Diagnostic accuracy of point shear wave elastography in the detection of portal hypertension in pediatric patients

Abstract Purpose Clinically significant portal hypertension (CSPH) is responsible for most of the complications in patients with cirrhosis. Liver stiffness (LS) measurement by vibration-controlled transient elastography (VCTE) is currently used to evaluate CSPH. Bi-dimensional shear wave elastography from General Electric (2D-SWE.GE) has not yet been validated for the diagnosis of PHT. Our aims were to test whether 2D-SWE.GE-LS is able to evaluate CSPH, to determine the reliability criteria of the method and to compare its accuracy with that of VCTE-LS in this clinical setting. Materials and Methods Patients with chronic liver disease referred to hepatic catheterization (HVPG) were consecutively enrolled. HVPG and LS by both VCTE and 2D-SWE.GE were performed on the same day. The diagnostic performance of each LS method was compared against HVPG and between each other. Results 2D-SWE.GE-LS was possible in 123/127 (96.90 %) patients. The ability to record at least 5 LS measurements by 2D-SWE.GE and IQR < 30 % were the only features associated with reliable results. 2D-SWE.GE-LS was highly correlated with HVPG (r = 0.704; p < 0.0001), especially if HVPG < 10 mmHg and was significantly higher in patients with CSPH (15.52 vs. 8.14 kPa; p < 0.0001). For a cut-off value of 11.3 kPa, the AUROC of 2D-SWE.GE-LS to detect CSPH was 0.91, which was not inferior to VCTE-LS (0.92; p = 0.79). The diagnostic accuracy of LS by 2D-SWE.GE-LS to detect CSPH was similar with the one of VCTE-LS (83.74 % vs. 85.37 %; p = 0.238). The diagnostic accuracy was not enhanced by using different cut-off values which enhanced the sensitivity or the specificity. However, in the subgroup of compensated patients with alcoholic liver disease, 2D-SWE.GE-LS classified CSPH better than VCTE-LS (93.33 % vs. 85.71 %, p = 0.039). Conclusion 2D-SWE.GE-LS has good accuracy, not inferior to VCTE-LS, for the diagnosis of CSPH.

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Liver Stiffness in Pediatric Patients with Fatty Liver Disease: Diagnostic Accuracy and Reproducibility of Shear-Wave Elastography

Radiology ◽

10.1148/radiol.2016161002 ◽

2017 ◽

Vol 283 (3) ◽

pp. 820-827 ◽

Cited By ~ 28

Author(s):

Matteo Garcovich ◽

Silvio Veraldi ◽

Enrico Di Stasio ◽

Maria Assunta Zocco ◽

Lidia Monti ◽

...

Keyword(s):

Liver Disease ◽

Diagnostic Accuracy ◽

Fatty Liver ◽

Shear Wave ◽

Fatty Liver Disease ◽

Pediatric Patients ◽

Liver Stiffness ◽

Shear Wave Elastography

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Portal hypertension in hepatitis B‐related cirrhosis: Diagnostic accuracy of liver and spleen stiffness by 2‐D shear‐wave elastography

Hepatology Research ◽

10.1111/hepr.13306 ◽

2019 ◽

Vol 49 (5) ◽

pp. 540-549 ◽

Cited By ~ 8

Author(s):

Yu‐li Zhu ◽

Hong Ding ◽

Tian‐tian Fu ◽

Shi‐yun Peng ◽

Shi‐yao Chen ◽

...

Keyword(s):

Portal Hypertension ◽

Hepatitis B ◽

Diagnostic Accuracy ◽

Shear Wave ◽

Shear Wave Elastography ◽

Spleen Stiffness

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The novel point shear-wave elastography method ElastPQ® is accurate for non-invasive evaluation of liver fibrosis and portal hypertension

Zeitschrift für Gastroenterologie ◽

10.1055/s-0037-1603404 ◽

2017 ◽

Vol 55 (05) ◽

pp. e28-e56

Author(s):

TA Bucsics ◽

B Grasl ◽

P Schwabl ◽

M Mandorfer ◽

J Dmitrieva ◽

...

