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

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.

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

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.

scholarly journals The usefulness of noninvasive liver stiffness assessment using shear-wave elastography for predicting liver fibrosis in children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Seunghyun Lee ◽  
Young Hun Choi ◽  
Yeon Jin Cho ◽  
Seul Bi Lee ◽  
Jung-Eun Cheon ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Shear Wave ◽  
Liver Diseases ◽  
Diagnostic Performance ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Fibrosis Stage ◽  
Cutoff Value ◽  
Significant Fibrosis ◽  
Necroinflammatory Activity

Abstract Background Pediatric patients with liver disease require noninvasive monitoring to evaluate the risk of fibrosis progression. This study aimed to identify the significant factors affecting liver stiffness values using two-dimensional shear-wave elastography (2D-SWE), and determine whether liver stiffness can predict the fibrosis stage of various childhood liver diseases. Methods This study included 30 children (22 boys and 8 girls; mean age, 5.1 ± 6.1 years; range, 7 days–17.9 years) who had undergone biochemical evaluation, 2D-SWE examination, histopathologic analysis of fibrosis grade (F0 to F3), assessment of necroinflammatory activity, and steatosis grading between August 2016 and March 2020. The liver stiffness from 2D-SWE was compared between fibrosis stages using Kruskal–Wallis analysis. Factors that significantly affected liver stiffness were evaluated using univariate and multivariate linear regression analyses. The diagnostic performance was determined from the area under the receiver operating curve (AUC) values of 2D-SWE liver stiffness. Results Liver stiffness at the F0-1, F2, and F3 stages were 7.9, 13.2, and 21.7 kPa, respectively (P < 0.001). Both fibrosis stage and necroinflammatory grade were significantly associated with liver stiffness (P < 0.001 and P = 0.021, respectively). However, in patients with alanine aminotransferase (ALT) levels below 200 IU/L, the only factor affecting liver stiffness was fibrosis stage (P = 0.030). The liver stiffness value could distinguish significant fibrosis (≥ F2) with an AUC of 0.950 (cutoff value, 11.3 kPa) and severe fibrosis (F3 stage) with an AUC of 0.924 (cutoff value, 18.1 kPa). The 2D-SWE values for differentiating significant fibrosis were 10.5 kPa (≥ F2) and 18.1 kPa (F3) in patients with ALT levels below 200 IU/L. Conclusion The liver stiffness values on 2D-SWE can be affected by both fibrosis and necroinflammatory grade and can provide excellent diagnostic performance in evaluating the fibrosis stage in various pediatric liver diseases. However, clinicians should be mindful of potential confounders, such as necroinflammatory activity or transaminase level, when performing 2D-SWE measurements for liver fibrosis staging.

scholarly journals The Diagnostic Accuracy of LOGIQ S8 and E9 Shear Wave Elastography for Staging Hepatic Fibrosis, in Comparison with Transient Elastography

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1817
Author(s):  
Jeong-Ju Yoo ◽  
Sang Gyune Kim ◽  
Young Seok Kim
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Chronic Liver Disease ◽  
Shear Wave ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Chronic Liver ◽  
Significant Fibrosis

Background: The aim of this study was to evaluate the usefulness of two different types of 2-dimensional shear wave elastography (2D-SWE) for predicting liver fibrosis stages in comparison to transient elastography (TE), using a histologic METAVIR scoring system as the reference method. Methods: A total of 203 patients with chronic liver disease were prospectively enrolled in the study. Two different 2D-SWEs (LOGIQ S8 and E9 systems, GE Healthcare, Chalfont St Giles, UK) were assessed for liver stiffness in patients with chronic liver diseases. Patients received 2D-SWE examinations with the S8 and E9 systems, and also underwent TE (FibroScan®, Echosens, France) tests and liver biopsies on the same day. Results: The most common etiology of chronic liver disease was non-alcoholic fatty liver disease (28.7%), followed by chronic hepatitis B (25.1%). Liver fibrosis stages consisted of F0 (22.6%), F1 (29.7%), F2 (16.9%), F3 (12.8%) and F4 (17.9%). Overall, S8 and E9 were well correlated with the histologic fibrosis stages. The optimal cut-off values for S8 and E9 to differentiate significant fibrosis (≥F2) were 6.70 kPa and 6.42 kPa, respectively, while the cut-off values for S8 and E9 in distinguishing liver cirrhosis were 9.15 kPa and 8.88 kPa, respectively. Among the 195 patients who had successful measurements in both S8 and E9, liver stiffness showed good inter-equipment correlation (ICC: 0.900, p < 0.001). Regarding diagnostic ability, upon comparison (FibroScan®), there were no significant differences between 2D-SWEs and TE for detecting every stage of liver fibrosis. Conclusion: In comparison to TE, 2D-SWE with LOGIQ S8 and E9 (GE Healthcare) are useful non-invasive tools for predicting significant fibrosis and liver cirrhosis.

