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New virtual touch quantification criteria offers reliable fibrosis detection

Researchers developed new and comprehensive reliability criteria for virtual touch quantification to assess liver fibrosis based on the interquartile range/median ratio and the shear wave speed measurement result, according to recently published data.

“The correct interpretation of elastography results plays a crucial role in ensuring appropriate patient management, but remains a challenge for physicians, as several conditions other than liver fibrosis can increase liver stiffness,” Jérôme Boursier, MD, PhD, from the Hospices Civils de Lyon in France, and colleagues wrote. “We defined new and comprehensive reliability criteria for [virtual touch quantification (VTQ)] examination resulting in ‘very reliable,’ ‘reliable,’ and ‘unreliable’ categories, all with significantly different diagnostic accuracies.”

Boursier and colleagues prospectively enrolled into the study 1,084 patients with biopsy-confirmed chronic liver disease.

Overall, VTQ accuracy decreased as the interquartile range/median (IQR/M) increased. Patients with IQR/M less than 0.15 had very reliable examinations, whereas those with IQR/M of 0.35 or higher and VTQ results of 1.37 m/s or higher had the most unreliable examinations.

Patients with an IQR/M range of 0.15 to 0.34 had reliable results. Examinations of patients with an IQR/M of 0.35 or higher but VTQ less than 1.37 m/s were similarly reliable to those in the IQR/M 0.15 to 0.34 range, but significantly better than those with VTQ results of 1.37 m/s or higher.

In the whole population, the researchers considered 23.6% of the VTQ examinations very reliable, 55% reliable and 21.4% unreliable. Multivariate analysis including age, sex, nonalcoholic fatty liver disease etiology, skin-liver capsule distance, liver steatosis and alanine aminotransferase, showed that unreliable VTQ examination correlated independently with age and skin-liver capsule distance.

“Intrinsic characteristics of [shear wave speed measurement (SSM)] examination can be improved by operator experience,” Boursier and colleagues wrote. “Our new reliability criteria for SSM with VTQ will help physicians not only to identify the examinations which must be not considered for clinical decisions, but also to refine their practice and progress to more reliable examinations.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.