Virtual Touch Tissue Quantification Technique Research Articles

The Role of Virtual Touch Tissue Quantification Technique in Differentiating Between Benign Prostatic Hyperplasia and Prostatic Carcinoma

The Role of Virtual Touch Tissue Quantification Technique in Differentiating Between Benign Prostatic Hyperplasia and Prostatic Carcinoma

USEFULNESS OF TRANSPERINEAL VIRTUAL TOUCH QUANTIFICATION IN THE CERVIX FOR PREDICTING OUTCOME OF LABOR INDUCTION

This study aimed to explore the feasibility of transperineal virtual touch tissue quantification (VTQ) for predicting the outcome of labor induction. A total of 80 nulliparous pregnant women were included. Before labor induction, cervical length was measured by B-mode sonography, cervical stiffness was measured by VTQ, and Bishop score was assessed by vaginal examination. Subsequently, labor was induced using standard oxytocin infusion in all patients. Delivery within 24 hours after labor induction was classified as spontaneous delivery; otherwise, cesarean delivery was performed. Out of 80 participants, 48 (60%) delivered vaginally and 32 (40%) underwent cesarean delivery. The cervical length was significantly longer and the shear wave velocity (SWV) was greater in the cesarean delivery group than in the vaginal delivery group (p = 0.004 and p < 0.000, respectively). Logistic regression analysis indicated that only the mean SWV had independent predictive value for the outcome of labor induction (p = 0.011). The best diagnostic cut-off point of the mean SWV was 1.23 m/s, with a sensitivity of 93.8% and a specificity of 89.6%. Transperineal VTQ technique could predict the outcome of labor induction using oxytocin.

Acoustic Radiation Force Impulse Imaging With Virtual Touch Tissue Quantification Enables Characterization of Mild Hypoxic-Ischemic Brain Damage in Neonatal Rats.

The aim of this study was to investigate whether the measurement of brain tissue stiffness using acoustic radiation force impulse (ARFI) elastography with virtual touch tissue quantification can improve the early detection of neonatal hypoxic-ischemic brain damage in rats. Seven-day-old Sprague-Dawley rats were randomly assigned to 3 groups: the mild asphyxia (n = 30), moderate asphyxia (n = 30), and sham control (n = 10) groups. Rats in the mild and moderate asphyxia groups were exposed to 8% oxygen (hypoxia) for 30 and 60 minutes, respectively, at 1 hour after ligation of the right common carotid artery. An ultrasound diagnostic instrument was used to obtain 2-dimensional ultrasound images, and ARFI with virtual touch tissue quantification was used to measure shear wave velocity preoperatively and at 12, 24, 48, and 72 hours postoperatively. Hematoxylin-eosin staining was used to evaluate brain damage. Two-dimensional ultrasound imaging detected swelling and increased echogenicity at 48 to 72 hours in the mild asphyxia group and at 24 to 72 hours in the moderate asphyxia group. The shear wave velocity substantially increased from 0.65 ± 0.04 m/s preoperatively to 0.78 ± 0.07 m/s at 72 hours in the moderate asphyxia group and from 0.64 ± 0.04 m/s preoperatively to 0.70 ± 0.03 m/s at 72 hours in the mild asphyxia group. The changes in the shear wave velocity coincided with the histopathologic changes in the brain, which included neuronal demyelination, hyperplasia, and necrosis; edema around vascular structures; and hemorrhage in the ependymal and periventricular areas. Shear wave velocity data obtained with the virtual touch tissue quantification technique may be used for early diagnosis of neonatal hypoxic-ischemic brain damage.

Shear Wave Elastography Improves Specificity of Ultrasound for Parotid Nodules.

