scholarly journals NON INVASIVE ASSESSMENT OF LIVER FIBROSIS USING ULTRASOUND POINT SHEAR WAVE ELASTOGRAPHY

2021 ◽  
pp. 1-3
Author(s):  
Sunil Patel ◽  
Chinmay Kulkarni ◽  
Srikanth Moorthy
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Shear Wave ◽  
Hepatic Fibrosis ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Non Invasive ◽  
Elevated Liver Enzymes ◽  
Clinically Significant

Aim To prospectively determine the sensitivity, specificity and accuracy of point shear wave elastography as a non-invasive method in the diagnosis of clinically significant hepatic fibrosis with various etiologies of liver using liver biopsy as gold standard.To determine the stiffness cut-off values for point shear wave elastography (pSWE) diagnosis of clinically significant hepatic fibrosis. Methods Fifty patients with elevated liver enzymes were examined by point shear wave Elastography and they subsequently underwent percutaneous liver biopsy. Ultrasound Elastography findings were correlated with the histopathology fibrosis staging (METAVIR / Brunt Scoring) Results Liver stiffness value of >7.6 kPa was cut-off for clinically significant fibrosis and had a sensitivity of 92%, a specificity of 78.3% and an accuracy of 86%. Conclusions ElastPQ is a non-invasive and sensitive technique for determining the clinically significant liver fibrosis in patients with various etiologies.

scholarly journals Two-Dimensional Shear Wave Elastography versus Transient Elastography: A Non-Invasive Comparison for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis C

Diagnostics ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 313
Author(s):  
Rosanna Villani ◽  
Francesco Cavallone ◽  
Antonino Davide Romano ◽  
Francesco Bellanti ◽  
Gaetano Serviddio
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Shear Wave ◽  
Chronic Hepatitis C ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Operating Characteristics ◽  
Non Invasive

In recent years, several non-invasive methods have been developed for staging liver fibrosis in patients with chronic hepatitis C. A 2D-Shear wave elastography (SWE) technique has been recently introduced on the EPIQ 7 US system (ElastQ), but its accuracy has not been validated in patients with chronic hepatitis C virus (HCV) infection. We enrolled 178 HCV patients to assess their liver fibrosis stage with ElastQ software using transient elastography as a reference standard. The best cut-off values to diagnose ≥ F2, ≥ F3, and F4 were 8.15, 10.31, and 12.65 KPa, respectively. Liver stiffness values had a positive correlation with transient elastography (r = 0.57; p < 0.001). The area under the receiver operating characteristics (AUROC) was 0.899 for ≥ F2 (moderate fibrosis), 0.900 for ≥ F3 (severe fibrosis), and 0.899 for cirrhosis. 2D-SWE has excellent accuracy in assessing liver fibrosis in patients with chronic hepatitis C and an excellent correlation with transient elastography.

scholarly journals Motion effects on the measurement of stiffness on ultrasound shear wave elastography: a moving liver fibrosis phantom study

2018 ◽  
Vol 1 (1) ◽  
pp. 14 ◽  
Author(s):  
Hyun Joo Shin ◽  
Myung-Joon Kim ◽  
Choon-Sik Yoon ◽  
Kwanseop Lee ◽  
Kwan Sik Lee ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Shear Wave ◽  
Acoustic Radiation ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Normal Liver ◽  
Ultrasound Elastography ◽  
Acoustic Radiation Force Impulse ◽  
Lower Velocity ◽  
Velocity Motion

Aims: To evaluate the differences between shear wave velocities (SWVs) measured with ultrasound elastography during the continuous motion using liver fibrosis phantoms.Materials and methods: Elasticities were measured with convex and linear transducers of supersonic shear wave imaging (SSI) and acoustic radiation force impulse imaging (ARFI) using liver elasticity phantoms (3.0 and 16.9 kPa) at depths of 2, 3, 4, and 5 cm. Motion velocities were 30 and 60 rpm with the phantoms in an upright position on the Orbital shaker. To simulate different directional motion, the phantoms were laid on their side on the shaker. The values between moving and static status were compared, and the number of measurement failure was counted. Results: In SSI, the convex transducer was less affected by motion at 30 rpm with the 3 kPa phantom. In the higher velocity motion and in the higher stiffness phantom, most values from SSI were different comparing with static status, and there was a tendency for elasticity values to increase during movement. In ARFI, there were frequent measurement failures without stable results during the motion.Conclusions: Motion affected the measurement of elasticity differently in SSI and ARFI, according to the velocity, direction of the motion, and phantom stiffness. The convex transducer of SSI was less affected by motion in lower velocity motion and when using normal liver stiffness phantom.

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

Non-invasive methods in the assessment of portal hypertension severity

2021 ◽  
Vol 75 (2) ◽  
pp. 125-133
Author(s):  
Soňa Franková ◽  
Jan Šperl
Keyword(s):  
Portal Hypertension ◽  
Liver Fibrosis ◽  
Shear Wave ◽  
Transient Elastography ◽  
Venous Pressure ◽  
Liver Stiffness ◽  
Invasive Technique ◽  
Hepatic Veins ◽  
Oesophageal Varices ◽  
Non Invasive

Portal hypertension represents a wide spectrum of complications of chronic liver diseases and may present by ascites, oesophageal varices, splenomegaly, hypersplenism, hepatorenal and hepatopulmonary syndrome or portopulmonary hypertension. Portal hypertension and its severity predicts the patient‘s prognosis: as an invasive technique, the portosystemic gradient (HPVG – hepatic venous pressure gradient) measurement by hepatic veins catheterisation has remained the gold standard of its assessment. A reliable, non-invasive method to assess the severity of portal hypertension is of paramount importance; the patients with clinically significant portal hypertension have a high risk of variceal bleeding and higher mortality. Recently, non-invasive methods enabling the assessment of liver stiffness have been introduced into clinical practice in hepatology. Not only may these methods substitute for liver biopsy, but they may also be used to assess the degree of liver fibrosis and predict the severity of portal hypertension. Nowadays, we can use the quantitative elastography (transient elastography, point shear-wave elastrography, 2D-shear-wave elastography) or magnetic resonance imaging. We may also assess the severity of portal hypertension based on the non-invasive markers of liver fibrosis (i.e. ELF test) or estimate clinically signifi cant portal hypertension using composite scores (LSPS – liver spleen stiff ness score), based on liver stiffness value, spleen diameter and platelet count. Spleen stiffness measurement is a new method that needs further prospective studies. The review describes current possibilities of the non-invasive assessment of portal hypertension and its severity.

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.

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