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For: Bende F, Sporea I, Sirli R, Popescu A, Mare R, Miutescu B, Lupusoru R, Moga T, Pienar C. Performance of 2D-SWE.GE for predicting different stages of liver fibrosis, using Transient Elastography as the reference method. Med Ultrason 2017;19:143-149. [PMID: 28440347 DOI: 10.11152/mu-910] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]

For:	Bende F, Sporea I, Sirli R, Popescu A, Mare R, Miutescu B, Lupusoru R, Moga T, Pienar C. Performance of 2D-SWE.GE for predicting different stages of liver fibrosis, using Transient Elastography as the reference method. Med Ultrason 2017;19:143-149. [PMID: 28440347 DOI: 10.11152/mu-910] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]

Number

Cited by Other Article(s)

Vidili G, Arru M, Meloni P, Solinas G, Atzori S, Maida I. Comparison of 2D Shear Wave Elastography and Transient Elastography in Non-Invasive Evaluation of Liver Fibrosis in Hepatitis C Virus-Related Chronic Liver Disease. J Clin Med 2024;13:4061. [PMID: 39064101 PMCID: PMC11278231 DOI: 10.3390/jcm13144061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/28/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open

He R, Liu C, Grgurevic I, Guo Y, Xu H, Liu J, Liu Y, Wang X, Shi H, Madir A, Podrug K, Zhu Y, Hua Y, Wang K, Wen J, Su M, Zhang Q, Li J, Qi X. Validation of Baveno VII criteria for clinically significant portal hypertension by two-dimensional shear wave elastography. Hepatol Int 2024;18:1020-1028. [PMID: 38740698 DOI: 10.1007/s12072-024-10657-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/02/2024] [Indexed: 05/16/2024]

Affiliation(s)

Ruiling He Department of Ultrasound, Donggang Branch of the First Hospital of Lanzhou University, Lanzhou, China The First Clinical Medical College of Lanzhou University, Lanzhou, China
Chuan Liu Center of Portal Hypertension, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing, China Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University; State Key Laboratory of Digital Medical Engineering, Nanjing, China
Ivica Grgurevic Department of Gastroenterology, Hepatology and Clinical Nutrition, School of Medicine and Faculty of Pharmacy and Biochemistry, University Hospital Dubrava, University of Zagreb, Zagreb, Croatia
Ying Guo Department of Hepatology, The Third People's Hospital of Taiyuan, Taiyuan, China
Huixiong Xu Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
Jiacheng Liu Department of Infectious Diseases, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China
Yunfang Liu Department of Hepatology, The Third People's Hospital of Taiyuan, Taiyuan, China
XiaoYan Wang Department of Hepatology, The Third People's Hospital of Taiyuan, Taiyuan, China
Hongmei Shi Department of Ultrasound, The Third People's Hospital of Taiyuan, Taiyuan, China
Anita Madir 4-University Hospital Dubrava, Zagreb, Croatia
Kristian Podrug Department of Gastroenterology and Hepatology, University Hospital Center Split, Split, Croatia
Yuli Zhu Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
Yongli Hua Department of Hepatology, The Third People's Hospital of Taiyuan, Taiyuan, China
Kun Wang Department of Hepatology, The Third People's Hospital of Taiyuan, Taiyuan, China
Jing Wen Department of Hepatology, The Third People's Hospital of Taiyuan, Taiyuan, China
Meiqin Su Department of Ultrasound, The Third People's Hospital of Taiyuan, Taiyuan, China
Qun Zhang Department of Infectious Disease, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
Jie Li Department of Infectious Diseases, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China.
Xiaolong Qi The First Clinical Medical College of Lanzhou University, Lanzhou, China.

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Coelho M, Fernandes F, Cardoso SW, Piedade J, Torres da Silva MV, Santos R, Veloso VG, Grinsztejn B, Pereira GH, Perazzo H. Accuracy and concordance of two-dimensional shear-wave elastography using transient elastography as the reference in chronic viral hepatitis and HIV infection in Rio de Janeiro, Brazil. Eur J Gastroenterol Hepatol 2023;35:583-590. [PMID: 36966773 DOI: 10.1097/meg.0000000000002537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]

Abstract

OBJECTIVES

Evaluate the accuracy and agreement of two-dimensional shear-wave elastography (2D-SWE) LOGIQ-S8 with transient elastography in patients from Rio de Janeiro, Brazil.

METHOD

This retrospective study compared liver stiffness measurements (LSMs) using transient elastography (M and XL probes) and 2D-SWE GE-LOGIQ-S8 performed by a single experienced operator on the same day in 348 consecutive individuals with viral hepatitis or HIV infection. Suggestive and highly suggestive compensated-advanced chronic liver disease (c-ACLD) were defined by transient elastography-LSM ≥10 kPa and ≥15 kPa, respectively. Agreement between techniques and accuracy of 2D-SWE using transient elastography-M probe as the reference was assessed. Optimal cut-offs for 2D-SWE were identified using the maximal Youden index.