This study aimed to determine the performance of Virtual Touch tissue quantification (VTQ) technique in the differential evaluation of parotid gland nodules. Acoustic radiation force impulse VTQ technique was used to determine the shear wave velocity (SWV) of 76 patients with parotid nodules and 30 subjects with normal parotid gland. These nodules were assigned to benign and malignant nodules according to histopathology, measurements of SWV were compared, a cutoff point for benign and malignant nodules was obtained with reference to receiver-operating characteristic curve, and relevant sensitivity and specificity were evaluated. There were 61 of 76 patients with benign parotid nodules and 15 of 76 patients with malignant nodules. The SWV of the malignant nodules was higher than the SWV of the benign nodules, and the SWV of the benign and malignant nodules was higher than the normal parotid glands. There were significant differences between benign and malignant nodules as well as normal parotid glands in terms of the age and SWV of the nodules (all P < 0.001). The area under the curve is 0.893, the cutoff is 2.445 m/s, and the sensitivity and specificity are 80.0% and 91.8%, respectively. Acoustic radiation force impulse VTQ technique can determine the stiffness of parotid nodules in general, its ability to distinct malignant from benign nodular nodule is still not strong, and overlay of SWV of VTQ between benign and malignant nodules is the main impedance to set cutoff point.

The application study of the virtual touch tissue quantification technique in predicting the outcome of labor induction

Objective To estimate cervical stiffness during late pregnancy with virtual touch tissue quantification technique(VTQ) and investigate the value of predicting the outcome of labor induction. Methods Cervical length in pregnancy women at 35-41 weeks′gestation was measured through perineum ultrasound examination before labor induction, and then VTQ was applied to measure shear wave velocity(SWV)values in region of interest(ROI), the maximum, minimum and average of SWV values were obtained from multiple SWV measurement under the VTQ mode. The outcomes of labor induction were tracked and Bishop scores were recorded, vaginal delivery and cesarean delivery groups were compared using Student′s t-test for continuous variables. ROC curve was plotted to analyze the correlation between parameters and the outcome of labor induction and to determine the most accurate SWV value and cut-off value for diagnosis. Univariate and multivariate logistic regression analysis were used to determine which of the following parameters were significant predictors of the outcome of labor induction. Results The SWV mix, SWV max and SWV mean of vaginal delivery and cesarean section were (0.92±0.13)m/s, (1.37±0.14)m/s, (1.13±0.10)m/s and (1.03±0.13)m/s, (1.74±0.42)m/s, (1.36±0.11)m/s, respectively, there were significant differences between vaginal delivery and cesarean section(all P<0.05). Based on ROC curve analysis, the SWV mean value in cervix was the best value for predicting the outcome of labor induction. The cut-off value of SWV mean value was 1.23 m/s, the sensitivity, specificity and Youden index were 93.8%, 83.4%, 0.77, respectively. The SWV value and cervical length were closely correlated to the outcome of labor induction, especially the SWV value according to multivariate logistic analysis. Conclusions VTQ can assess the cervical stiffness with SWV values during pregnancy, and it may have an application value of predicting the outcome of labor induction. Key words: Virtual touch tissue quantification; Shear wave velocity; Pregnancy; Cervix; The outcome of labor induction

Virtual touch tissue quantification of liver in thalassemia

Background: Objective of current study was to study the liver stiffness measurements in thalassemia patients by virtual touch tissue quantification technique. Methods: Study was case control study. Study was conducted in Pediatrics department in a tertiary care teaching hospital, between Febrauary 2015 to June 2015. 32 thalassemia patients attending outpatient department or admitted for blood transfusion were included in the study. 32 nonthalassemic patients with normal liver function tests were selected by convenience as controls to detect normal liver stiffness value. Assessment of liver stiffness was done using Acoustic radiation force impulse elastography from Philips iu22 machine using low frequency C5-2probe. 10 measurements were taken from right lobe segment-5 of liver about 1 to 2 cm from skin surface, from the right intercostal window, with patient lying in supine position, with right arm abducted. Liver stiffness measurements were taken by the same person (radiologist) to minimize inter-observer variabilities. Serum ferritin was measured by particle induced immunoturbidimetric method in the biochemistry laboratory. Primary outcome was mean value of liver stiffness measurement in thalassemia patient and to know the effect of sex, age, serum ferritin and annual blood cell requirement on the Liver stiffness value. Results: Mean value of liver stiffness value in thalassemia patients was 1.48 m/s and non-thalassemia patients were 1.15 m/s. Difference between Liver stiffness measurement between thalassemia cases and controls were significant with p value

Diagnostic value of virtual touch tissue quantification in discriminating the small breast lesions

