Ruling-in and ruling-out significant fibrosis and cirrhosis using a shear wave measurement method

Aims: To prospectively assess the cutoff values of a point shear wave measurement (SWM) method for ruling-in and ruling-out significant fibrosis and cirrhosis using transient elastography (TE) as the reference standard.Method: Consecutive patients with chronic hepatitis C were enrolled. Liver stiffness was assessed with the SWM method implemented on the HI VISION Ascendus ultrasound system (Hitachi Ltd, Japan) and with the TE method of the FibroScan® device (Echosens, France). For staging significant fibrosis (F≥2) and cirrhosis (F=4) we used the TE cutoffs of 7.0 and 12.0 kiloPascal (kPa), respectively. The diagnostic performance of SWM was assessed by calculating the area under the receiver operating characteristic (AUROC) curve. Cutoffs with specificity or sensitivity > 90% were chosen to rule-in or rule-out F≥2 and F=4.Results: 445 individuals [235 males, 210 females; mean age, 61.1 (13.3) years] were studied: 190 (42.7%) individuals had F0-F1 fibrosis stage, 82 (18.4%) F2, 46 (10.3%) F3, and 127 (28.6%) F4 fibrosis stage. For ruling-in F≥2 the SWM cutoff was 6.78 kPa [sensitivity, 76.9%(70.6-82.4); specificity, 90.3% (85.0-94.3)] and for ruling-out it was 5.55 kPa [sensitivity, 90.6% (85.8-94.1); specificity, 72.2% (64.9-78.6)]. For ruling-in F=4 the SWM cutoff was 9.15 kPa [sensitivity, 83.3% (74.4-90.2); specificity, 90.1% (86.0-93.2)] and for ruling-out it was 8.41 kPa [sensitivity, 90.6% (82.9-95.6); specificity, 82.2% (77.3-86.4)]. AUROCs were 0.92 (0.89-0.94) for F≥2 and 0.94 (0.91-0.96) for F=4.Conclusions. In clinical practice, the use of a dual cutoff of SWM may increase the confidence in staging liver fibrosis with a non-invasive shear wave elastography technique.Abbreviations: ARFI: acoustic radiation force impulse; AUROC: area under the ROC curve; CCC: concordance correlation coefficient; IQR/M: interquartile range/median; LSM: liver stiffness measurement; ROC: receiver operating characteristic; pSWE: point shear wave elastography; SWM: shear wave measurement; TE: transient elastography; US: ultrasound.

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Feasibility and usefulness of endoscopic ultrasonography-guided shear-wave measurement for assessment of autoimmune pancreatitis activity: a prospective exploratory study

Choonpa Igaku ◽

10.3179/jjmu.jjmu.k.22 ◽

2020 ◽

Author(s):

Eizaburo OHNO ◽

Yoshiki HIROOKA ◽

Hiroki KAWASHIMA ◽

Takuya ISHIKAWA ◽

Hiroyuki TANAKA ◽

...

Keyword(s):

Shear Wave ◽

Endoscopic Ultrasonography ◽

Autoimmune Pancreatitis ◽

Exploratory Study ◽

Wave Measurement

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Tu1397 USEFULLNESS OF EUS-GUIDED SHEAR-WAVE MEASUREMENT (EUS-SWM) FOR THE ASSESSMENT OF ACTIVITIES OF AUTOIMMUNE PANCREATITIS; A PROSPECTIVE EXPLORATORY STUDY

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2019.03.1054 ◽

2019 ◽

Vol 89 (6) ◽

pp. AB608

Author(s):

Eizaburo Ohno ◽

Yoshiki Hirooka ◽

Hiroki Kawashima ◽

Takuya Ishikawa ◽

Hiroyuki Tanaka ◽

...

Keyword(s):

Shear Wave ◽

Autoimmune Pancreatitis ◽

Exploratory Study ◽

Wave Measurement

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Feasibility of EUS-guided shear-wave measurement: A preliminary clinical study

Endoscopic Ultrasound ◽

10.4103/eus.eus_6_19 ◽

2019 ◽

Vol 8 (3) ◽

pp. 215 ◽

Cited By ~ 1

Author(s):

Yoshiki Hirooka ◽

Eizaburo Ohno ◽

Hiroki Kawashima ◽

Takuya Ishikawa

Keyword(s):

Clinical Study ◽

Shear Wave ◽

Wave Measurement

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1052 PERFORMANCE OF REAL-TIME STRAIN ELASTOGRAPHY, SHEAR WAVE ELASTOGRAPHY, AND TRANSIENT ELASTOGRAPHY IN ASSESSING SIGNIFICANT FIBROSIS IN CHRONIC VIRAL HEPATITIS

Journal of Hepatology ◽

10.1016/s0168-8278(12)61064-2 ◽

2012 ◽

Vol 56 ◽

pp. S412

Author(s):

G. Ferraioli ◽

C. Tinelli ◽

B. Dal Bello ◽

R. Lissandrin ◽

M. Zicchetti ◽

...