RESULTS

Three hundred five patients [61.3% male, median age = 51 [interquartile range (IQR), 42-62] years, 24% with hepatitis C virus (HCV) ± HIV; 17% with hepatitis B virus (HBV) ± HIV; 31% were HIV mono-infected and 28% had HCV ± HIV post-sustained virological response] were included. The overall correlation (Spearman's ρ ) was moderate between 2D-SWE and transient elastography-M ( ρ = 0.639) and weak between 2D-SWE and transient elastography-XL ( ρ = 0.566). Agreements were strong ( ρ > 0.800) in people with HCV or HBV mono-infection, and poor in HIV mono-infected ( ρ > 0.400). Accuracy of 2D-SWE for transient elastography-M ≥ 10 kPa [area under the receiver operating characteristic (AUROC) = 0.91 (95% confidence interval [CI], 0.86-0.96); optimal cut-off = 6.4 kPa, sensitivity = 84% (95% CI, 72-92), specificity = 89% (95% CI, 84-92)] and for transient elastography-M ≥ 15 kPa [AUROC = 0.93 (95% CI, 0.88-0.98); optimal cut-off = 7.1 kPa; sensitivity = 91% (95% CI, 75-98), specificity = 89% (95% CI, 85-93)] were excellent.

CONCLUSION

2D-SWE LOGIQ-S8 system had a good agreement with transient elastography and an excellent accuracy to identify individuals at high risk for c-ACLD.

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Testino G, Pellicano R. Metabolic associated liver disease. Panminerva Med 2022;64:555-563. [PMID: 36533665 DOI: 10.23736/s0031-0808.22.04730-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]

Agreement and accuracy of shear-wave techniques (point shear-wave elastography and 2D-shear-wave elastography) using transient elastography as reference. Eur J Gastroenterol Hepatol 2022;34:873-881. [PMID: 35802529 DOI: 10.1097/meg.0000000000002400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]

Tran LC, Ley D, Bourdon G, Coopman S, Lerisson H, Tillaux C, Béhal H, Gottrand F, Aumar M. Noninvasive Pediatric Liver Fibrosis Measurement: Two-Dimensional Shear Wave Elastography Compared With Transient Elastography. Front Pediatr 2022;10:849815. [PMID: 35573968 PMCID: PMC9095976 DOI: 10.3389/fped.2022.849815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/10/2022] [Indexed: 12/20/2022] Open

Affiliation(s)

Léa Chantal Tran University of Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
Delphine Ley University of Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
Gurvan Bourdon Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
Stéphanie Coopman Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
Héloïse Lerisson Department of Paediatric Imaging, Jeanne de Flandre Children's Hospital, CHU Lille, Lille, France
Céline Tillaux Department of Paediatric Imaging, Jeanne de Flandre Children's Hospital, CHU Lille, Lille, France
Hélène Béhal University of Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
Frédéric Gottrand University of Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
Madeleine Aumar University of Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France

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Moga TV, David C, Popescu A, Lupusoru R, Heredea D, Ghiuchici AM, Foncea C, Burdan A, Sirli R, Danilă M, Ratiu I, Bizerea-Moga T, Sporea I. Multiparametric Ultrasound Approach Using a Tree-Based Decision Classifier for Inconclusive Focal Liver Lesions Evaluated by Contrast Enhanced Ultrasound. J Pers Med 2021;11:jpm11121388. [PMID: 34945860 PMCID: PMC8709328 DOI: 10.3390/jpm11121388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open

Affiliation(s)

Tudor Voicu Moga Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania; (T.V.M.); (A.P.); (D.H.); (A.M.G.); (C.F.); (A.B.); (R.S.); (M.D.); (I.R.); (I.S.)
Ciprian David Electronics and Telecommunications Faculty, “Politehnica” University of Timișoara, 300006 Timișoara, Romania;
Alina Popescu Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania; (T.V.M.); (A.P.); (D.H.); (A.M.G.); (C.F.); (A.B.); (R.S.); (M.D.); (I.R.); (I.S.)
Raluca Lupusoru Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania; (T.V.M.); (A.P.); (D.H.); (A.M.G.); (C.F.); (A.B.); (R.S.); (M.D.); (I.R.); (I.S.) Center for Modeling Biological Systems and Data Analysis, Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania Correspondence: ; Tel.: +40-733912028
Darius Heredea Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania; (T.V.M.); (A.P.); (D.H.); (A.M.G.); (C.F.); (A.B.); (R.S.); (M.D.); (I.R.); (I.S.)
Ana M. Ghiuchici Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania; (T.V.M.); (A.P.); (D.H.); (A.M.G.); (C.F.); (A.B.); (R.S.); (M.D.); (I.R.); (I.S.)
Camelia Foncea Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania; (T.V.M.); (A.P.); (D.H.); (A.M.G.); (C.F.); (A.B.); (R.S.); (M.D.); (I.R.); (I.S.)
Adrian Burdan Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania; (T.V.M.); (A.P.); (D.H.); (A.M.G.); (C.F.); (A.B.); (R.S.); (M.D.); (I.R.); (I.S.)
Roxana Sirli Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania; (T.V.M.); (A.P.); (D.H.); (A.M.G.); (C.F.); (A.B.); (R.S.); (M.D.); (I.R.); (I.S.)
Mirela Danilă Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania; (T.V.M.); (A.P.); (D.H.); (A.M.G.); (C.F.); (A.B.); (R.S.); (M.D.); (I.R.); (I.S.)
Iulia Ratiu Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania; (T.V.M.); (A.P.); (D.H.); (A.M.G.); (C.F.); (A.B.); (R.S.); (M.D.); (I.R.); (I.S.)
Teofana Bizerea-Moga Department of Pediatrics—1st Pediatric Discipline, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
Ioan Sporea Advanced Regional Research Center in Gastroenterology and Hepatology, Department of Gastroenterology and Hepatology, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania; (T.V.M.); (A.P.); (D.H.); (A.M.G.); (C.F.); (A.B.); (R.S.); (M.D.); (I.R.); (I.S.)