Objective To evaluate the application value of virtual touch tissue quantification(VTQ) in the differential diagnosis of small breast lesions.Methods Fifty-six patients with sixty-nine small breast lesions whose largest diameter were less than or equal to 1 cm were evaluated with VTQ.The shear wave velocity (SWV) of the lesions and normal breast tissue were measured to analyze the diversity of different pathological types lesions of SWV and to find the optimal cut-off points using ROC curve to predict small breast cancer.Resuits The mean SWV(Vm) and the ratio (mean of lesions and normal tissue) of SWV (Vm1/Vm2) in benign group was (2.93 ± 1.32)m/s,1.79 ± 0.63,respectively,and that in malignant group was (5.65 ± 2.63) m/s,3.61 ± 1.35,respectively,there were statistically significant differences between benign group and malignant group (t test,P ＜0.05).The cut-off point of Vm was determined as 4.43 m/ s,the sensitivity,specificity and accuracy of diagnosing breast cancer were 80.5％,89.3％,92.8％,respectively.The cut-off point of Vm1/Vm2 was determined as 2.37,the sensitivity,specificity and accuracy of diagnosing breast cancer were 76.9％,81.2％,89.9％,respectively.Conclusions VTQ technique can provide helpful information in the differential diagnosis of small breast lesions. Key words: Ultrasonography; Breast diseases; Virtual touch tissue quantification

Study of virtual touch tissue quantification in noninvasive assessment of the effect of transjugular intrahepatic portosystemic stent shunt

Objective To explore the feasibility of virtual touch tissue quantification(VTQ) technique in noninvasive assessment of transjugular intrahepatic portosystemic stent shunt (TIPSS).Methods Twenty-four patients were enrolled in this study.Shear wave velocity(SWV) of the liver and spleen were obtained by VTQ technique on one day before TIPSS insertion and one week after TIPSS placement,and the portal vein pressure was measured while placing the TIPSS.The correlation between SWV of the liver and spleen and portal venous pressure were analysed.In addition,fourteen patients were followed up for one month after TIPSS placement.Results There was significant difference in portal vein pressure pre [(27.82 ± 4.07) mm Hg] and post [(16.26-± 3.10) mm Hg] TIPSS insertion.The SWV of the liver in patients pre and post TIPSS measured (2.43 ± 0.37)m/s and (2.40 ± 0.34)m/s,respectively.The SWV of the spleen in patients pre and post TIPSS were (3.49 ± 0.40)m/s and (3.08 ± 0.39)m/s,respectively,there was significant difference (P =0.000).However,SWV of the liver pre and post TIPSS placement was no significant difference(P =0.130).And as well as the patients which were followed up for one month after TIPSS placement.A significant,direct,linear correlation(r =0.602,P =0.000) was found between SWV of the spleen and portal vein pressure,but liver SWV was not correlated with the portal venous pressure.Conclusions SWV of the spleen measured by VTQ technique has a significant correlation with portal vein pressure.Hence,the spleen SWV based on VTQ technique can be used as a non-invasive method for quantitatively in monitoring the portal vein pressure as the function of the TIPSS.However,evidence to support a similar role for liver stiffness is lacking. Key words: Ultrasonography; Portosystemic shunt, transjugular intrahepatic; Hypertension, portal; Virtual touch tissue quantification

Value of virtual touch tissue quantification technique in the diagnosis of small solid thyroid nodules

Objective To explore the application value of virtual touch tissue quantification(VTQ) technique in differentiating small solid thyroid nodules.Methods The patients with suspiciously malignant thyroid nodules(solitary,size range 5-15 mm),homogeneous and normal color Doppler flow imaging in the rest of thyroid parenchyma,were enrolled in this study.Five repeated measurements were performed on both nodules and extra-nodular tissues using VTQ.A receiver-operating characteristic (ROC) curve was drew according to shear wave velocity(Vs).Results 62 patients with a total of 67 lesions were included in this study,turned out to be 39 malignant and 28 benign.The Vs of malignant group nodules,malignant group extra-nodular tissues,benign group nodules and benign group extra-nodular tissues were (3.91 ±1.85) m/s,(2.03 ± 0.42)m/s,(2.29 ± 0.56)m/s,(1.84 ± 0.45)m/s,respectively.The Vs difference between malignant and benign nodules was statistically significant (P =0.000),while the Vs difference between malignant and benign extra-nodular tissues had no statistical significance (P =0.07).The best cutoff Vs value for distinguishing malignant from benign nodules was 2.78 m/s,with the sensitivity,specificity and accuracy of 76.9％,78.6％ and 80.6％ respectively.The area under ROC curve was 0.84.Conclusions VTQ could evaluate the elasticity of thyroid nodules,and was helpful in the diagnostic work-up of thyroid nodules. Key words: Ultrasonography; Thyroid neoplasms; Virtual touch tissue quantification

