Liver stiffness measured with two-dimensional shear wave elastography comparable to histopathology falls dominantly on the severe liver fibrosis

2021 ◽  
pp. 1-10
Author(s):  
Ya Li ◽  
Size Wu
Keyword(s):  
Liver Fibrosis ◽  
Shear Wave ◽  
Characteristic Curve ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Two Dimensional ◽  
Severe Liver ◽  
Institutional Ethics ◽  
Cutoff Values ◽  
Histopathological Results

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.

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.

Noninvasive Assessment of Liver Diseases using 2D Shear Wave Elastography

2016 ◽  
Vol 25 (4) ◽  
pp. 525-532 ◽  
Author(s):  
Monica Lupșor-Platon ◽  
Radu Badea ◽  
Mirela Gersak ◽  
Anca Maniu ◽  
Ioana Rusu ◽  
...  
Keyword(s):  
Shear Wave ◽  
Predictive Value ◽  
Liver Diseases ◽  
Venous Pressure ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Two Dimensional ◽  
Non Invasive ◽  
Examination Technique

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

Performance of two--dimensional ultrasound shear wave elastography: reference values of normal liver stiffness in children

2018 ◽  
Vol 49 (1) ◽  
pp. 91-98 ◽  
Author(s):  
Paraskevi Galina ◽  
Efthymia Alexopoulou ◽  
Aglaia Zellos ◽  
Virginia Grigoraki ◽  
Tania Siahanidou ◽  
...  
Keyword(s):  
Shear Wave ◽  
Reference Values ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Normal Liver ◽  
Two Dimensional

scholarly journals Two-dimensional Shear-Wave Elastography and Conventional US: The Optimal Evaluation of Liver Fibrosis and Cirrhosis

Radiology ◽  
2015 ◽  
Vol 275 (1) ◽  
pp. 290-300 ◽  
Author(s):  
Jian Zheng ◽  
Huanyi Guo ◽  
Jie Zeng ◽  
Zeping Huang ◽  
Bowen Zheng ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Two Dimensional ◽  
Optimal Evaluation

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

scholarly journals Diagnostic Performance of Two-dimensional Shear Wave Elastography in Advanced Liver Fibrosis: A Prospective Pathology-based Study

2020 ◽  
Author(s):  
Yao-Kuang Huang ◽  
Ren-Ching Wang ◽  
Sheng-Shun Yang ◽  
Shou-Wu Lee ◽  
Hsin-Ju Tsai ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Shear Wave ◽  
Liver Diseases ◽  
Diagnostic Performance ◽  
Shear Wave Elastography ◽  
Two Dimensional ◽  
Liver Disorders ◽  
Advanced Liver Fibrosis ◽  
Invasive Method

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.

scholarly journals Comparison between shear wave elastography and serological findings for the evaluation of fibrosis in chronic liver disease

2021 ◽  
Vol 21 (86) ◽  
pp. e186-e193
Author(s):  
Mahjabeen Liaqat ◽  
◽  
Kashif Siddique ◽  
Imran Yousaf ◽  
Raham Bacha ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Diagnostic Accuracy ◽  
Chronic Liver Disease ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Chronic Liver ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Cutoff Values

Aim: In this study, we sought to examine the optimal cutoff values for predicting different stages of liver fibrosis, and to determine the level of agreement between shear wave elastography and aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4) scores in patients with chronic liver disease. Methodology: A descriptive, cross-sectional study was performed at the Radiology Department of Shaukat Khanum Memorial Hospital Lahore from 1 Jun 2019 until 1 June 2020. FIB-4 and APRI scores were determined by the following formula: FIB-4 = (age × AST) ÷ (platelet count × (√ (ALT)) and APRI = (AST÷AST upper limit of normal) ÷ platelet × 100. Data was analyzed with the help of SPSS version 24.0 and Microsoft Excel 2013. Results: Eighty individuals were conveniently selected, of which 62.5% were men and 37.5% were women. The mean age of the subjects was 43.47 SD ± 13.85 years. APRI and FIB-4 scores predicted F4 patients using the cutoff values of 0.47 (Sn. 72%, Sp. 70%) and 1.27 (Sn. 78%, Sp. 73%), respectively. The cutoff values of 0.46 for APRI and 1.27 for FIB-4 predicted F3–F4 patients (Sn. 74% and 77%; Sp. 76% and 76%), respectively. To predict F1–F4 compared to F0, the cutoff value was 0.34 (Sn. 68%, Sp. 75%) for APRI, while the cutoff value for FIB was 0.87 (Sn. 72%, Sp. 75%). The findings suggest that FIB-4 shows better diagnostic accuracy than APRI. Conclusion: This study provides optimal cutoff values for different groups of fibrosis patients for both serum markers. Also, the diagnostic accuracy of FIB-4 for predicting liver fibrosis was found to be superior to APRI in all disease stages.

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