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Brazilian Society of Hepatology and Brazilian College of Radiology practice guidance for the use of elastography in liver diseases. Ann Hepatol 2021;22:100341. [PMID: 33737252 DOI: 10.1016/j.aohep.2021.100341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/21/2021] [Accepted: 03/01/2021] [Indexed: 02/07/2023]

Zarei F, Moini M, Abedi M, Ravanfar Haghighi R, Zeinali-Rafsanjani B. Liver Fibrosis Assessment Using Transient Elastography by FibroScan and Shear Wave Elastography by Sonography: A Comparative Cross-sectional Study in an Outpatient Liver Clinic. IRANIAN JOURNAL OF RADIOLOGY 2021;18. [DOI: 10.5812/iranjradiol.112589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]

Abstract Background: Non-alcoholic fatty liver disease (NAFLD) is the second most common cause of liver transplantation in the United States, with a continuously growing prevalence. There are several non-invasive methods to detect liver fibrosis, which is defined as the accumulation of extracellular matrix proteins, particularly collagens. It is most commonly associated with chronic liver diseases, such as NAFLD. Objectives: This study aimed to investigate the concordance between transient elastography (TE) and shear wave elastography (SWE) for liver fibrosis staging and also to examine the congruence between the controlled attenuation parameter (CAP) and the B-mode hepatorenal ratio for hepatic steatosis grading in patients with NAFLD. Patients and Methods: In this cross-sectional study conducted during March 2018 - 2019, NAFLD patients, referred to the liver clinic of our center for the non-invasive assessment of hepatic fibrosis, were enrolled. However, patients with sonographic features of cirrhosis, multiple hepatic masses, or moderate to large ascites were excluded; also, patients who were uncooperative during the tests were excluded. Measurements obtained by different tools were recorded. Kolmogorov-Smirnov test, Chi-square test, independent t-test, or Mann-Whitney tests, as well as Pearson’s correlation coefficient test, were used to analyze the data. Results: Sixty-five patients (male-to-female ratio, 1:13), with a median age of 47 years, were included in the study. The tools for assessing fibrosis (r = 0.9538, 95% CI: 0.9252 - 0.9717, P < 0.0001) and steatosis (r = 0.429, 95% CI: 0.2048 - 0.6104, P < 0.0001) were perfectly and moderately correlated, respectively. Sex, age, and body mass index (BMI) did not affect the results. Conclusion: The two elastography modalities showed a strong correlation for fibrosis staging in our study population. Also, the CAP and B-mode hepatorenal ratio were moderately correlated for grading hepatosteatosis. Overall, selection of the best assessment method among the studied modalities depends on factors other than internal validity. Collapse

Manesis EK, Schina M, Vafiadis I, Gatos I, Theotokas J, Zoumpoulis P, Drazinos P, Ketikoglou J, Delladetsima IK, Tiniakos DG. Liver stiffness measurements by 2-dimensional shear wave elastography compared to histological and ultrasound parameters in primary biliary cholangitis. Scand J Gastroenterol 2021;56:1187-1193. [PMID: 34375562 DOI: 10.1080/00365521.2021.1928277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]

Galina P, Alexopoulou E, Mentessidou A, Mirilas P, Zellos A, Lykopoulou L, Patereli A, Salpasaranis K, Kelekis NL, Zarifi M. Diagnostic accuracy of two-dimensional shear wave elastography in detecting hepatic fibrosis in children with autoimmune hepatitis, biliary atresia and other chronic liver diseases. Pediatr Radiol 2021;51:1358-1368. [PMID: 33755748 DOI: 10.1007/s00247-020-04959-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/13/2020] [Accepted: 12/22/2020] [Indexed: 12/11/2022]

Abstract

BACKGROUND

Although fibrosis is the main determinant of liver stiffness, other disease-related factors usually disregarded in studies on liver elastography, such as inflammation and cholestasis, may influence liver stiffness.

OBJECTIVE

To evaluate the accuracy of two-dimensional (2-D) shear wave elastography in assessing liver fibrosis in children with chronic liver disease by controlling for the confounding role of several disease- and patient-related factors.

MATERIALS AND METHODS

Three disease groups were studied: 1) various chronic liver diseases, 2) autoimmune hepatitis and 3) biliary atresia. The METAVIR (meta-analysis of histological data in viral hepatitis) score was used for fibrosis staging and grading of necroinflammatory activity. Multiple linear regression was used to evaluate the relationship between liver stiffness measurements and disease-related factors. The diagnostic accuracy of elastography for predicting fibrosis stages was assessed by calculating the area under the receiver operating characteristic curves.