Keyword(s):

Viral Hepatitis ◽

Real Time ◽

Shear Wave ◽

Transient Elastography ◽

Shear Wave Elastography ◽

Chronic Viral Hepatitis ◽

Significant Fibrosis ◽

Strain Elastography

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Comparison of Two-Dimensional Shear Wave Elastography and Point Shear Wave Elastography for Assessing Liver Fibrosis

10.21203/rs.2.17352/v1 ◽

2019 ◽

Author(s):

Xiaozhuan Zhou ◽

Jiawei Rao ◽

Xukun Wu ◽

Ronghai Deng ◽

Yi Ma

Keyword(s):

Liver Fibrosis ◽

Shear Wave ◽

Large Scale ◽

Characteristic Curve ◽

Shear Wave Elastography ◽

Cochrane Library ◽

Two Dimensional ◽

Advanced Fibrosis ◽

Likelihood Ratios ◽

Significant Fibrosis

Abstract Background: Progressive liver fibrosis may result in cirrhosis, portal hypertension, and hepatocellular carcinoma (HCC). We performed a meta-analysis to compare liver fibrosis staging in chronic liver disease patients using two-dimensional shear wave elastography (2D-SWE) and point shear wave elastography (pSWE). Methods: PubMed, Web of Science, and Cochrane Library databases were searched until September 30th 2019 for studies evaluating the diagnostic performance of 2D-SWE and pSWE for assessing liver fibrosis. Pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratios, and area under receiver operating characteristic curve (AUC) were estimated using the bivariate random effects model. Results: Eighteen studies with 3,082 patients were included in the analysis. The pooled sensitivities of 2D-SWE and pSWE were significantly different for the detection of significant fibrosis (0.83 vs. 0.70, P < 0.001) and advanced fibrosis (0.89 vs. 0.78, P < 0.05), but not for detection of cirrhosis (0.87 vs. 0.83, P > 0.05). The pooled specificities of 2D-SWE and pSWE were not significantly different for detection of significant fibrosis (0.83 vs. 0.83, P > 0.05), advanced fibrosis (0.80 vs. 0.85, P > 0.05), or cirrhosis (0.84 vs. 0.88, P > 0.05). Conclusions: Both 2D-SWE and pSWE have high sensitivity and specificity for detecting each stage of liver fibrosis. 2D-SWE has higher sensitivity than pSWE for detection of significant fibrosis and advanced fibrosis. Large-scale and multi-center studies are needed to directly compare 2D-SWE and pSWE.

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Geogrid Stabilization of Unbound Aggregates Evaluated Through Bender Element Shear Wave Measurement in Repeated Load Triaxial Testing

Transportation Research Record Journal of the Transportation Research Board ◽

10.1177/0361198120908230 ◽

2020 ◽

Vol 2674 (3) ◽

pp. 113-125

Author(s):

Mingu Kang ◽

Joon Han Kim ◽

Issam I. A. Qamhia ◽

Erol Tutumluer ◽

Mark H. Wayne

Keyword(s):

Shear Wave ◽

Wave Velocity ◽

Shear Wave Velocity ◽

Resilient Modulus ◽

Triaxial Tests ◽

Triaxial Testing ◽

Bender Element ◽

Wave Measurement ◽

Repeated Load ◽

Repeated Load Triaxial

This paper describes the use of the bender element (BE) shear wave measurement technology for quantifying the effectiveness of geogrid stabilization of unbound aggregate materials with improved mechanical properties from repeated load triaxial testing. Crushed stone aggregate specimens were prepared with three different gradations, that is, upper bound (UB), mid-range engineered (ENG), and lower bound, according to the dense graded base course gradation specification in Illinois. The specimens were compacted at modified Proctor maximum dry densities and optimum moisture contents. Two geogrids with different triaxial aperture sizes were placed at specimen mid-height, and unstabilized specimens with no geogrid were also prepared for comparison. To measure shear wave velocity, three BE pairs were placed at different heights above geogrid. Repeated load triaxial tests were conducted following the AASHTO T307 standard resilient modulus test procedure, while shear wave velocity was measured from the installed BE pairs. After initial specimen conditioning, and at low, intermediate, and high applied stress states, both the resilient moduli and accumulated permanent strains were determined to relate to the geogrid local stiffening effects in the specimens quantified by the measured shear wave velocities. The resilient modulus and shear wave velocity trends exhibited a directly proportional relationship, whereas permanent strain and shear wave velocity values were inversely related. The enhancement ratios calculated for the geogrid stabilized over the unstabilized specimens showed significant improvements in mechanical behavior for the UB and ENG gradations, and a maximum enhancement was achieved for the engineered gradation specimens stabilized with the smaller aperture geogrid.

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Correlation of the Stiffness of Hepatocellular Carcinoma and Surrounding Liver Parenchyma by Point Shear Wave Elastography

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479318801587 ◽

2018 ◽

Vol 35 (1) ◽

pp. 10-15

Author(s):

Bundit Chaopathomkul ◽

Ornalin Boonsirisak ◽

Krit Pongpirul

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Fibrosis ◽

Shear Wave ◽

Statistical Significance ◽

Shear Wave Elastography ◽

Liver Parenchyma ◽

Significant Fibrosis ◽

Significant Difference ◽

Comparison Groups ◽

Cirrhotic Group

The purpose of this study was to assess the correlation between hepatocellular carcinoma (HCC) and surrounding liver parenchyma stiffness using point shear wave elastography (pSWE). HCC was diagnosed using the criteria of the American Association for the Study of Liver Diseases. Liver fibrosis was classified into three groups (nonsignificant fibrosis, significant fibrosis, and cirrhosis). pSWE was performed on the HCC and the adjacent hepatic parenchyma and was expressed as kilopascal (kPa). A total of 59 HCC patients with 64 tumors were included in the study. The mean stiffnesses of HCC and liver background were 9.25 ± 3.76 and 10.84 ± 4.81 kPa, respectively. There was no statistical significance in HCC stiffness in any stage of liver fibrosis. Low HCC/liver background stiffness ratio was noted in the cirrhotic group and statistically significant in two comparison groups (cirrhosis vs significant fibrosis and cirrhosis vs nonsignificant fibrosis), with P < .001. In this cohort, HCC stiffness alone demonstrated no statistically significant difference in various stages of liver fibrosis.

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