Predicting acute rejection in transplanted liver with virtul touch tissue quantification technique: a preliminary study

Objective To investigate the viability of virtual touch tissue quantification (VTQ)technique in the prediction of acute rejection in transplanted liver.Methods One hundred and eighteen patients enrolled in the study were categorized into four groups:normal control (n =31),cirrhosis ( n =29),transplanted liver with acute rejection (n =28),transplant liver without any complications (n =30).All the patients were confirmed by pathology or clinical results.The VTQ of right robe of liver was obtained by a ultrasound system with VTQ technique and the data was compared among the four groups.Results The VTQ was (1.10 ± 0.29)m/s,(1.33 ± 0.33) m/s,(1.81 ± 0.47) m/s and (2.12 ± 0.59) m/s in normal control,transplanted liver without any complications,transplanted liver with acute rejection and cirrhosis group,respectively.It was significantly different in all four groups (P＜0.01).Patients with acute rejection were associated with the increase of the VTQ values (P＜0.01).Using a cutoff of VTQ＞1.36 m/s measured in the transplanted liver for prediction of acute rejection,the sensitivity and specificity were 82.1％ and 68.2％.Conclusions VTQ technique may have some clinical value in evaluation the acute rejection in transplanted liver. Key words: Ultrasonography; Liver transplantation; Graft rejection; Virtual touch tissues quantification

Measurement of virtual touch tissue quantification in healthy liver of adults

Objective To explore the feasibility of detecting liver stiffness by virtual touch tissue quantification (VTQ) technique and establish a reference range of shear-wave velocity in healthy liver of adults.Methods One hundred and sixty-one healthy adults underwent VTQ detection to obtain the shearwave velocities of livers.Each subject received VTQ measurement in four parts of liver.Ten subjects were performed twice by two sonographers,respectively.Results ① The liver shear-wave velocities of 161 healthy adults had a 95％ confidence interval from 1.089 to 1.105 m/s.Shear-wave speed values of intrahepatic different parts had no statistically significant.The ICC of measurement value of four parts in healthy liver was 0.80(95 ％ CI:0.75- 0.85).②The difference of shear-wave velocities in healthy livers in different age groups had no statistically significant,whereas the mean values in different gender had statistically significant (P =0.001).③No statistically significant was observed between the mean shear-wave velocity values obtained by different operators (P =0.82).Conclusions The liver shear-wave velocities of the healthy group have a reference range from 1.089 to 1.105 m/s.VTQ technique has a good reproduction and stability,therefore,using this technology to assess hepatic stiffness is noninvasive and feasible. Key words: Ultrasonography ; Liver; Virtual touch tissue quantification

Initial clinical study of virtual touch tissue quantification on Hashimoto's thyroiditis

Objective To explore the clinical application value of virtual touch tissue quantification (VTQ) technique in Hashimoto's thyroiditis(HT).Methods Fifty-three patients with HT and 46 health subjects were examed by conventional ultrasonography and VTQ, their shear were velocity (Vs) was measured.A receiver-operating characteristie(ROC) curve was drew according to Vs which can obtain the value of optimal operating point for diagnosing HT.Results The 2D ultrasonic appearance of 53 cases HT were classified into five species, but there was no significant difference in the Vs (F = 0.424, P = 0.790).The area under the ROC curve was 0.976,which showed a high statistical significances(P = 0.000).ROC curve displayed that Vs of 2.53 m/s could be used to diagnose HT,the sensitivity and specificity were 87％and 100％ ,respectively.Fifty-three patients with HT were classified into three groups according to thyroid function, 10 patients with hyperthyroidism, 25 patients with hypothyroidism and 18 patients with euthyroidism.The Vs of HT among the three groups were no significant difference(P = 0.884), but their Vs were all obviously higher than that of normal thyroid Vs(P = 0.000).Conclusions VTQ technique can evaluate the hardness of thyroid and has some help for differential diagnosis of HT. Key words: Ultrasonography ; Hashimoto disease