RESULTS

The various chronic liver diseases group (n=32; 7.1±4.9 [mean±standard deviation] years) showed liver stiffness of 8.9±5.0 (mean±standard deviation) kPa, the autoimmune hepatitis group (n=33; 8.1±4.4 years) of 7.1±2.7 kPa, and the biliary atresia group (n=19; 0.2±0.1 years) of 19.7±15.2 kPa. Liver stiffness measurements differed across METAVIR fibrosis categories in all disease groups. The highest values were found in biliary atresia, at fibrosis stages ≥F2 (F2: 12.4±1.6 kPa, F3: 17.8±2 kPa, F4: 41.5±12.4 kPa). Liver stiffness was strongly associated only with fibrosis (P<0.0001) in various chronic liver diseases, but with necroinflammatory activity (P<0.0001) and fibrosis (P=0.002) in autoimmune hepatitis, and with age (P<0.0001), fibrosis (P<0.0001) and cholestasis (P=0.009) in biliary atresia. Optimal cutoffs for detecting advanced fibrosis (≥F3) were 16 kPa (area under curve: 0.98; sensitivity: 87.5%; specificity: 96.7%) in biliary atresia and 8.7 kPa (area under curve: 0.98; sensitivity: 93.8%; specificity: 96.1%) in other chronic liver diseases.

CONCLUSION

Two-dimensional shear wave elastography is reliable in assessing liver fibrosis in children with chronic liver diseases.

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Aksakal M, Oktar SO, Sendur HN, Esendaglı G, Ozenirler S, Cindoruk M, Hızel K. Diagnostic performance of 2D shear wave elastography in predicting liver fibrosis in patients with chronic hepatitis B and C: a histopathological correlation study. Abdom Radiol (NY) 2021;46:3238-3244. [PMID: 33723676 DOI: 10.1007/s00261-021-03019-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/21/2021] [Accepted: 02/25/2021] [Indexed: 12/13/2022]

Fofiu R, Bende F, Popescu A, Șirli R, Miuţescu B, Sporea I. Assessing Baveno VI Criteria Using Liver Stiffness Measured with a 2D-Shear Wave Elastography Technique. Diagnostics (Basel) 2021;11:diagnostics11050737. [PMID: 33919033 PMCID: PMC8142982 DOI: 10.3390/diagnostics11050737] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 12/18/2022] Open

Sriphoosanaphan S, Thanapirom K, Kerr SJ, Suksawatamnuay S, Thaimai P, Sittisomwong S, Sonsiri K, Srisoonthorn N, Teeratorn N, Tanpowpong N, Chaopathomkul B, Treeprasertsuk S, Poovorawan Y, Komolmit P. Effect of vitamin D supplementation in patients with chronic hepatitis C after direct-acting antiviral treatment: a randomized, double-blind, placebo-controlled trial. PeerJ 2021;9:e10709. [PMID: 33614272 PMCID: PMC7879942 DOI: 10.7717/peerj.10709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/15/2020] [Indexed: 12/16/2022] Open

Abstract

Background

Replacement of vitamin D (VD) among patients with chronic hepatitis C (CHC) before viral eradication has demonstrated a protective effect on serum markers associated with hepatic fibrogenesis. We therefore hypothesized that VD may facilitate further fibrosis amelioration following curative treatment with direct-acting antivirals (DAA).

Methods

This study was a randomized, double-blind, placebo-controlled trial conducted between February 2018 and August 2018. Patients with CHC and VD deficiency were randomized in a 1:1 ratio to either receive ergicalciferol or placebo over 6 weeks. Biochemical analysis indicators, including 25-hydroxyvitamin D (25(OH)D), fibrogenic markers [(transforming growth factor beta 1 (TGF-β1) and tissue inhibitors of matrix metalloproteinases 1 (TIMP-1)], and fibrolytic markers [matrix metalloproteinase 9 (MMP-9) and amino terminal type III procollagen peptide (P3NP)], were assessed at baseline and at 6 weeks. Serum 25(OH)D was analyzed by a chemiluminescence immunoassay. Serum hepatic fibrogenesis markers were measured using a quantitative sandwich enzyme-linked immunosorbent assay.

Results

Seventy-five patients with CHC and VD deficiency were randomly assigned to VD (n = 37) and placebo (n = 38) groups. At the end of the study, the mean serum 25(OH)D level had risen to a normal level in the VD group, but was still deficient in the placebo group (41.8 ± 9.1 vs. 18.1 ± 4.6 ng/mL, p < 0.001). Upon restoration of the VD level, there were no significant mean differences in the change from baseline for TGF-β1 (-0.6 ng/mL (95% confidence interval (95% CI) [-2.8-1.7]), p = 0.63), TIMP-1 (-5.5 ng/mL (95% CI [-26.4 -15.3]), p = 0.60), MMP-9 (122.9 ng/mL (95% CI [-69.0 -314.8]), p = 0.21), and P3NP (-0.1 ng/mL (95% CI [-2.4 -2.2]), p = 0.92) between the VD and placebo groups.

Conclusion

Short-term VD supplementation after DAA treatment in patients with CHC does not improve serum fibrogenesis markers and may not expedite the residual liver fibrosis healing process. Future studies are warranted to evaluate the long-term effect of VD supplementation on hepatic fibrosis regression.