Keyword(s):

Portal Hypertension ◽

Liver Fibrosis ◽

Shear Wave ◽

Shear Wave Elastography ◽

The Novel ◽

Non Invasive ◽

Invasive Evaluation

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Shear wave elastography in optic neuritis: diagnostic accuracy of the optic nerve and adjacent fat tissue values

Journal of Ultrasonography ◽

10.15557/jou.2021.0031 ◽

2021 ◽

Vol 21 (86) ◽

pp. e194-e199

Author(s):

Mustafa Devran Aybar ◽

◽

Onder Turna ◽

Keyword(s):

Optic Nerve ◽

Diagnostic Accuracy ◽

Optic Neuritis ◽

Shear Wave ◽

Shear Wave Elastography ◽

Curve Analysis ◽

Fat Tissue ◽

Roc Curve Analysis ◽

Optic Nerves ◽

The Mean

Introduction: In this study, we attempt to determine the diagnostic performance of shear wave elastography of the optic nerve and adjacent fat tissue in patients with optic neuritis. Methods: The study included a patient group consisting of 72 eyes of 36 patients who were diagnosed with unilateral optic neuritis, and an age-matched control group of 36 eyes of 18 healthy subjects. The patient group consisted of 25 multiple sclerosis patients and 11 recurrent isolated optic neuritis patients. The mean shear wave elastography values of the optic nerves and intraorbital fat tissue adjacent optic nerves were recorded using m/s and kPa as units. ROC curve analysis was performed, and the diagnostic accuracy of shear wave elastography values was determined. Results: The mean shear wave elastography values of the optic nerves with neuritis (2.49 ± 0.41 m/s and 17.56 ± 4.42 kPa) were significantly higher than the values of the contralateral normal optic nerves (1.71 ± 0.32 m/s and 9.02 ± 2.34 kPa) (p = 0.006 and p = 0.004, respectively) in the optic neuritis group. The mean shear wave elastography values of intraorbital fat tissue adjacent optic nerves with neuritis (1.87 ± 0.32 m/s and 9.65 ± 1.12 kPa) were significantly higher than the values of the contralateral normal side (1.47 ± 0.27 m/s and 6.78 ± 1.14 kPa) (p = 0.025 and p = 0.022, respectively) in the optic neuritis group. ROC curve analysis showed a high diagnostic accuracy for determining optic neuritis with shear wave elastography values of the optic nerves (AUC 0.955 [95% CI, 0.933–0.978] in m/s and AUC 0.967 [95% CI, 0.940–0.985] in kPa). Conclusions: Shear wave elastography may be an important alternative diagnostic tool in the diagnosis of optic neuritis.

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Comparison between shear wave elastography and serological findings for the evaluation of fibrosis in chronic liver disease

Journal of Ultrasonography ◽

10.15557/jou.2021.0030 ◽

2021 ◽

Vol 21 (86) ◽

pp. e186-e193

Author(s):

Mahjabeen Liaqat ◽

◽

Kashif Siddique ◽

Imran Yousaf ◽

Raham Bacha ◽

...

Keyword(s):

Liver Disease ◽

Liver Fibrosis ◽

Diagnostic Accuracy ◽

Chronic Liver Disease ◽

Shear Wave ◽

Shear Wave Elastography ◽

Chronic Liver ◽

Optimal Cutoff ◽

Cutoff Value ◽

Cutoff Values

Aim: In this study, we sought to examine the optimal cutoff values for predicting different stages of liver fibrosis, and to determine the level of agreement between shear wave elastography and aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4) scores in patients with chronic liver disease. Methodology: A descriptive, cross-sectional study was performed at the Radiology Department of Shaukat Khanum Memorial Hospital Lahore from 1 Jun 2019 until 1 June 2020. FIB-4 and APRI scores were determined by the following formula: FIB-4 = (age × AST) ÷ (platelet count × (√ (ALT)) and APRI = (AST÷AST upper limit of normal) ÷ platelet × 100. Data was analyzed with the help of SPSS version 24.0 and Microsoft Excel 2013. Results: Eighty individuals were conveniently selected, of which 62.5% were men and 37.5% were women. The mean age of the subjects was 43.47 SD ± 13.85 years. APRI and FIB-4 scores predicted F4 patients using the cutoff values of 0.47 (Sn. 72%, Sp. 70%) and 1.27 (Sn. 78%, Sp. 73%), respectively. The cutoff values of 0.46 for APRI and 1.27 for FIB-4 predicted F3–F4 patients (Sn. 74% and 77%; Sp. 76% and 76%), respectively. To predict F1–F4 compared to F0, the cutoff value was 0.34 (Sn. 68%, Sp. 75%) for APRI, while the cutoff value for FIB was 0.87 (Sn. 72%, Sp. 75%). The findings suggest that FIB-4 shows better diagnostic accuracy than APRI. Conclusion: This study provides optimal cutoff values for different groups of fibrosis patients for both serum markers. Also, the diagnostic accuracy of FIB-4 for predicting liver fibrosis was found to be superior to APRI in all disease stages.

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