Original Article
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2014; 20(38): 13920-13929
Published online Oct 14, 2014. doi: 10.3748/wjg.v20.i38.13920
Real time shear wave elastography in chronic liver diseases: Accuracy for predicting liver fibrosis, in comparison with serum markers
Jae Yoon Jeong, Tae Yeob Kim, Joo Hyun Sohn, Yongsoo Kim, Woo Kyoung Jeong, Young-Ha Oh, Kyo-Sang Yoo
Jae Yoon Jeong, Tae Yeob Kim, Joo Hyun Sohn, Kyo-Sang Yoo, Department of Gastroenterology, Hanyang University College of Medicine, Seoul 133-791, South Korea
Joo Hyun Sohn, Department of Internal Medicine, Hanyang Univesity Guri Hospital, Guri 471-701, South Korea
Yongsoo Kim, Department of Radiology, Hanyang University College of Medicine, Seoul 133-791, South Korea
Woo Kyoung Jeong, Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea
Young-Ha Oh, Department of Pathology, Hanyang University College of Medicine, Seoul 133-791, South Korea
Author contributions: Jeong JY, Kim TY and Sohn JH were responsible for the conception and design of the study and the development of the methodology; Kim TY, Sohn JH and Yoo K were responsible for the acquisition of data; Kim Y and Jeong WK were responsible for the radiological analysis; Oh Y was responsible for the pathological analysis; Jeong JY, Kim TY and Sohn JH were responsible for the analysis and interpretation of data, as well as the writing review and revision of this manuscript; Jeong JY and Kim TY have contributed equally to this work as co-first authors.
Supported by Research fund of the Hanyang University, No. HY-2010-G
Correspondence to: Joo Hyun Sohn, MD, PhD, Department of Internal Medicine, Hanyang Univesity Guri Hospital, 153 Gyeongchun-ro, Guri 471-701, South Korea. sonjh@hanyang.ac.kr
Telephone: +82-31-5602225 Fax: +82-31-5552998
Received: January 7, 2014
Revised: March 7, 2014
Accepted: April 28, 2014
Published online: October 14, 2014
Processing time: 282 Days and 1.9 Hours
Abstract

AIM: To evaluate the correlation between liver stiffness measurement (LSM) by real-time shear wave elastography (SWE) and liver fibrosis stage and the accuracy of LSM for predicting significant and advanced fibrosis, in comparison with serum markers.

METHODS: We consecutively analyzed 70 patients with various chronic liver diseases. Liver fibrosis was staged from F0 to F4 according to the Batts and Ludwig scoring system. Significant and advanced fibrosis was defined as stage F ≥ 2 and F ≥ 3, respectively. The accuracy of prediction for fibrosis was analyzed using receiver operating characteristic curves.

RESULTS: Seventy patients, 15 were belonged to F0-F1 stage, 20 F2, 13 F3 and 22 F4. LSM was increased with progression of fibrosis stage (F0-F1: 6.77 ± 1.72, F2: 9.98 ± 3.99, F3: 15.80 ± 7.73, and F4: 22.09 ± 10.09, P < 0.001). Diagnostic accuracies of LSM for prediction of F ≥ 2 and F ≥ 3 were 0.915 (95%CI: 0.824-0.968, P < 0.001) and 0.913 (95%CI: 0.821-0.967, P < 0.001), respectively. The cut-off values of LSM for prediction of F ≥ 2 and F ≥ 3 were 8.6 kPa with 78.2% sensitivity and 93.3% specificity and 10.46 kPa with 88.6% sensitivity and 80.0% specificity, respectively. However, there were no significant differences between LSM and serum hyaluronic acid and type IV collagen in diagnostic accuracy.

CONCLUSION: SWE showed a significant correlation with the severity of liver fibrosis and was useful and accurate to predict significant and advanced fibrosis, comparable with serum markers.

Keywords: Elastography; Liver fibrosis; Liver stiffness; Liver biopsy; Serum markers

Core tip: This study showed that liver stiffness measurement by real time shear wave elastography was highly accurate to predict the biopsy-proven significant and advanced liver fibrosis and its accuracy was comparable with that of serum markers of hyaluronic acid and type IV collagen.