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Affiliation(s)

Supachaya Sriphoosanaphan Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Liver Diseases, Thai Red Cross, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Kessarin Thanapirom Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Liver Diseases, Thai Red Cross, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.,Liver Fibrosis and Cirrhosis Research Unit, Chulalongkorn University, Bangkok, Thailand
Stephen J Kerr Biostatistics Excellence Center, Department of Research Affairs, Chulalongkorn University, Bangkok, Thailand
Sirinporn Suksawatamnuay Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Liver Diseases, Thai Red Cross, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.,Liver Fibrosis and Cirrhosis Research Unit, Chulalongkorn University, Bangkok, Thailand
Panarat Thaimai Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Sukanya Sittisomwong Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Kanokwan Sonsiri Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Nunthiya Srisoonthorn Center of Excellence in Liver Diseases, Thai Red Cross, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Nicha Teeratorn Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Natthaporn Tanpowpong Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Bundit Chaopathomkul Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Sombat Treeprasertsuk Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Yong Poovorawan Center of Excellence in Clinical Virology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Piyawat Komolmit Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Liver Diseases, Thai Red Cross, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.,Liver Fibrosis and Cirrhosis Research Unit, Chulalongkorn University, Bangkok, Thailand

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Lim Z, Whitaker T, DeColle K, Barrett K, Harlton C, Paskar L, Low G. Interobserver and Intraobserver Reliability of Hepatic Shear Wave Elastography and the Influence of Fasted Versus Nonfasted States in Healthy Volunteers. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021;40:259-267. [PMID: 32686849 DOI: 10.1002/jum.15395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/25/2020] [Accepted: 05/30/2020] [Indexed: 06/11/2023]

Performance and cutoffs for liver fibrosis staging of a two-dimensional shear wave elastography technique. Eur J Gastroenterol Hepatol 2021;33:89-95. [PMID: 32118850 DOI: 10.1097/meg.0000000000001702] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]

Fofiu R, Bende F, Popescu A, Şirli R, Lupușoru R, Ghiuchici AM, Sporea I. Spleen and Liver Stiffness for Predicting High-Risk Varices in Patients with Compensated Liver Cirrhosis. ULTRASOUND IN MEDICINE & BIOLOGY 2021;47:76-83. [PMID: 33067019 DOI: 10.1016/j.ultrasmedbio.2020.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/19/2020] [Accepted: 09/11/2020] [Indexed: 06/11/2023]

Noninvasive assessment of liver fibrosis in a real-world cohort of patients with known or suspected chronic liver disease using 2D-shear wave elastography. Eur J Gastroenterol Hepatol 2020;32:1559-1565. [PMID: 31922976 DOI: 10.1097/meg.0000000000001675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]

Bende F, Sporea I, Şirli R, Nistorescu S, Fofiu R, Bâldea V, Popescu A. The Performance of a 2-Dimensional Shear-Wave Elastography Technique for Predicting Different Stages of Liver Fibrosis Using Transient Elastography as the Control Method. Ultrasound Q 2020;37:97-104. [PMID: 33136935 DOI: 10.1097/ruq.0000000000000527] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]

Bâldea V, Sporea I, Lupușoru R, Bende F, Mare R, Popescu A, Șirli R. Comparative Study Between the Diagnostic Performance of Point and 2-D Shear-Wave Elastography for the Non-invasive Assessment of Liver Fibrosis in Patients With Chronic Hepatitis C Using Transient Elastography as Reference. ULTRASOUND IN MEDICINE & BIOLOGY 2020;46:2979-2988. [PMID: 32807571 DOI: 10.1016/j.ultrasmedbio.2020.07.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 06/11/2023]

Stefanescu H, Rusu C, Lupsor-Platon M, Nicoara Farcau O, Fischer P, Grigoras C, Horhat A, Stancu O, Ardelean A, Tantau M, Badea R, Procopet B. Liver Stiffness Assessed by Ultrasound Shear Wave Elastography from General Electric Accurately Predicts Clinically Significant Portal Hypertension in Patients with Advanced Chronic Liver Disease. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2020;41:526-533. [PMID: 31476787 DOI: 10.1055/a-0965-0745] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]

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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An HS, Choi YH, Song MK, Lee SY, Kim GB, Bae EJ. Early development of hepatic fibrosis after Fontan procedure: A non-invasive study of a subclinical liver disease. Int J Cardiol 2020;320:64-69. [PMID: 32800914 DOI: 10.1016/j.ijcard.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 06/22/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022]

Kim DW, Suh CH, Kim KW, Pyo J, Park C, Jung SC. Technical Performance of Two-Dimensional Shear Wave Elastography for Measuring Liver Stiffness: A Systematic Review and Meta-Analysis. Korean J Radiol 2020;20:880-893. [PMID: 31132814 PMCID: PMC6536798 DOI: 10.3348/kjr.2018.0812] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/06/2019] [Indexed: 12/19/2022] Open

Abstract

Objective

To assess the technical performance of two-dimensional shear wave elastography (2D-SWE) for measuring liver stiffness.

