Conclusions: The course of the bile ducts can be recognized on conventional ultrasound by referencing virtual ultrasonography constructed by Gd-EOB-DTPAenhanced MRI. This imaging technology is useful

in avoiding bile duct injury during RFA. Disclosures: BTK inhibitor The following people have nothinq to disclose: Yohei Koizumi, Masashi Himooka, Hironori Ochi, Yoshio Tokumoto, Masanomi Abe, Fujimasa Tada, Atsushi Himaoka, Himoaki Tanaka, Takahamu Tsuda, Temuhito Mochizuki, Yoichi Hiasa Background and Aim Virtual Touch Quantification (VTQ) can be used to easily measure spleen stiffness (SS) by referring to the corresponding B-mode image without restricting the measurement distance. However, the usefulness and challenges associated with the measurement of SS for the prediction of liver fibrosis stage are not well documented. In the present study, we aimed to evaluate SS by VTQ for the prediction of liver fibrosis. Patients and Methods From December 2010 to February 2013, 352 patients (162 men and learn more 190 women) with chronic liver disease confirmed by liver biopsy were evaluated by VTQ for the measurement of liver stiffness (LS) and SS (average age 55.8 ± 13.5 years; 90 patients with hepatitis B, 179 with hepatitis C, and 1 with hepatitis B and C; 76 patients had non-B non-C hepatitis). The New Inuyama Classification was used to evaluate the degree

of hepatitis. The distribution of liver fibrosis stages was as follows: stage over F0 (n =15), F1(n =134), F2 (n = 66), F3 (n = 73), and F4 (n = 64). VTQ measurements were performed using the Siemens Acuson S2000 ultrasound system. SS values were compared with clinical parameters including measurements of LS; platelet count; levels of AST, ALT, bilirubin, hyaluronic acid, and albumin; prothrombin time; and APRI. Results The LS and SS values corresponding to each fibrosis stage were 1.16 and 2.40 for stage F0, 1.14 and 2.33 for stage F1, 1.34 and 2.44 for stage F2, 1.53 and 2.54 for stage F3, and 2.30 and 3.18 for stage F4, respectively. Significant differences between stages F3 and F4 were observed for both LS and SS values (P < 0.0001). SS values showed the highest correlation

with LS values (r = 0.595, P < 0.0001). The area under the receiver operating characteristic curve for SS to distinguish between fibrosis was the highest among all the parameters (SS = 0.918; LS = 0.905; hyaluronic acid = 0.830; APRI = 0.772; platelet count = 0.738; prothrombin time = 0.738). However, for SS measurements, 20% (n = 3) of F0 and 16% (n = 22) of F1 patients fell above the F4 cutoff levels; these rates were higher than those for LS (0% of F0; 3% of F1). All cases with high SS values and F0 and F1 stages had a small spleen except for 1 severely obese F1 patient. Conclusion SS measurements obtained using VTQ could be a good predictor of liver fibrosis stage, although the occurrence of false positive results should be carefully considered in cases with small spleens.