Evaluation of 2D- Shear Wave Elastography for Characterisation of Focal Liver Lesions

2017 ◽  
Vol 26 (3) ◽  
pp. 283-290 ◽  
Author(s):  
Ludmila Gerber ◽  
Daniel Fitting ◽  
Kajana Srikantharajah ◽  
Nina Weiler ◽  
Georgia Kyriakidou ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Shear Wave ◽  
Focal Nodular Hyperplasia ◽  
Shear Wave Elastography ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Contrast Enhanced ◽  
Significant Difference ◽  
Nodular Hyperplasia ◽  
Glutamyl Transferase

Background & Aim: This is a prospective study for evaluation of 2D-shear wave elastography (2D-SWE) for characterisation and differentiation of benign und malignant focal liver lesions (FLLs).Methods: The patients referred to our ultrasound unit were prospectively included. B-mode ultrasound and 2D-SWE (Aixplorer® France) were performed for one FLL in each patient. Liver histology and/or contrast-enhanced imaging were used as a reference method.Results: 140 patients with FLL were included. SWE acquisitions failed in 24% of them. Therefore, 106 patients with FLL could be analysed, 42/106 with benign and 64/106 with malignant FLLs. The median stiffness for benign FLLs was 16.4 (2.1-71.9) kPa: 16.55 kPa for 18 focal nodular hyperplasia (FNH), 16.35 kPa for 18 hemangioma, 9.8 kPa for 3 focal fatty sparings (FFS), 8.9 kPa for 1 adenoma, 20 kPa for one regenerative node and 29 kPa for one cholangiofibroma, and for the malignant FLLs 36 (4.1-142.9) kPa: 44.8 kPa for 16 hepatocellular carcinoma (HCC), 70.7 kPa for 7 cholangiocarcinoma (CCC) and 29.5 kPa for the 41 metastasis (p<0.001). Malignant FLLs were significantly stiffer than benign FLLs (p<0.0001). Cholangiocarcinomas were the stiffest malignant FFLs with significantly higher values as compared to HCCs and metastases (p=0.033 and p=0.0079, respectively). No significant difference in stiffness could be observed between the different benign FLL entities. No significant difference was observed whether 2D-SWE included the whole FLL, the periphery or only the hardest area of the FLL.Conclusions: 2D-SWE provides further characterising information for interpretation of FLLs and may be useful at least in differentiation of CCCs and HCCs.Abbreviations: ALT: alanine aminotransaminase; AST: aspartate aminotransaminase; AUROC: area under the ROC; ARFI: acoustic radiation force impulse; CCC: cholangiocarcinoma; CECT: contrast-enhanced CT; CEMRI: contrast-enhanced MRI; CEUS: contrast-enhanced ultrasound; FFS: focal fatty sparing; FLL: focal liver lesion; FNH: focal nodular hyperplasia; GGT: gamma-glutamyl-transferase; HCC: hepatocellular carcinoma; NASH: nonalcoholic steatohepatitis; pSWE: point shear wave elastography; ROC: receiver-operating-characteristic; ROI: region of interest; 2D-SWE: 2D-shear wave elastography; TE: transient elastography.

Shear Wave Elastography in Assessment of Liver Fibrosis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Alaa Kanaan Abdulateef ◽  
Sherif Abou Gamrah ◽  
Ayman Hassan Hassan ◽  
Samar Ramzy Ragheb
Keyword(s):  
Hepatitis C ◽  
Liver Fibrosis ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Radiology Department ◽  
P Value ◽  
Significant Fibrosis ◽  
Medicine Research ◽  
Medical Issues ◽  
Significant Liver Fibrosis

Abstract Background Liver fibrosis is major medical issues in patients with chronic hepatitis C (CHC). It may lead to cirrhosis, hepatocellular carcinoma (HCC) and liver-related death. Therefore, assessing the degree of fibrosis in patients with chronic liver diseases, especially before the advanced stage, is clinically important to allow early care and prevent fatal liver disease. Objective The plan was to do shear-wave Elastography after fibroscan (TE) in order to assess the stiffness of the liver, detect the changes occurred in hepatitis C patients and measure diagnostic accuracy of 2D- SWE by using TE as reference standard. Methods A cross-section study included 30 persons with positive hepatitis C. They were referred to Radiology department at National Hepatology and tropical medicine research institute. Results Our study included (30) patients who have hepatitis C positive, their ages ranged from (18) years old to (60) years old with mean SD of 52.97 ± 9.43. They were 17 females (56.7%) and 13 males (43.3%). Different liver fibrosis stages were observed by 2D-SWE as following: (FO) 4 patients (13.3%), (Fl) 4 patients (13.3%), (F2) 9 patients (30.0%), (F3) 10 patients (33.3%), (F4) 3 patients (10.0%). While TE (fibroscan) shows (FO) 6 (20.0%), (Fl) 3 patients (10.0%), (F2) 7 patients (23.3%), (F3) 8 patients (26.7%) (F4) 6 patients (20.0%). Our study showed that the relation between TE (fibroscan) and SWE finding had positive correlation of most patients with liver fibrosis with (p-value 0.006 and r-value 0.487). Because the impoltant of significant fibrosis for initiate antiviral protocol therapy, 30 patients classified into FO—FI (non-significant liver fibrosis) versus F2—F4 (significant liver fibrosis). Our study show significant discrimination was found between no/mild fibrosis (FO-FI) and significant fibrosis (F2-F4), shows the sensitivity of SWE in detection of significant fibrosis results is 95.2% and the specificity is 77.8%, PPV 90.91 %, NPV 87.5% and the accuracy 90.0% with cutoff value &gt;5.7kPa. Conclusion SD-SWE is accurate in prediction significant fibrosis (2F2), Thus is expected to overcome the limitation of TE as a reliable method to assess fibrosis induce by hepatitis.

Pre-operative Detection of Liver Fibrosis in Hepatocellular Carcinoma Patients Using 2D Shear Wave Elastography: Where to Measure?

2020 ◽  
Vol 46 (6) ◽  
pp. 1412-1423 ◽  
Author(s):  
Li-Ting Xie ◽  
Jiong-Hui Gu ◽  
Wei-Lu Chai ◽  
Ren-Dong Chen ◽  
Qi-Yu Zhao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Fibrosis ◽  
Shear Wave ◽  
Shear Wave Elastography

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.

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