Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: A pilot study
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- 31 August 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Hepatology
- Vol. 56 (6), 2125-2133
- https://doi.org/10.1002/hep.25936
Abstract
Real‐time shear wave elastography (SWE) is a novel, noninvasive method to assess liver fibrosis by measuring liver stiffness. This single‐center study was conducted to assess the accuracy of SWE in patients with chronic hepatitis C (CHC), in comparison with transient elastography (TE), by using liver biopsy (LB) as the reference standard. Consecutive patients with CHC scheduled for LB by referring physicians were studied. One hundred and twenty‐one patients met inclusion criteria. On the same day, real‐time SWE using the ultrasound (US) system, Aixplorer (SuperSonic Imagine S.A., Aix‐en‐Provence, France), TE using FibroScan (Echosens, Paris, France), and US‐assisted LB were consecutively performed. Fibrosis was staged according to the METAVIR scoring system. Analyses of receiver operating characteristic (ROC) curve were performed to calculate optimal area under the ROC curve (AUROC) for F0‐F1 versus F2‐F4, F0‐ F2 versus F3‐F4, and F0‐F3 versus F4 for both real‐time SWE and TE. Liver stiffness values increased in parallel with degree of liver fibrosis, both with SWE and TE. AUROCs were 0.92 (95% confidence interval [CI]: 0.85‐0.96) for SWE and 0.84 (95% CI: 0.76‐0.90) for TE (P = 0.002), 0.98 (95% CI: 0.94‐1.00) for SWE and 0.96 (95% CI: 0.90‐0.99) for TE (P = 0.14), and 0.98 (95% CI: 0.93‐1.00) for SWE and 0.96 (95% CI: 0.91‐0.99) for TE (P = 0.48), when comparing F0‐F1 versus F2‐ F4, F0‐ F2 versus F3‐F4, and F0 ‐F3 versus F4, respectively. Conclusion: The results of this study show that real‐time SWE is more accurate than TE in assessing significant fibrosis (≥F2). With respect to TE, SWE has the advantage of imaging liver stiffness in real time while guided by a B‐mode image. Thus, the region of measurement can be guided with both anatomical and tissue stiffness information. (HEPATOLOGY 2012;56:2125–2133)This publication has 37 references indexed in Scilit:
- Medical ultrasound: imaging of soft tissue strain and elasticityJournal of The Royal Society Interface, 2011
- Etiology-related determinants of liver stiffness values in chronic viral hepatitis B or CJournal of Hepatology, 2011
- Diagnostic accuracy of FibroScan and comparison to liver fibrosis biomarkers in chronic viral hepatitis: A multicenter prospective study (the FIBROSTIC study)Journal of Hepatology, 2010
- Diagnosis, management, and treatment of hepatitis C: An updateHepatology, 2008
- Magnetic Resonance Elastography for the Noninvasive Staging of Liver FibrosisGastroenterology, 2008
- Performance of Transient Elastography for the Staging of Liver Fibrosis: A Meta-AnalysisGastroenterology, 2008
- Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver diseaseGut, 2007
- Noninvasive assessment of liver fibrosis by measurement of stiffness in patients with chronic hepatitis CHepatology, 2004
- Sampling variability of liver fibrosis in chronic hepatitis CHepatology, 2003
- An algorithm for the grading of activity in chronic hepatitis CHepatology, 1996