Virtual touch tissue quantification of liver in thalassemia


  • Shivaraja A Department of Pediatrics, Father Muller Medical College, Mangalore, Karnataka, India
  • Pavan Hegde Department of Pediatrics, Father Muller Medical College, Mangalore, Karnataka, India
  • Mario J. Bukelo Department of Pediatrics, Father Muller Medical College, Mangalore, Karnataka, India
  • Sanjaykumar P Department of Radiodiagnosis, Father Muller Medical College, Mangalore, Karnataka, India
  • Ram Shenoy Basti Department of Radiodiagnosis, Father Muller Medical College, Mangalore, Karnataka, India



ARFI, Liver stiffness, Serum ferritin, Thalassemia


Background: Objective of current study was to study the liver stiffness measurements in thalassemia patients by virtual touch tissue quantification technique.
Methods: Study was case control study. Study was conducted in Pediatrics department in a tertiary care teaching hospital, between Febrauary 2015 to June 2015. 32 thalassemia patients attending outpatient department or admitted for blood transfusion were included in the study. 32 nonthalassemic patients with normal liver function tests were selected by convenience as controls to detect normal liver stiffness value. Assessment of liver stiffness was done using Acoustic radiation force impulse elastography from Philips iu22 machine using low frequency C5-2probe. 10 measurements were taken from right lobe segment-5 of liver about 1 to 2 cm from skin surface, from the right intercostal window, with patient lying in supine position, with right arm abducted. Liver stiffness measurements were taken by the same person (radiologist) to minimize inter-observer variabilities. Serum ferritin was measured by particle induced immunoturbidimetric method in the biochemistry laboratory. Primary outcome was mean value of liver stiffness measurement in thalassemia patient and to know the effect of sex, age, serum ferritin and annual blood cell requirement on the Liver stiffness value.
Results: Mean value of liver stiffness value in thalassemia patients was 1.48 m/s and non-thalassemia patients were 1.15 m/s. Difference between Liver stiffness measurement between thalassemia cases and controls were significant with p value <0.001. Cut off value of 1.24 differentiates between the two groups with sensitivity of 93.8 % and specificity of 94%. Liver stiffness value is highly correlated with serum ferritin level (r=0.517, p<0.002). There were no statistically significant difference in Liver stiffness measurement between cases and controls with respect to age, sex, annual blood cell requirement.
Conclusions: Liver stiffness value is higher in patients with thalassmia and differs significantly from non thalassmic children.


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