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Evaluation of hepatic fibrosis by ultrasonic acoustic structure quantification.

ABSTRACT: To evaluate the diagnostic accuracy of ultrasonic acoustic structure quantification (ASQ) for grading hepatic fibrosis/cirrhosis by comparing ultrasonographic features of regions of interest on ASQ images with the pathological characteristics of stage F0-F4 hepatic fibrosis cases.We retrospectively analyzed the medical records of 97 patients with chronic hepatitis who underwent ASQ evaluation at the Ultrasound Room of Dongfang Hepatobiliary Surgery Hospital (Shanghai, China) between July 2012 and October 2013. Regions of interest on stored ASQ images were analyzed to obtain cm values on modes, averages, and standard deviations. Correlation analysis, principal component analysis (PCA), and multivariate analysis of variance (MANOVA) of the mean cm values with hepatic fibrosis staging were performed. A receiver operating characteristic (ROC) curve was used to assess the diagnostic accuracy of ASQ.The mean cm of ASQ correlated with the pathological stage of hepatic fibrosis, with the best correlation coefficient (r = 0.81) in the right lobe below rib 2. The best cm average 1 and 2 values, which differed significantly among different hepatic fibrosis/cirrhosis stages, were also found in this area. The maximal area under the ROC curve (0.969) was for cmaverage 1 for the F0 versus F1 to F4 group, with a low criterion (110), while the maximal criterion (145) was for cm average 2 for the F0-F3 versus F4 group, with a relatively small AUC (0.882).With objective and accurate results, ASQ analysis is a promising non-invasive method for grading hepatic fibrosis, although this should be verified in further studies.

SUBMITTER: Cheng L

PROVIDER: S-EPMC6708933 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:In droplet-based microfluidic platforms, precise separation of microscale droplets of different chemical composition is increasingly necessary for high-throughput combinatorial chemistry in drug discovery and screening assays. A variety of droplet sorting methods have been proposed, in which droplets of the same kind are translocated. However, there has been relatively less effort in developing techniques to separate the uniform-sized droplets of different chemical composition. Most of the previous droplet sorting or separation techniques either rely on the droplet size for the separation marker or adopt on-demand application of a force field for the droplet sorting or separation. The existing droplet microfluidic separation techniques based on the in-droplet chemical composition are still in infancy because of the technical difficulties. In this study, we propose an acoustofluidic method to simultaneously separate microscale droplets of the same volume and dissimilar acoustic impedance using ultrasonic surface acoustic wave (SAW)-induced acoustic radiation force (ARF). For extensive investigation on the SAW-induced ARF acting on both cylindrical and spherical droplets, we first performed a set of the droplet sorting experiments under varying conditions of acoustic impedance of the dispersed phase fluid, droplet velocity, and wave amplitude. Moreover, for elucidation of the underlying physics, a new dimensionless number ARD was introduced, which was defined as the ratio of the ARF to the drag force acting on the droplets. The experimental results were comparatively analyzed by using a ray acoustics approach and found to be in good agreement with the theoretical estimation. Based on the findings, we successfully demonstrated the simultaneous separation of uniform-sized droplets of the different acoustic impedance under continuous application of the acoustic field in a label-free and detection-free manner. Insomuch as on-chip, precise separation of multiple kinds of droplets is critical in many droplet microfluidic applications, the proposed acoustofluidic approach will provide new prospects for microscale droplet separation.

Project description:PurposeTo evaluate the feasibility of using contrast material-enhanced computed tomographic (CT) measurements of hepatic fractional extracellular space (fECS) and macromolecular contrast material (MMCM) uptake to measure severity of liver fibrosis.Materials and methodsAll procedures were approved by and executed in accordance with University of California, San Francisco, institutional animal care and use committee regulations. Twenty-one rats that received intragastric CCl(4) for 0-12 weeks were imaged with respiratory-gated micro-CT by using both a conventional contrast material and a novel iodinated MMCM. Histopathologic hepatic fibrosis was graded qualitatively by using the Ishak fibrosis score and quantitatively by using morphometry of the fibrosis area. Hepatic fECS and MMCM uptake were calculated for each examination and correlated with histopathologic findings by using uni- and multivariate linear regressions.ResultsIshak fibrosis scores ranged from a baseline of 0 in untreated animals to a maximum of 5. Histopathologic liver fibrosis area increased from 0.46% to 3.5% over the same interval. Strong correlations were seen between conventional contrast-enhanced CT measurements of fECS and both the Ishak fibrosis scores (R(2) = 0.751, P < .001) and the fibrosis area (R(2) = 0.801, P < .001). Strong negative correlations were observed between uptake of MMCM in the liver and Ishak fibrosis scores (R(2) = 0.827, P < .001), as well as between uptake of MMCM in the liver and fibrosis area (R(2) = 0.643, P = .001). Multivariate linear regression analysis showed a trend toward independence for fECS and MMCM uptake in the prediction of Ishak fibrosis scores, with an R(2) value of 0.86 (P = .081 and P = .033, respectively).ConclusionContrast-enhanced CT measurements of fECS and MMCM uptake are individually capable of being used to estimate the degree of early hepatic fibrosis in a rat model.Supplemental materialhttp://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112452/-/DC1.

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Evaluation of hepatic fibrosis by ultrasonic acoustic structure quantification.

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