Clinical relevance of Shear Wave Elastography compared with Transient Elastography and other markers of liver fibrosis ‒ a cross‐sectional study

Background: Non-alcoholic fatty liver disease (NAFLD) is the second most common cause of liver transplantation in the United States, with a continuously growing prevalence. There are several non-invasive methods to detect liver fibrosis, which is defined as the accumulation of extracellular matrix proteins, particularly collagens. It is most commonly associated with chronic liver diseases, such as NAFLD. Objectives: This study aimed to investigate the concordance between transient elastography (TE) and shear wave elastography (SWE) for liver fibrosis staging and also to examine the congruence between the controlled attenuation parameter (CAP) and the B-mode hepatorenal ratio for hepatic steatosis grading in patients with NAFLD. Materials and Methods: In this cross-sectional study conducted during March 2018 - 2019, NAFLD patients, referred to the liver clinic of our center for the non-invasive assessment of hepatic fibrosis, were enrolled. However, patients with sonographic features of cirrhosis, multiple hepatic masses, or moderate to large ascites were excluded; also, patients who were uncooperative during the tests were excluded. Measurements obtained by different tools were recorded. Kolmogorov-Smirnov test, Chi-square test, independent t-test, or Mann-Whitney tests, as well as Pearson’s correlation coefficient test, were used to analyze the data. Results: Sixty-five patients (male-to-female ratio, 1:13), with a median age of 47 years, were included in the study. The tools for assessing fibrosis (r = 0.9538, 95% CI: 0.9252 - 0.9717, P < 0.0001) and steatosis (r = 0.429, 95% CI: 0.2048 - 0.6104, P < 0.0001) were perfectly and moderately correlated, respectively. Sex, age, and body mass index (BMI) did not affect the results. Conclusion: The two elastography modalities showed a strong correlation for fibrosis staging in our study population. Also, the CAP and B-mode hepatorenal ratio were moderately correlated for grading hepatosteatosis. Overall, selection of the best assessment method among the studied modalities depends on factors other than internal validity.

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Liver ultrasound elastography for the evaluation of periportal fibrosis in schistosomiasis mansoni: A cross-sectional study

10.1101/450494 ◽

2018 ◽

Author(s):

Joelma Carvalho Santos ◽

Andrea Dória Batista ◽

Carla Maria Mola Vasconcelos ◽

Roberto Souza Lemos ◽

Valter Romão de Souza ◽

...

Keyword(s):

Shear Wave ◽

Shear Wave Elastography ◽

Cross Sectional Study ◽

Cutoff Point ◽

Sectional Study ◽

Cross Sectional ◽

Predictive Values ◽

Cutoff Value ◽

Periportal Fibrosis ◽

Schistosomiasis Mansoni

AbstractBackgroundARFI elastrography has been used as a noninvasive method to assess the severity of liver fibrosis in viral hepatitis, although with few studies in schistosomiasis mansoni. We aimed to evaluate the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point.Methodology/Principal findingsThis cross-sectional study included 358 adult schistosomotic patients subjected to US and pSWE on the right lobe. Two hundred two patients (62.0%) were women, with a median age of 54 (ranging 18-92) years. The pSWE measurements were compared to the US patterns of PPF, as gold standard, according to the Niamey classification. The performance of pSWE was calculated as the area under the ROC curve (AUC). Patients were further classified into two groups: 86 patients with mild PPF and 272 patients with significant PPF. The median pSWE of the significant fibrosis group was higher (1.40 m/s) than that of mild fibrosis group (1.14 m/s, p<0.001). AUC was 0.719 with ≤1.11 m/s as the best cutoff value for excluding significant PPF. Sensitivity and negative predictive values were 80.5% and 40.5%, respectively. Whereas, for confirming significant PPF, the best cutoff value was >1.39 m/s, with specificity of 86.1% and positive predictive value of 92.0%.Conclusions/SignificancepSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.Author summaryIn the developing world, over 207 million people are infected with parasitic Schistosoma worms. Among the species of Schistosoma that infect humans Schistosoma mansoni is one of the most common causes of illness. Here, we investigated the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. We examined 358 people from northeast of Brazil for Schistosoma infections. The present study showed that pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.

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Renal shear wave elastography for the assessment of nephron hypertrophy: a cross-sectional study in chronic kidney disease

Journal of Medical Ultrasonics ◽

10.1007/s10396-018-0866-1 ◽

2018 ◽

Vol 45 (4) ◽

pp. 571-576 ◽

Cited By ~ 4

Author(s):

Takuji Iyama ◽

Tomoaki Takata ◽

Masahiko Koda ◽

Satoko Fukuda ◽

Shotaro Hoi ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Shear Wave ◽

Shear Wave Elastography ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Use of transient elastography in detection of liver fibrosis in psoriasis patients – A cross- sectional study

Indian Dermatology Online Journal ◽

10.4103/idoj.idoj_312_19 ◽

2020 ◽

Vol 11 (3) ◽

pp. 387

Author(s):

D Banerjee ◽

Shekhar Neema ◽

S Radhakrishnan ◽

Biju Vasudevan ◽

Preema Sinha ◽

...

Keyword(s):

Liver Fibrosis ◽

Transient Elastography ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Using FIB-4 score as a screening tool in the assessment of significant liver fibrosis (F2) in patients with transfusion dependent beta thalassaemia: a cross sectional study

10.1101/2022.01.15.22269369 ◽

2022 ◽

Author(s):

Padmapani Padeniya ◽

Dileepa S Ediriweera ◽

Arjuna De Silva ◽

Madunil Niriella ◽

Anuja Premawardhena

Keyword(s):

Liver Fibrosis ◽

Screening Tool ◽

Transient Elastography ◽

Elevated Serum ◽

Cross Sectional Study ◽

Resource Poor Setting ◽

Beta Thalassemia ◽

Sectional Study ◽

Cross Sectional ◽

Significant Liver Fibrosis

Abstract Objective To evaluated the performance of FIB-4 score as a screening tool to detect significant liver fibrosis (F2) compared to transient elastography (TE) among chronic transfusion-dependent beta-thalassemia (TDT) patients, in a resource-poor setting. Design A cross-sectional study Setting Adolescent and Adult Thalassaemia Care Center (University Medical Unit) Kiribathgoda Sri Lanka. Participants 45 TDT patients who have undergone more than 100 blood transfusions with elevated serum ferritin more than 2000ng/mL were selected for the study. Patients who were serologically positive for hepatitis C antibody were excluded. Outcome measures TE and FIB-4 score were estimated at the time of recruitment in all participants. Pre-defined cut-off values for F2 extracted from previous studies for TE and FIB-4 score were compared. A new cut-off value for FIB-4 score was estimated using ROC curve analysis to improve the sensitivity for F2 prediction. Results Of the selected 45 TDT patients 22(49%) were males. FIB-4 score showed a significant linear correlation with TE (r= 0.52 p< 0.0003). The FIB-4 score was improbable to lead to a false classification of TDT patients to have F2 when the FIB-4 cut-off value was 1.3. On the other hand it had a very low diagnostic yield in missing almost all (except one) of those who had F2. Using a much-lowered cut-off point of 0.32 for FIB-4 we improved the pick-up rate of F2 to 72%. Conclusions Regardless of the cut-off point FIB-4 score cannot be used as a good screening tool to pick-up F2 in patients with TDT irrespective of their splenectomy status. On the contrary at 1.3 cut off value though FIB-4 is a very poor detector for F2 fibrosis it will not erroneously diagnose F2 fibrosis in those who do not have it.

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