Acoustic Structure Quantification (ASQ): A New Tool in the Sonographic Diagnosis of Liver

Lesions in Hepatic Alveolar Echinococcosis

Innovation for the Management of EchinococcosisMarch 27, 2014Besançon, France

Tanja Kaltenbach,Dr. Tilmann Gräter,University Hospital UIm Germany

Methods

• Comparative ASQ examination of HAE liver lesions and of healthy liver tissue was performed with Toshiba Aplio 500

• Maximum size of lesions was measured in B-mode and in ASQ mode

• ASQ videos were stored as raw data and used for quantitative analysis with ASQ software

• ASQ parameters Mode, Average, Standard Deviation and FD-Ratio of lesions and of healthy tissue were compared

Patients

• 24 patients (13 women, 11 men)

• mean age 52 years (16 - 85 years)

• mean disease duration 68 months (1– 334 months)

• diagnostically confirmed HAE liver lesion(s)

• fasting at least 6 hours

Examinations

Methods

Quantitative ASQ examination

Example of placing four oval ROIs of similar size in a HAE lesion.

Example of placing four ROIs in healthy liver parenchyma on level with the lesion.

Results

• Subjectively, parasitic tumors in HAE appear more prominent in color-

coded ASQ imaging

• lesions’ size measured in ASQ mode does not differ from size

measured in B-mode

• Median FD-ratio of lesions was 3 (0.1 to 3), compared with 0.5 (0.1 to

1.8) in healthy liver (p < 0.0001)

• Comparison of other ASQ parameters shows highly significant results

Conclusion

• Qualitative and quantitative ASQ is a practical and useful method to

detect structural changes of liver parenchyma in HAE

• FD-ratio can be considered a representative and practical ASQ

parameter indicating tissue alterations in infested parenchyma

• If lesion-specific ASQ reference values can be defined in future long-

term-studies, ASQ technology could provide additional information for

follow up examinations of HAE liver lesions