Prospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2017; 23(26): 4839-4846
Published online Jul 14, 2017. doi: 10.3748/wjg.v23.i26.4839
Non-invasive assessment of liver fibrosis using two-dimensional shear wave elastography in patients with autoimmune liver diseases
Jie Zeng, Ze-Ping Huang, Jian Zheng, Tao Wu, Rong-Qin Zheng
Jie Zeng, Ze-Ping Huang, Tao Wu, Rong-Qin Zheng, Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangdong Key Laboratory of Liver Disease Research, Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
Jian Zheng, Department of Medical Ultrasonics, Third Hospital of Longgang, Shenzhen 518115, Guangdong Province, China
Author contributions: Zeng J designed and performed the research and wrote the paper; Huang ZP, Zheng J and Wu T detected the patients and collected the data for the research; and Zheng RQ designed the research and supervised the report.
Institutional review board statement: This study was approved by the clinical medical research ethics committee of our hospital.
Informed consent statement: Informed consent was obtained from all the patients.
Conflict-of-interest statement: The authors declare no financial conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rong-Qin Zheng, MD, Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangdong Key Laboratory of Liver Disease Research, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China. zhengrq@mail.sysu.edu.cn
Telephone: +86-20-85252010 Fax: +86-20-85252416
Received: March 7, 2017
Peer-review started: March 7, 2017
First decision: March 30, 2017
Revised: April 12, 2017
Accepted: May 4, 2017
Article in press: May 4, 2017
Published online: July 14, 2017
Processing time: 126 Days and 21.9 Hours
Abstract
AIM

To determine the diagnostic accuracy of two-dimensional shear wave elastography (2D-SWE) for the non-invasive assessment of liver fibrosis in patients with autoimmune liver diseases (AILD) using liver biopsy as the reference standard.

METHODS

Patients with AILD who underwent liver biopsy and 2D-SWE were consecutively enrolled. Receiver operating characteristic (ROC) curves were constructed to assess the overall accuracy and to identify optimal cut-off values.

RESULTS

The characteristics of the diagnostic performance were determined for 114 patients with AILD. The areas under the ROC curves for significant fibrosis, severe fibrosis, and cirrhosis were 0.85, 0.85, and 0.86, respectively, and the optimal cut-off values associated with significant fibrosis (≥ F2), severe fibrosis (≥ F3), and cirrhosis (F4) were 9.7 kPa, 13.2 kPa and 16.3 kPa, respectively. 2D-SWE showed sensitivity values of 81.7% for significant fibrosis, 83.0% for severe fibrosis, and 87.0% for cirrhosis, and the respective specificity values were 81.3%, 74.6%, and 80.2%. The overall concordance rate of the liver stiffness measurements obtained using 2D-SWE vs fibrosis stages was 53.5%.

CONCLUSION

2D-SWE showed promising diagnostic performance for assessing liver fibrosis stages and exhibited high cut-off values in patients with AILD. Low overall concordance rate was observed in the liver stiffness measurements obtained using 2D-SWE vs fibrosis stages.

Keywords: Autoimmune liver disease; Liver fibrosis; Two-dimensional shear wave elastography; Ultrasound; Liver stiffness

Core tip: The study determined the diagnostic accuracy of two-dimensional shear wave elastography (2D-SWE) for the non-invasive assessment of liver fibrosis in patients with autoimmune liver diseases (AILD) using liver biopsy as the reference standard. The characteristics of the diagnostic performance were determined for 114 patients with AILD. The areas under the receiver operating characteristic curves for significant fibrosis, severe fibrosis, and cirrhosis were 0.85, 0.85 and 0.86, respectively, and the optimal cut-off values were 9.7 kPa, 13.2 kPa and 16.3 kPa, respectively. 2D-SWE showed promising diagnostic performance in assessing liver fibrosis stages and exhibited high cut-off values in patients with AILD.