Materials and Methods

The Ovid-MEDLINE and EMBASE databases were searched for studies reporting the technical performance of 2D-SWE, including concerns with technical failures, unreliable measurements, interobserver reliability, and/or intraobserver reliability, published until June 30, 2018. The pooled proportion of technical failure and unreliable measurements was calculated using meta-analytic pooling via the random-effects model and inverse variance method for calculating weights. Subgroup analyses were performed to explore potential causes of heterogeneity. The pooled intraclass correlation coefficients (ICCs) for interobserver and intraobserver reliability were calculated using the Hedges-Olkin method with Fisher's Z transformation of the correlation coefficient.

Results

The search yielded 34 articles. From 20 2D-SWE studies including 6196 patients, the pooled proportion of technical failure was 2.3% (95% confidence interval [CI], 1.3–3.9%). The pooled proportion of unreliable measurements from 20 studies including 6961 patients was 7.5% (95% CI, 4.7–11.7%). In the subgroup analyses, studies conducting more than three measurements showed fewer unreliable measurements than did those with three measurements or less, but no intergroup difference was found in technical failure. The pooled ICCs for interobserver reliability (from 10 studies including 517 patients) and intraobserver reliability (from 7 studies including 679 patients) were 0.87 (95% CI, 0.82–0.90) and 0.93 (95% CI, 0.89–0.95), respectively, suggesting good to excellent reliability.

Conclusion

2D-SWE shows good technical performance for assessing liver stiffness, with high technical success and reliability. Future studies should establish the quality criteria and optimal number of measurements.

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Wu M, Zhou RH, Xu F, Li XP, Zhao P, Yuan R, Lan YP, Zhou WX. Multi-parameter ultrasound based on the logistic regression model in the differential diagnosis of hepatocellular adenoma and focal nodular hyperplasia. World J Gastrointest Oncol 2019;11:1193-1205. [PMID: 31908724 PMCID: PMC6937441 DOI: 10.4251/wjgo.v11.i12.1193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/13/2019] [Accepted: 09/10/2019] [Indexed: 02/05/2023] Open

Abstract

BACKGROUND

Focal nodular hyperplasia (FNH) has very low potential risk, and a tendency to spontaneously resolve. Hepatocellular adenoma (HCA) has a certain malignant tendency, and its prognosis is significantly different from FNH. Accurate identification of HCA and FNH is critical for clinical treatment.

AIM

To analyze the value of multi-parameter ultrasound index based on logistic regression for the differential diagnosis of HCA and FNH.

METHODS

Thirty-one patients with HCA were included in the HCA group. Fifty patients with FNH were included in the FNH group. The clinical data were collected and recorded in the two groups. Conventional ultrasound, shear wave elastography, and contrast-enhanced ultrasound were performed, and the lesion location, lesion echo, Young’s modulus (YM) value, YM ratio, and changes of time intense curve (TIC) were recorded. Multivariate logistic regression analysis was used to screen the indicators that can be used for the differential diagnosis of HCA and FNH. A ROC curve was established for the potential indicators to analyze the accuracy of the differential diagnosis of HCA and FNH. The value of the combined indicators for distinguishing HCA and FNH were explored.

RESULTS

Multivariate logistic regression analysis showed that lesion echo (P = 0.000), YM value (P = 0.000) and TIC decreasing slope (P = 0.000) were the potential indicators identifying HCA and FNH. In the ROC curve analysis, the accuracy of the YM value distinguishing HCA and FNH was the highest (AUC = 0.891), which was significantly higher than the AUC of the lesion echo and the TIC decreasing slope (P < 0.05). The accuracy of the combined diagnosis was the highest (AUC = 0.938), which was significantly higher than the AUC of the indicators diagnosing HCA individually (P < 0.05). This sensitivity was 91.23%, and the specificity was 83.33%.

CONCLUSION

The combination of lesion echo, YM value and TIC decreasing slope can accurately differentiate between HCA and FNH.

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Matos J, Paparo F, Bacigalupo L, Cenderello G, Mussetto I, De Cesari M, Bernardi SP, Cevasco L, Forni GL, Cassola G, Rollandi GA. Noninvasive liver fibrosis assessment in chronic viral hepatitis C: agreement among 1D transient elastography, 2D shear wave elastography, and magnetic resonance elastography. Abdom Radiol (NY) 2019;44:4011-4021. [PMID: 31696266 DOI: 10.1007/s00261-019-02295-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]

Yoo HW, Kim YS, Kim SG, Yoo JJ, Jeong SW, Jang JY, Lee SH, Kim HS, Kim YD, Cheon GJ, Jun B, Kim BS. Usefulness of noninvasive methods including assessment of liver stiffness by 2-dimensional shear wave elastography for predicting esophageal varices. Dig Liver Dis 2019;51:1706-1712. [PMID: 31281068 DOI: 10.1016/j.dld.2019.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 05/31/2019] [Accepted: 06/01/2019] [Indexed: 12/11/2022]

Zjacic Puljiz D, Mestrovic A, Zaja I, Tonkic A, Grgurevic I, Duplancic D, Delic Jukic IK, Ljutic D, Puljiz Z. Impact of hemodialysis on liver stiffness measured with real-time two-dimensional shear wave elastography. Wien Klin Wochenschr 2019;133:96-101. [PMID: 31781940 DOI: 10.1007/s00508-019-01577-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 10/30/2019] [Indexed: 11/26/2022]

Ryu H, Ahn SJ, Yoon JH, Lee JM. Inter-platform reproducibility of liver stiffness measured with two different point shear wave elastography techniques and 2-dimensional shear wave elastography using the comb-push technique. Ultrasonography 2019;38:345-354. [PMID: 31500403 PMCID: PMC6769187 DOI: 10.14366/usg.19001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/13/2019] [Accepted: 03/23/2019] [Indexed: 12/12/2022] Open

Abstract

PURPOSE

The purpose of this study was to compare the technical success rate and reliability of measurements made using three shear wave elastography (SWE) techniques and to assess the inter-platform reproducibility of the resultant liver stiffness measurements.

