Introduction: Current evidence suggests that subcutaneous “insulin ball”, a feature of the tissue-dystrophy, provokes hormonal perturbation in insulin absorption. Unforeseen 3-dimension (3D) whole human abdominal subcutaneous tissue within the insulin injecting subjects, we tried to elucidate a novel 3D ultrasound acoustic radiation force impulse (3D-ARFI) to quantitates the entire “tissue-dystrophy” volume in human.

Methods: Seven patients with daily insulin injected diabetes were enrolled and the 3D-ARFI was applied to measure tissue displacement. To generate the elasticity gradients along the depth axis of the whole abdominal subcutaneous tissue, we compared lateral region of the abdomen as internal-control. A subcutaneous insulin tolerance test was conducted to validate the rate of insulin absorption at the site of the tissue-dystrophyand control. We also analyzed the volume of whole insulin induced tissue-dystrophy with entire abdominal wall volume governed by consecutive ARFI slice imaging.

Results: Subcutaneous tissue stiffness measured by ARFI revealed that ARFI enabled the elastic characterization (p<.01). The 3D-ARFI demonstrated the differentiated elastic layers in the 3D model of entire human abdominal wall, and calculatedthe 3D volume of the tissue-dystrophy from entire abdominal subcutaneous volume (2.59±1.20%). The serum concentration area-under the curve (0-240min) after the 0.1U/kg IAsp injection was 33% lower at the tissue-dystrophylesions compared to the control lesion (p<.05).

Conclusion: We present the first example of virtual touch quantification imaging with the 3D-ARFI of human abdominal subcutaneous tissue, focusing on insulin injected diabetes and demonstrate its application for the biomedical 3D structure.


G. Sato: None. H. Uchino: None. Y. Shimizu: None. K. Ishii: None. A. Ishiko: None. T. Morita: None. N. Kumashiro: Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc. Speaker’s Bureau; Self; Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited. T. Hirose: Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited. Speaker’s Bureau; Self; AstraZeneca, Lilly Diabetes, Novo Nordisk Inc., Sanofi, Sumitomo Dainippon Pharma Co., Ltd.


Japan Society for the Promotion of Science (17K01425)

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