New device measuring liver stiffness using invisible, high-intensity waves receives NICE recommendation for liver disease diagnosis
Ground-breaking new ultrasound technology capable of diagnosing and monitoring liver disease without the need for surgery has been approved for use by the NHS.
The ultrasound technique, called Virtual Touch Quantification (VTQ) is manufactured by Siemens Healthcare and assesses the stiffness of the liver based on readings from invisible, high-intensity shear waves that are transmitted through the organ.
For almost a century, clinicians have used the liver biopsy to diagnose liver disease, involving a long needle with risk of bleeding and infection
The National Institute for Health and Care Excellence (NICE) has today issued guidance, including cost modelling that suggests the use of VTQ could save the NHS around £434 per patient compared with a highly-invasive liver biopsy.
The current gold standard method for assessing liver damage - a biopsy - involves putting patients under a local anaesthetic and removing a section of the liver for assessment. This method only takes a small sample size from a focal area and results in a misdiagnosis in 20-40% of cases on average.
VTQ uses Acoustic Radiation Force Impulse (ARFI) to provide an accurate evaluation of liver tissue stiffness, a key indicator of liver disease, through 10 measurements taken across the organ. Shear waves are transmitted through the liver and attenuate approximately 10,000 times more rapidly than with conventional ultrasound. The waves travel at varying speeds through liver tissue depending on whether the liver is flexible and healthy, or stiff and damaged due to fibrous scar tissue caused by an ongoing liver condition.
The NICE guidance recommends VTQ for diagnosis of chronic hepatitis B or C.
Liver disease is the only major cause of death still increasing year-on-year and is currently the third-most-common cause of premature death in the UK. It is also estimated that up to 466,000 people have the chronic hepatitis C virus in the UK. It is possible, however, to reverse liver disease if diagnosed at the early stages.
Andrew Langford, chief executive of the British Liver Trust, said: "The VTQ ultrasound technique marks a step towards improved diagnosis – both unobtrusive and swift. More investment into innovative diagnosis treatments and technology could save thousands of lives. If we can identify liver disease early enough there is opportunity to introduce effective lifestyle changes or treatment plans with the potential to reverse its effects. It is essential that diagnostic tests are easily accessible, safe and provide rapid results."
The Virtual Touch Quantification procedure takes no longer than five minutes to complete and is performed by a clinician who will also interpret the data, meaning results can be obtained rapidly. Unlike a biopsy, no hospital stay or post procedure monitoring is required.
Virtual Touch Quantification has the potential to transform this practice, using tissue strain imaging which should remove the need for an invasive procedure
Mark Flint, division lead foru at Siemens Healthcare UK, added: “For almost a century, clinicians have used the liver biopsy to diagnose liver disease, involving a long needle with risk of bleeding and infection.
“Virtual Touch Quantification has the potential to transform this practice, using tissue strain imaging which should remove the need for an invasive procedure. It is also beneficial for patients where current methods of non-invasive liver damage assessment are unsuitable due to factors including obesity or illness.”
“We believe the NICE guidance will see this under-utilised technology become increasingly prevalent within the NHS. In the future, this could even be extended to primary care settings such as GP surgeries for ease-of-access.”