Comparison of Acoustic Structure Quantification (ASQ), shearwave elastography and histology in patients with diffuse hepatopathies

BACKGROUND Objective of the study was to evaluate the diagnostic value of novel ultrasonographic modalities in comparison with simultaneously performed liver biopsy. METHODS The results of simultaneously performed examinations using Acoustic Structure Quantification (ASQ), Virtual Touch Imaging and Quantification (VTIQ) and Virtual Touch Tissue Quantification (VTTQ) were compared with the findings of liver biopsy in patients with a wide variety of diffuse hepatopathies (n = 51). The histologically determined fibrosis stage according to Desmet and Scheuer was compared with quantitative measurements returned by the ultrasonographic imaging modalities. RESULTS No statistically significant correlation with histologically determined fibrosis stage could be identified for any measurements returned using ASQ. Increasing severity of hepatic steatosis, however, was associated with a reduction in the focal disturbance (FD) ratio (r = -0.55; p < 0.0001). The shearwave velocities measured using VTTQ satisfyingly correlated with fibrosis stage (r = 0.56; p > 0.0001). Fibrosis stages > F2 were associated with an area under the curve (AUC) of 0.94 (95%-CI:0.84-0.99). A cut-off value for shearwave velocity of 1.66 m/s was determined with a sensitivity of 100% and a specificity of 84 %. VTIQ showed a less pronounced but acceptable correlation with fibrosis stage (r = 0.35; p = 0.0154). For fibrosis stages > F2 analysis showed an AUC of 0.84 (95%-CI:0.70-0.93). The cut-off value was 1.82 m/s with a sensitivity of 100% and a specificity of 58 %. CONCLUSION While ASQ showed no diagnostic advantage in our patient collective, VTTQ showed high reliability for determining severe liver fibrosis in a group of patients with diffuse liver diseases of different etiology.