METHODS

This prospective study included 54 patients with liver disease. Liver stiffness (LS) measurements were obtained using 2-point SWE techniques (Virtual Touch Quantification and S-Shearwave) and 2-dimensional (2D) SWE, with transient elastography (TE) serving as the reference standard. The technical success rates and measurement reliability of the three techniques were compared. LS values measured using the three SWE techniques and TE were compared using Spearman correlation coefficients and 95% Bland-Altman limits of agreement. Intra-class correlation coefficients (ICC) were used to analyze the inter-platform reproducibility of LS measurements.

RESULTS

The three SWE techniques and TE showed similar technical success rates (P=0.682) but demonstrated significant differences in the reliability of LS measurements (P=0.006) and mean LS measurements (P<0.001). Despite strong correlations (r=0.73-0.94) between SWE systems, various degrees of inter-platform reproducibility (ICC, 0.58-0.92) were observed for the three SWE techniques. The best agreement was observed between S-Shearwave and TE (ICC, 0.92), and the worst agreement was observed between 2D-SWE and TE (ICC, 0.58). In the BlandAltman analysis, a tendency toward lower LS values with the three SWE techniques than with TE in patients with F3 and F4 disease was observed.

CONCLUSION

Significant inter-system variability was observed in LS measurements made using the three SWE techniques. Therefore, LS values measured using different SWE techniques should not be used interchangeably for longitudinal follow-up.

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Petzold G, Grieme B, Bremer SCB, Knoop RF, Goetze RG, Ellenrieder V, Kunsch S, Neesse A. Prospective comparison of 2D-shearwave elastography in both liver lobes in healthy subjects and in patients with chronic liver disease. Scand J Gastroenterol 2019;54:1138-1145. [PMID: 31433262 DOI: 10.1080/00365521.2019.1653961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]

Petzold G, Hofer J, Ellenrieder V, Neesse A, Kunsch S. Liver Stiffness Measured by 2-Dimensional Shear Wave Elastography: Prospective Evaluation of Healthy Volunteers and Patients With Liver Cirrhosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019;38:1769-1777. [PMID: 30536601 DOI: 10.1002/jum.14866] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/19/2018] [Indexed: 06/09/2023]

Abstract

OBJECTIVES

We aimed to establish normal values for liver stiffness measurement, performed by 2-dimensional shear wave elastography (LOGIQ E9; GE Healthcare, Wauwatosa, WI), in healthy volunteers, patients with nonhepatic morbidities, and patients with histologically confirmed liver cirrhosis.

METHODS

A total of 175 participants were included between July 2016 and February 2018. Three cohorts were analyzed: healthy volunteers (n = 68), patients with healthy livers but nonhepatic morbidities (n = 57), and patients with liver cirrhosis (n = 50). Liver stiffness measurement was performed by 2 observers with different levels of experience to determine interobserver agreement.

RESULTS

Of the 175 participants included, 91 were male, and the mean age ± SD was 44.4 ± 19.4 years. The success rate for 175 liver stiffness measurements was 95.4%. The number of unsuccessful measurements was significantly higher in the liver cirrhosis cohort (P = .04). The interobserver agreement was excellent (intraclass correlation coefficient, 0.87). Liver stiffness in the healthy-liver patient cohort (4.93 ± 0.83 kPa) was not significantly different from that in the healthy-volunteer cohort (5.19 ± 1.03 kPa; P = .13). Apart from male sex in the healthy-volunteer cohort, age, body mass index, mild steatosis, and nonhepatic morbidities had no significant impact on liver stiffness. Liver stiffness values in participants without liver disease (healthy volunteers and healthy-liver patients; n = 125) ranged from 3.62 to 7.02 kPa (2.5th-97.5th percentiles). Notably, there was no overlap of liver stiffness measurements between the patients without liver disease and the cirrhosis cohort (13.29 ± 3.27 kPa [7.76-19.49 kPa]).

CONCLUSIONS

Liver stiffness values in healthy individuals vary widely and are not dependent on age, body mass index, or specific nonhepatic comorbidities. Liver stiffness values within the normal range can noninvasively rule out cirrhosis, as liver stiffness is significantly higher in cirrhotic patients (P < .001). Two-dimensional shear wave elastography has excellent interobserver agreement.

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Yoo J, Lee JM, Joo I, Yoon JH. Assessment of liver fibrosis using 2-dimensional shear wave elastography: a prospective study of intra- and inter-observer repeatability and comparison with point shear wave elastography. Ultrasonography 2019;39:52-59. [PMID: 31623416 PMCID: PMC6920625 DOI: 10.14366/usg.19013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 06/07/2019] [Indexed: 12/18/2022] Open

Abstract

PURPOSE

The purpose of this study was to prospectively investigate the intra- and interobserver repeatability of a new 2-dimensional (2D) shear wave elastography (SWE) technique (S-Shearwave Imaging) for assessing liver fibrosis in chronic liver disease patients, and to compare liver stiffness measurements (LSMs) made using 2D-SWE with those made using point SWE (pSWE).

