Impact of Virtual Touch Quantification in Acoustic Radiation Force Impulse for Skeletal Muscle Mass Loss in Chronic Liver Diseases

Abstract

Background and aims: We sought to clarify the relationship between virtual touch quantification (VTQ) in acoustic radiation force impulse and skeletal muscle mass as assessed by bio-electronic impedance analysis in patients with chronic liver diseases (CLDs, n = 468, 222 males and 246 females, median age = 62 years). Patients and methods: Decreased skeletal muscle index (D-SMI) was defined as skeletal muscle index (SMI) <7.0 kg/m2 for males and as SMI <5.7 kg/m2 for females, according to the recommendations in current Japanese guidelines. We examined the correlation between SMI and VTQ levels and investigated factors linked to D-SMI in the univariate and multivariate analyses. The area under the receiver operating curve (AUROC) for the presence of D-SMI was also calculated. Results: In patients with D-SMI, the median VTQ level was 1.64 meters/second (m/s) (range, 0.93–4.32 m/s), while in patients without D-SMI, the median VTQ level was 1.11 m/s (range, 0.67–4.09 m/s) (p < 0.0001). In the multivariate analysis, higher VTQ was found to be an independent predictor linked to the presence of D-SMI (p < 0.0001). In receiver operating characteristic analysis, body mass index had the highest AUROC (0.805), followed by age (0.721) and VTQ (0.706). Conclusion: VTQ levels can be useful for predicting D-SMI in patients with CLDs.

Nutrition and Liver Disease

“…The results of the study by Imai et al overall confirmed that sarcopenia negatively impacts the survival of patients with HCC, and is a valuable prognostic factor that might be impacted by liver functional reserve and the clinical stage of HCC. Therelationship between the loss of SMM, as assessed by bioelectric impedance analysis (BIA), and liver fibrosis, as measured by virtual-touch-quantification (VTQ) and acoustic-radiation-force-impulse elastography in patients with chronic liver disease (CLD), was reported by Nishikawa et al [ 2 ]. Interestingly, BCAAs-to-tyrosine ratio (BTR) showed the second strongest correlation with the VTQ level, and was an independent predictor for decreased SMM index.…”

“…The study by Imai et al [ 1 ] was based on imaging techniques, and, although these assessments are objective and not affected by defects in hepatic synthesis or retention of NaCl and water, they are either expensive or involve radiation and cannot easily be repeated to monitor progress. The other twostudies [ 2 , 3 ] that used BIA, which is based on a two-component model of body composition (fat and fat-free mass), may have drawbacks. As recently emphasized by Amodio et al [ 4 ] the validity of this technique is in fact critically dependent on assumptions relating to tissue density and hydration.…”

“…Therelationship between the loss of SMM, as assessed by bioelectric impedance analysis (BIA), and liver fibrosis, as measured by virtual-touch-quantification (VTQ) and acoustic-radiation-force-impulse elastography in patients with chronic liver disease (CLD), was reported by Nishikawa et al [ 2 ]. Interestingly, BCAAs-to-tyrosine ratio (BTR) showed the second strongest correlation with the VTQ level, and was an independent predictor for decreased SMM index.…”