi-Jian Liu, Jun Du
Pei-Xuan Sun, Jing Shi, Huan Zhang, Jun Du, Diagnostic Imaging Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
Yu-Yang Tong, Department of Ultrasound, Shanghai Cancer Center, Fudan University, Shanghai 200032, China
Shi-Jian Liu, Department of Clinical Epidemiology and Biostatistics, Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
Author contributions: All authors helped to perform the study; Sun PX and Tong YY contributed equally to the manuscript; Sun PX, Tong YY, and Du J contributed to the study conception and design; Sun PX, Shi J, and Zhang H contributed to performing the procedures and collecting the data; Liu SJ participated in the protocol design and statistical analysis; all authors approved the final version of the manuscript.
Supported by Science and Technology Foundation of Pudong New District, No. PKJ2015-Y05); Medical and Industrial Interdisciplinary Fund of Shanghai Jiao Tong University, No. YG2016MS30; General Program of Shanghai Health and Family Planning Commission, No. 201740095; Guiding Project of Shanghai Science and Technology Commission, No. 19411965400.
Institutional review board statement: The study was approved by the institutional ethics committee of Shanghai Children’s Medical Center.
Clinical trial registration statement: This study is registered at https://register.clinicaltrials.gov/. The registration identification number is NCT03645655.
Informed consent statement: Parental informed consent was obtained in all cases.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jun Du, MD, Associate Professor, Director, Diagnostic Imaging Center, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, No. 1678, Dongfang Road, Pudong District, Shanghai 200127, China. scmcdujun@163.com
Telephone: +86-18930830855 Fax: +86-21-38626161
Received: June 15, 2019
Peer-review started: June 18, 2019
First decision: August 1, 2019
Revised: September 25, 2019
Accepted: October 15, 2019
Article in press: October 15, 2019
Published online: November 6, 2019
Processing time: 145 Days and 21.3 Hours
Abstract
BACKGROUND

Several studies have demonstrated the feasibility and effectiveness of using ultrasound elastography to assess liver tissue stiffness. Virtual touch imaging quantification (VTIQ) based on acoustic radiation force impulse imaging has been developed as a latest and noninvasive method for assessing liver stiffness in children.

AIM

To determine the standard value in healthy children, and to identify possible factors that might influence the VTIQ measurement.

METHODS

With the ethical approval, 202 children between 1 month and 15 years old were included in this study. None of them had any liver or systematic diseases. All children had a normal ultrasound scan and normal body mass index (BMI) range. The subjects were divided into four age and BMI groups. The effects of gender, age, liver lobe, measurement depth, and BMI on liver elasticity were investigated.

RESULTS

A significant correlation was found between age and shear wave velocity (SWV) value. At measurement depths of 1.5 cm and 2.0 cm in the left lobe, there were significant differences among the age groups. SWV values were significantly negatively correlated with the measurement depth. Gender, liver lobe, and BMI showed no significant effect on the SWV values. Age and BMI may influence the quality of the elastogram.

CONCLUSION

VTIQ is a noninvasive technique that is feasible to measure liver stiffness in children. The afore-mentioned velocity value obtained utilizing VTIQ method could be used as reference value for normal liver stiffness in children.

Keywords: Acoustic radiation force impulse; Virtual touch imaging quantification; Liver stiffness; Shear wave velocity

Core tip: Virtual touch imaging quantification (VTIQ) is the latest elastic technology based on acoustic radiation force impulse imaging. Previously, the high-frequency linear probe (9L4) with VTIQ technology was used for the evaluation of breast and thyroid lesions. We found that this probe might also be suitable for the abdominal organs in children. This study analyzed the normal liver stiffness measured by VTIQ method and assessed the potential influencing factors of VTIQ value and factors affecting the quality of the elastogram. This study suggested that VTIQ is a feasible technique to measure liver stiffness in children.