making a clinical difference, and the future challenges for both busi-nesses and consumers going forward.

Monday, May 29, 2006SCIENTIFIC SESSIONS

DIFFUSE LIVER DISEASE

2000

Quantification of liver fibrosis in patients with chronic hepatitisC using a new analysis softwareToyoda H, Kumada T, Kamiyama N, Yamaguchi T, Hachiya H,Ogawa S, Otobe K, Ogaki Municipal Hospital, Japan; ToshibaMedical Systems Corp., Japan; Chiba University, Japan

Objectives: To develop and validate the novel quantification softwarethat utilize the statistical information in the radio frequency (RF) on thebasis of ultrasound echo signals to quantify the stage of the liverfibrosis in patients with chronic hepatitis.Methods: B-mode images and RF-based echo data were stored atroutine ultrasound examinations in 82 patients with chronic hepatitis Cin whom diagnosis of chronic hepatitis but without cirrhosis wasconfirmed histologically. The quantification software, based on thestatistical Chi-square test, was validated for the echo data correspond-ing to the liver parenchyma and value was calculated for each patients.Results: The result of the analysis in a previous experiment indicated100 for uniform agar graphite phantoms. Mean values of the analysisresults in the present patient series (mean � SD) were 111 � 2.9 for F0fibrosis stage, 117 � 7.4 for F1, 124 � 7.6 for F2 and 135 � 10.8 forF3, respectively. A significant increase in the mean values was ob-served in association with the progression of fibrosis stage.Conclusions: Our findings indicated that our B-mode-based analysisalgorithm well correlates to the grade of fibrosis in patients withchronic hepatitis even if focusing on patients without cirrhosis.

2001

Correlation between standard deviation of liver parenchymaechotexture and liver fibrosis degreeLee SH, Cha SH, Chung HH, Lee KY, Je B-K, Park CM, Kim YH,Korea Univ Ansan Hospital Radiology, Korea; Korea Univ GuroHospital Radiology, Korea; Korea Univ Anam Hospital Radiology,Korea

Objectives: We examined whether the standard deviation (SD) valuesof parenchyma echotexture in the ultra sound (US) image could becorrelated with degree of fibrosis.Methods: We performed US in 137 patients. Two US units (ATL,HDI5000) were used in same set with linear probe (5-12 MHz) trans-ducer. Scanning was done intercostally with set time gain control. Oneimage in each patient was transformed from PACS to IA. The SD wasmeasured in the equally sized square-shaped area (82x82) at samedepth. Biopsy was performed in disease-suspected patient and classi-fied pathologically. The groups were categorized as liver cirrhosis(LC), fibrosis III, II, I, 0 and normal. These groups are recategorizedthree groups in different two methods. One categorization had group1(LC � fibrosis3), group2 (fibrosis2 � 1) and group 3 (fibrosis0 �normal). In the other categorization, group2 included fibrosis0. Normalgroup was proven by clinically with laboratory finding. The statisticalanalysis for multiple comparison of SDs of each (six) groups anddifferently re-categorized groups are done.Results: Among the 137 patients, numbers of liver cirrhosis, fibrosisIII, II, I, 0 and normal were 44, 16, 14, 14, 5 and 44. Statisticallysignificant difference was noted between some groups, but not in all.

But, difference (p � 0.05) was noted in each groups by two differentrecategorization.Conclusions: Quantitative value of SD showed correlation with degreeof liver parenchyma fibrosis.

2002

Quantitative echogram assessment in early viral liver cirrhosisdetection: First experiencePasynkov DV, Kliouchkin IV, Kazan Medical University, RussianFederation

Objectives: It is widely known that proper echographic diagnosis ofearly liver cirrhosis is often difficult or even impossible. We tried toinvent new and easy tool to use to solve this problem.Methods: One hundred forty-five patients (17 to 69 years old, mean–39� 10.2) with chronic viral hepatitis B and C and 67 patients (36 to61 years old, mean–48� 7.3) with viral liver cirrhosis have beenexamined. The diagnosis for all patients has been confirmed by percu-taneous liver biopsy. We proposed the criterium called cirrhotic index(CI) to assess the liver cirrhosis probability calculated with the help ofspecially developed program “Histography 1.1”. For all patients theconventional ultrasonography (Aloka-5000, Japan; Acuson Sequoia,USA) has been performed.Results: Twelve (17.9%) patients with class A child-Pugh cirrhosishave absolutely nonspecific echographic picture and Doppler values.Thirty-one (46.3%) patients had slight signs but it was also impossibleto confirm the liver cirrhosis. CI for patients with chronic hepatitisranged from 2.63 to 2.94 (mean—2.87 � 0.255), with liver cirrhosis—3.0 to 3.56 (mean—3.27 � 0.201); p � 0.001. Highest CI values inpatients with chronic hepatitis have been correlated with the severity ofliver fibrosis according to the biopsy result.Conclusions: The calculation of CI can improve the liver cirrhosisdetection.

2003

Comparison of leading edge 2D technologies for differentiationof liver cirrhosis and normal liver: ROC curve analysisLee JY, Choi BI, Choi JY, Kim HJ, Han JK, Lee JM, Kim SH, SeoulNational University Hospital, Korea

Objectives: To determine whether there is a difference of diagnosticperformance between advanced 2D technologies in the diagnosis ofnormal liver and cirrhotic liver.Methods: Thirty-nine normal patients and 27 cirrhosis patients wereenrolled in this study. Rapidly changing 2D imaging mode duringsingle breath hold, each identical liver image was obtained. Specklereduction imaging; compound imaging; harmonic imaging; focus andfrequency composite (FFC) were applied in either single or combinedmode. Two reviewers independently evaluated each image regardingthe degree of coarseness and confidence level of liver disease in scoresof seven and five, respectively. For statistical analysis, receiver oper-ating characteristic (ROC) curve analysis was done with comparison ofeach area under curve (AUC).Results: In the analysis of coarseness, AUC of FFC mode was thehighest among other imaging modes in all reviewers. However, it wasnot statistically significant (p � 0.05). In the analysis of confidencelevel of liver disease, AUC of FFC mode was the highest and showedstatistically significant difference from both conventional ultrasonog-raphy and combined use of speckle reduction and compound imaging(p � 0.05).Conclusions: Focus and frequency composite mode may be the mostuseful 2D imaging technique in the evaluation of chronic liver disease.

P84 Ultrasound in Medicine and Biology Volume 32, Number 5S, 2006