scholarly journals Reliability Criteria for Liver Stiffness Measurements with Real-Time 2D Shear Wave Elastography in Different Clinical Scenarios of Chronic Liver Disease

2016 ◽  
Vol 38 (06) ◽  
pp. 648-654 ◽  
Author(s):  
Maja Thiele ◽  
Bjørn Madsen ◽  
Bogdan Procopet ◽  
Janne Hansen ◽  
Linda Møller ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Standard Deviation ◽  
Real Time ◽  
Shear Wave ◽  
High Reliability ◽  
Intraclass Correlation ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Diagnostic Study ◽  
Clinical Scenarios

Abstract Purpose Liver stiffness measurement by real-time 2-dimensional shear wave elastography (2D-SWE) lacks universal reliability criteria. We sought to assess whether previously published 2D-SWE reliability criteria for portal hypertension were applicable for the evaluation of liver fibrosis and cirrhosis, and to look for criteria that minimize the risk of misclassification in this setting. Materials and Methods In a biopsy-controlled diagnostic study, we obtained five 2D-SWE measurements of optimal image quality. Correctly classified cases of fibrosis and cirrhosis were compared to misclassified cases. We compared reliability predictors (standard deviation (SD), SD/mean, size of region of interest (ROI) and difference between a single measurement and the patient’s median) with those obtained in a prior study on clinically significant portal hypertension. Results We obtained 678 2D-SWE measurements from 142 patients. Overall, the variability in liver stiffness within single 2D-SWE measurements was low (SD = 1.1 ± 1.5kPa; SD/mean = 12 ± 9 %). Intra-observer analysis showed almost perfect concordance (intraclass correlation coefficient = 0.95; 95 % CI 0.94 – 0.96; average difference from median = 0.4 ± 0.9kPa). For the diagnosis of cirrhosis, a smaller SD (optimally ≤ 1.75 kPa) and larger ROI size (optimally ≥ 18 mm) were associated with higher accuracy. Similarly, within the published cohort of patients assessed for portal hypertension, a low variability of measurements was associated with high reliability. Conclusion A high quality 2D-SWE elastogram ensures low variability and high reliability, regardless of indication. We recommend aiming for a combination of low standard deviation and large ROI.

Liver Elastography in Healthy Children Using Three Different Systems – How Many Measurements Are Necessary?

2020 ◽  
Author(s):  
Anders Batman Mjelle ◽  
Anesa Mulabecirovic ◽  
Roald Flesland Havre ◽  
Edda Jonina Olafsdottir ◽  
Odd Helge Gilja ◽  
...  
Keyword(s):  
Shear Wave ◽  
Transient Elastography ◽  
Intraclass Correlation ◽  
Age Groups ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Healthy Children ◽  
Significant Difference ◽  
Pediatric Liver Disease ◽  
Liver Elastography

Abstract Purpose Liver elastography is increasingly being applied in screening for and follow-up of pediatric liver disease, and has been shown to correlate well with fibrosis staging through liver biopsy. Because time is of the essence when examining children, we wanted to evaluate if a reliable result can be achieved with fewer acquisitions. Materials and Methods 243 healthy children aged 4–17 years were examined after three hours of fasting. Participants were divided into four age groups: 4–7 years; 8–11 years; 12–14 years and 15–17 years. Both two-dimensional shear wave elastography (2D-SWE; GE Logiq E9) and point shear wave elastography (pSWE; Samsung RS80A with Prestige) were performed in all participants, while transient elastography (TE, Fibroscan) was performed in a subset of 87 children aged 8–17 years. Median liver stiffness measurement (LSM) values of 3, 4, 5, 6, 7, and 8 acquisitions were compared with the median value of 10 acquisitions (reference standard). Comparison was performed for all participants together as well as within every specific age group. We investigated both the intraclass correlation coefficient (ICC) with absolute agreement and all outliers more than 10 %, 20 % or ≥ 0.5 or 1.0 kPa from the median of 10 acquisitions. Results For all three systems there was no significant difference between three and ten acquisitions, with ICCs ≥ 0.97. All systems needed 4 acquisitions to achieve no LSM deviating ≥ 1.0 kPa of a median of ten. To achieve no LSM deviating ≥ 20 % of a median of ten acquisitions, pSWE and TE needed 4 acquisitions, while 2D-SWE required 6 acquisitions. Conclusion Our results contradict recommendations of 10 acquisitions for pSWE and TE and only 3 for 2D-SWE.

scholarly journals Which factors influence liver stiffness measured by real-time two dimensional shear wave elastography in patients on maintenance hemodialysis?

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 ◽  
...  
Keyword(s):  
Real Time ◽  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Maintenance Hemodialysis ◽  
Two Dimensional

Liver Stiffness Assessed by Ultrasound Shear Wave Elastography from General Electric Accurately Predicts Clinically Significant Portal Hypertension in Patients with Advanced Chronic Liver Disease

2019 ◽  
Vol 41 (05) ◽  
pp. 526-533
Author(s):  
Horia Stefanescu ◽  
Corina Rusu ◽  
Monica Lupsor-Platon ◽  
Oana Nicoara Farcau ◽  
Petra Fischer ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Diagnostic Accuracy ◽  
Chronic Liver Disease ◽  
Shear Wave ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Chronic Liver ◽  
General Electric ◽  
Clinically Significant

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.

scholarly journals Liver Stiffness Assessed by Real-Time Two-dimensional Shear Wave Elastography Predicts Hypersplenism in Patients with Wilson’s Disease: A Prospective Study

2021 ◽  
Author(s):  
Jiajia Wang ◽  
Minxia Hu ◽  
Qiang Zhu ◽  
Lanting Sun
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Real Time ◽  
Shear Wave ◽  
Wilson’S Disease ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Wilson's Disease ◽  
Dynamic Monitoring ◽  
Two Dimensional

Abstract Background To explore the value of liver stiffness assessed by two-dimensional real-time shear wave elastography (2D-SWE）in predicting the occurrence of hypersplenism in patients diagnosed with Wilson’s disease (WD). Methods A total of 90 WD patients were enrolled in this prospective study between May 2018 and December 2018. Clinical data and ultrasound imaging including 2D-SWE liver stiffness of WD patients as baseline data were collected. Patients were followed up for 24 months, or patients developed hypersplenism after enrollment. Risk factors for hypersplenism were determined using cox regression and receiver operating characteristic curve. Results Twenty-night (32.2%) patients were found developed hypersplenism. The age, the diameter of portal vein, and the liver stiffness were independent risk factors associated with hypersplenism in WD. The cutoff value of liver stiffness for predicting hypersplenism was 10.45 kPa, with sensitivity and specificity of 75.9% and 73.8%, respectively. When patients were divided into two groups according to liver stiffness ≥10.45 kPa or <10.45 kPa, the incidence of hypersplenism were 57.9% vs. 13.5% (P<0.001), and the median time between the enrollment and the development of hypersplenism was 15 months vs. 22 months (P<0.001) for the two groups, respectively. Conclusion The liver stiffness measured by 2D-SWE was a reliable predictor of hypersplenism in WD patients. Dynamic monitoring WD patients using 2D-SWE is crucial for the early diagnosis of hypersplenism.

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