Methotrexate therapy is not associated with increased liver stiffness and significant liver fibrosis in rheumatoid arthritis patients: A cross-sectional controlled study with real-time two-dimensional shear wave elastography

2019 ◽  
Vol 69 ◽  
pp. 57-63 ◽  
Author(s):  
Gian Luca Erre ◽  
Maria Luisa Cadoni ◽  
Pierluigi Meloni ◽  
Floriana Castagna ◽  
Arduino Aleksander Mangoni ◽  
...  
Author(s):  
Ya Li ◽  
Size Wu

BACKGROUND: Two-dimensional shear-wave elastography (2D-SWE) has been used for years for liver assessment of patients with chronic hepatitis B (CHB), but its effectiveness remains unclear in different populations and using different ultrasound systems. OBJECTIVE: This study investigated the effectiveness of 2D-SWE in evaluating liver fibrosis in patients with CHB. METHODS: A prospective investigation was conducted after approval by the institutional ethics committee, with 116 out of 133 patients with CHB referred for liver biopsy included and 50 patients with healthy livers selected as controls. Assessment with 2D-SWE of liver stiffness measurement (LSM) was compared with histopathological results. Cutoff values for LSM were set to determine the degree of fibrosis, and area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity were calculated. RESULTS: The optimal LSM cutoff for differentiating healthy livers from livers with CHB and any liver fibrosis was 6.485 kPa, with an AUROC of 0.927, sensitivity of 94%, and specificity of 19.8%. The optimal LSM cutoff values for F1, F2, F3, and F4 were 6.19 kPa, 6.485 kPa, 7.46 kPa, and 9.62 kPa, respectively, with corresponding AUROCs of 0.516, 0.625, 0.779, and 0.881, respectively. Comparisons of AUROCs between F1 and F3, F1 and F4, F2 and F3, and F2 and F4 were all significantly different (P = 0.0001, P <  0.0001, P = 0.0139, and P = 0.0003, respectively); comparisons of AUROCs between F1 and F2 and between F3 and F4 were not significantly different (P = 0.1232 and P = 0.2462, respectively). Comparisons of LSMs between healthy livers and F0 and between healthy livers and a combination of F0 and F1 were significantly different (P = 0.002 and P = 0.001, respectively). Comparisons of LSMs between F1 and F2 and between F3 and F4 were not significantly different (P = 0.233 and P = 0.072, respectively). Other comparisons between fibrosis score groups were significantly different (F1 and F3, P = 0.003; F1 and F4, P = 0.007; F2 and F3, P = 0.013; F2 and F4, P = 0.015). CONCLUSION: 2D-SWE using a specific diagnostic ultrasound system is effective for the assessment of severe liver fibrosis and cirrhosis, but is limited in diagnosing mild liver fibrosis.


2016 ◽  
Vol 25 (4) ◽  
pp. 525-532 ◽  
Author(s):  
Monica Lupșor-Platon ◽  
Radu Badea ◽  
Mirela Gersak ◽  
Anca Maniu ◽  
Ioana Rusu ◽  
...  

There has been great interest in the development of non-invasive techniques for the diagnosis of liver fibrosis in chronic liver diseases, including ultrasound elastographic methods. Some of these methods have already been adequately studied for the non-invasive assessment of diffuse liver diseases. Others, however, such as two-dimensional Shear Wave Elastography (SWE), of more recent appearance, have yet to be validated and some aspects are for the moment incompletely elucidated. This review discusses some of the aspects related to two-dimensional SWE: the examination technique, the examination performance indicators, intra and interobserver agreement and clinical applications. Recommendations for a high-quality examination technique are formulated. Key words:  –  –  – Two-dimensional Shear Wave Elastography. Abbreviations: 2D- SWE: Two-dimensional Shear Wave Elastography; 3D- SWE: Three-dimensional Shear Wave Elastography; AUROC: area under the receiver operating characteristic curves; ARFI Acoustic Radiation Force Impulse Elastography; EFSUMB: European Federation of Societies for Ultrasound in Medicine and Biology; HVPG: hepatic venous pressure gradient; LS: liver stiffness; LR: likelihood ratio; NPV: negative predictive value; PPV: positive predictive value; ROI: region of interest; RT-E: Real Time-Elastography; Se: sensitivity; Sp: specificity; TE: Transient Elastography; US: ultrasound; VM: valid measurement; E: Young’s modulus


2018 ◽  
Vol 49 (1) ◽  
pp. 91-98 ◽  
Author(s):  
Paraskevi Galina ◽  
Efthymia Alexopoulou ◽  
Aglaia Zellos ◽  
Virginia Grigoraki ◽  
Tania Siahanidou ◽  
...  

Radiology ◽  
2015 ◽  
Vol 275 (1) ◽  
pp. 290-300 ◽  
Author(s):  
Jian Zheng ◽  
Huanyi Guo ◽  
Jie Zeng ◽  
Zeping Huang ◽  
Bowen Zheng ◽  
...  

2021 ◽  
Vol 62 (1) ◽  
pp. 34-43
Author(s):  
Danijela Zjačić Puljiz ◽  
Ivana Kristina Delić Jukić ◽  
Marko Puljiz ◽  
Lučana Vicelić Čutura ◽  
Iva Jerčić Martinić-Cezar ◽  
...  

2020 ◽  
Author(s):  
Yao-Kuang Huang ◽  
Ren-Ching Wang ◽  
Sheng-Shun Yang ◽  
Shou-Wu Lee ◽  
Hsin-Ju Tsai ◽  
...  

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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