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.
Diagnostic value of two dimensional shear wave elastography combined with texture analysis in early liver fibrosis
