Shear wave elastography: An accurate technique to stage liver fibrosis in chronic liver diseases

Liver cirrhosis is one of the most prevalent chronic liver diseases worldwide. In addition to viral hepatitis, diseases such as steatohepatitis, autoimmune hepatitis, sclerosing cholangitis and Wilson’s disease can also lead to cirrhosis. Moreover, alcohol can cause cirrhosis on its own and exacerbate chronic liver disease of other causes. The treatment of cirrhosis can be divided into addressing the cause of cirrhosis and reversing liver fibrosis. To this date, there is still no clear consensus on the treatment of cirrhosis. Recently, there has been a lot of interest in potential treatments that modulate the gut microbiota and gut-liver axis for the treatment of cirrhosis. According to recent studies, modulation of the gut microbiome by probiotics ameliorates the progression of liver disease. The precise mechanism for relieving cirrhosis via gut microbial modulation has not been identified. This paper summarizes the role and effects of the gut microbiome in cirrhosis based on experimental and clinical studies on absorbable antibiotics, probiotics, prebiotics, and synbiotics. Moreover, it provides evidence of a relationship between the gut microbiome and liver fibrosis.

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Diagnostic Performance of Two-dimensional Shear Wave Elastography in Advanced Liver Fibrosis: A Prospective Pathology-based Study

10.21203/rs.3.rs-122956/v1 ◽

2020 ◽

Author(s):

Yao-Kuang Huang ◽

Ren-Ching Wang ◽

Sheng-Shun Yang ◽

Shou-Wu Lee ◽

Hsin-Ju Tsai ◽

...

Keyword(s):

Chronic Hepatitis ◽

Liver Fibrosis ◽

Shear Wave ◽

Liver Diseases ◽

Diagnostic Performance ◽

Shear Wave Elastography ◽

Two Dimensional ◽

Liver Disorders ◽

Advanced Liver Fibrosis ◽

Invasive Method

Abstract Studies for evaluating the diagnostic performance of two-dimensional Shear-wave Elastography (2D-SWE) in a patient cohort including various liver disorders, remain limited. We aimed to evaluate the validity of 2D-SWE in the diagnosis of advanced liver fibrosis amongst patients with various liver disorders. In this pathology-based study, patients who underwent a liver biopsy for various benign liver diseases were prospectively recruited during the period between February, 2017 and September, 2020. Data of 2D-SWE, Fibrosis-4 Index (FIB-4), and Aspartate Aminotransferase to Platelet Ratio Index (APRI) were simultaneously collected. The cut-off values for predicting advanced fibrosis, i.e. Metavir fibrosis stage ≥ F3, were determined using Receiver Operating Characteristic (ROC) analysis. The diagnostic performance was evaluated and then compared by Area Under the ROC (AUROC). In total, 95 patients were recruited for study analysis. The diagnostic performance of 2D-SWE was significantly superior to that of both FIB-4 (AUROC: 0.88, 95% confidence interval [CI]: 0.80-0.94; vs 0.72, 95%CI: 0.62-0.81; p=0.001) and APRI (AUROC: 0.88, 95%CI: 80-0.94; vs 0.76, 95%CI: 0.66-0.84; p=0.007). With an optimal cutoff value of 9.3 kPa, the sensitivity and specificity were 90.91% and 76.47%, respectively. In subgroup analysis, the AUROC of 2D-SWE was the highest when compared to that of FIB-4 and APRI in patients with chronic hepatitis B, chronic hepatitis C, fatty liver, and concurrent hepatitis. 2D-SWE can therefore be a valid non-invasive method in the detection of advanced liver fibrosis in various liver diseases.

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