Liver disease

A global health concern

With increasing prevalence, Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) is the most common cause of chronic liver disease worldwide and a growing public health concern. It is a silent condition that can progress from steatohepatitis into fibrosis, and eventually cirrhosis – a major factor for liver transplants and mortality.

Liver analysis package

Diffuse liver disease represents a significant burden on the global health community. Non Alcoholic Fatty Liver Disease (NAFLD) is one of the most important causes of liver disease globally, creating an increasing burden on health systems. Globally NAFLD affects upwards of 20% of the world’s population, reaching as high as 35% in some regions. With concerning trends in childhood obesity, creating an increased risk of NAFLD in later life. Fatty liver disease is related to life-style factors, such as diet, exercise and alcohol consumption and can lead to cirrhosis and liver failure.

The Aplio series diagnostic ultrasound system incorporates the latest generation architecture and advanced transducer technology to deliver a new level of image quality. The newly developed liver tools aim to support clinicians to evaluate diffuse liver disease easier and faster.

Liver disease imaging is one of the major challenges faced by clinicians due to a wide range of pathologies that have overlapping appearances on medical imaging. To provide the diagnostic confidence and clarification needed, new and unique imaging tools have been developed to allow visualisation of changes in liver status.

Ultrasound diagnosis of the fatty liver using B-mode is difficult to reproduce and has a high degree of inter observer error. The ability to accurately and non-invasively grade the degree of “fatty” will help clinicians diagnose this condition more accurately and earlier.

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Aplio i-series liver Analysis

Covering the full range of liver disease

Liver disease is one of the major challenges in imaging today, with a wide range of pathologies. To provide the diagnostic confidence needed, new and unique imaging tools have been developed to allow visualisation of changes in liver status.

Attenuation Imaging (ATI)

Quantify and color-code changes in the liver composition (e.g. fat content)

Using statistical analysis of the attenuation throughout the region of interest, the system is able to quantify the accuracy of the sample. This provides information regarding the uniformity of the attenuation which is important for accuracy.
  • As the ultrasound wave is transmitted though tissue, it is attenuated through the process of scatter, absorption and heat.
  • The amount of attenuation is proportional to the frequency.

 

Shear Wave Dispersion (SWD)

Adds tissue viscosity to the routine stiffness assessment of Shear Wave Elastography

Tissue stiffness changes are common in liver disease, but any viscosity changes associated with disease processes such as fatty infiltration were not able to be assessed until now. The combination of SWE and SWD adds both stiffness and viscosity information for a more complete liver assessment.

In cases of liver inflammation, the liver becomes more viscous. It is these changes that SWD is quantifying.

Shear Wave Elastography (SWE)

Non-invasive, quantitative assessment of tissue stiffness

Canon's shear wave technology provides a quantitative measure and dynamic visual display of tissue stiffness in a variety of clinical settings.
  • Overcoming complications / limitations of biopsy
  • 5 smart maps to visualise and quantify shear wave propagation in real time, including a variance map
  • Canon unique propagation maps actually show shearwave propagation through the tissue
  • This assists in measurement placement ensuring accuracy, reproducibility and best practice
  • One shot or continuous mode scanning allowing multiple measurements from one acquisition and quicker examination times
  • Push pulse optimised for deeper regions

Shear waves are generated by means of an ultrasonic burst (left). Depending on tissue properties, shear waves travel at varying speed. Canon's unique propagation mode can be used to confirm the quality of the shear wave generation (right).

Multi-Parametric Report

Reporting for liver applications

Multi-parametric report which can combine results from both ultrasound as well as external exams (such as blood tests) for a combined result. This unique ability to bring multiple test results and combine into a single report can allow a more comprehensive understanding of liver status.

Results can be viewed in tabular format or as a spider plot (where the shape of the combined result mapping can give information on relationships between results in a visual way).

Multi-parametric report for the following liver applications:
  • Shear Wave Elastography
  • Shear Wave Dispersion map
  • Attenuation Imaging
  • User-registered label measurement

Transducer technology

Wideband multi-frequency iDMS convex: i8CX1 (PVI-475BX)

Covers the same bandwidth as two conventional transducers

Aplio i-series provides superior sensitivity and resolution for both near and far field. The ability to use one transducer across a wider range of patient types can potentially reduce cost, while providing better imaging.


Features:

  • Up to 50 cm penetration

Multi-frequency slim-face convex: i8C1 (PVI-475BT)

Enables easy intercostal scanning and more


This narrow face transducer features:

  • Improved shape for easy grip 
  • Super lightweight transducer head 
  • Light weight, thin and highly flexible cable

Multi-frequency micro-convex: 8MC1 (PVT-482BT)

The advantages of a curved array in a small footprint

Aplio i-series' thin micro-convex provides enhanced maneuverability and ease of access.


New Features:

  • Single crystal technology 
  • Lightweight and maneuverable 
  • New CIVCO® Verza™ Guidance System

Clinical Applications:

  • Abdominal 
  • Pediatric 
  • OB 
  • Biopsy Guidance

White Papers

Approaches to liver tumours

Shear Wave Elastography (SWE) and the needle navigation system are indispensable technologies not only for diagnosis but also for monitoring and assessing local treatment. Read the paper to hear Dr. Fuminori Moriyasu from Tokyo Medical University explain the SWE approach to liver tumors, including the differential diagnosis of tumors and the applications of SWE in local treatment.

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Laparoscopic liver resection as a less invasive treatment option for hepatocellular carcinoma

In this white paper, Dr. Satoru Seo, Department of Surgery from the Graduate School of Medicine, Kyoto University, shared his clinical impressions of the PET-805LA transducer used in combination with the Aplio series diagnostic ultrasound system and discussed the clinical usefulness of intraoperative contrast-enhanced ultrasound.

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» “The Aplio's shear wave application supplies the user with multiple indicators of the reliability of the shear wave propagation. These tools should be used in all cases. The operator should consider using a combination of continuous and one-shot modes, especially when working with a non-compliant patient” «

»“The most outstanding feature was the newly developed abdominal curve transducer 8C1. This transducer has the penetration and contrast resolution to scan through my bariatric patients with liver depths of 23 cm.” «

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