METHODS

This prospective study received institutional review board approval and informed consent was obtained from all patients. Fifty-three chronic liver disease patients were randomly allocated to group 1 (for intra-observer repeatability [n=33]) or group 2 (for inter-observer repeatability [n=20]). In group 1, two 2D-SWE sessions and one pSWE sessions were performed by one radiologist. In group 2, one 2D-SWE session and one pSWE session were performed by the aforementioned radiologist, and a second 2D-SWE session was performed by another radiologist. The intraclass correlation coefficient (ICC) was used to assess intra- and interobserver reliability. LSMs obtained using 2D-SWE and pSWE were compared and correlated using the paired t test and Pearson correlation coefficient, respectively.

RESULTS

LSMs made using 2D-SWE demonstrated excellent intra- and inter-observer repeatability (ICC, 0.997 [95% confidence interval, 0.994 to 0.999]) and 0.995 [0.988 to 0.998], respectively). LSMs made using 2D-SWE were significantly different from those made using pSWE (2.1±0.6 m/sec vs. 1.9±0.6 m/sec, P<0.001), although a significant correlation existed between the 2D-SWE and pSWE LSMs (rho=0.836, P<0.001).

CONCLUSION

S-Shearwave Imaging demonstrated excellent intra- and inter-observer repeatability, and a strong correlation with pSWE measurements of liver stiffness. However, because of the significant difference between LSMs obtained using 2D-SWE and pSWE, these methods should not be used interchangeably.

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Grosu I, Bob F, Sporea I, Popescu A, Sirli R, Schiller A. Two-Dimensional Shear-Wave Elastography for Kidney Stiffness Assessment. Ultrasound Q 2019;37:144-148. [PMID: 31166295 DOI: 10.1097/ruq.0000000000000461] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]

A Noninvasive Method—Shear-Wave Elastography Compared With Transient Elastography in Evaluation of Liver Fibrosis in Patients With Chronic Hepatitis B. Ultrasound Q 2019;35:147-152. [DOI: 10.1097/ruq.0000000000000399] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]

Petzold G, Tsaknakis B, Bremer SCB, Knoop RF, G Goetze R, Amanzada A, Ellenrieder V, Neesse A, Kunsch S. Evaluation of liver stiffness by 2D-SWE in combination with non-invasive parameters as predictors for esophageal varices in patients with advanced chronic liver disease. Scand J Gastroenterol 2019;54:342-349. [PMID: 30879344 DOI: 10.1080/00365521.2019.1585571] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]

Zhang W, Zhu Y, Zhang C, Ran H. Diagnostic Accuracy of 2-Dimensional Shear Wave Elastography for the Staging of Liver Fibrosis: A Meta-analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019;38:733-740. [PMID: 30171621 PMCID: PMC7379518 DOI: 10.1002/jum.14760] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 06/01/2018] [Accepted: 06/29/2018] [Indexed: 05/12/2023]

Petzold G, Porsche M, Ellenrieder V, Kunsch S, Neesse A. Impact of Food Intake on Liver Stiffness Determined by 2-D Shear Wave Elastography: Prospective Interventional Study in 100 Healthy Patients. ULTRASOUND IN MEDICINE & BIOLOGY 2019;45:402-410. [PMID: 30396598 DOI: 10.1016/j.ultrasmedbio.2018.09.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 06/08/2023]

Performance of two--dimensional ultrasound shear wave elastography: reference values of normal liver stiffness in children. Pediatr Radiol 2019;49:91-98. [PMID: 30267166 DOI: 10.1007/s00247-018-4244-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 07/14/2018] [Accepted: 08/15/2018] [Indexed: 12/11/2022]

Ryu H, Ahn SJ, Yoon JH, Lee JM. Reproducibility of liver stiffness measurements made with two different 2-dimensional shear wave elastography systems using the comb-push technique. Ultrasonography 2018;38:246-254. [PMID: 30744303 PMCID: PMC6595128 DOI: 10.14366/usg.18046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 11/23/2018] [Indexed: 12/12/2022] Open

Chauhan A. The Emerging Role of Two-dimensional US Shear-Wave Elastography in Chronic Liver Disease. Radiology 2018;289:416-417. [DOI: 10.1148/radiol.2018181281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]

Moga TV, Stepan AM, Pienar C, Bende F, Popescu A, Șirli R, Dănilă M, Sporea I. Intra- and Inter-Observer Reproducibility of a 2-D Shear Wave Elastography Technique and the Impact of Ultrasound Experience in Achieving Reliable Data. ULTRASOUND IN MEDICINE & BIOLOGY 2018;44:1627-1637. [PMID: 29801976 DOI: 10.1016/j.ultrasmedbio.2018.03.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 03/06/2018] [Accepted: 03/29/2018] [Indexed: 06/08/2023]

Abstract

The aim of the study described here was to evaluate the reproducibility of a new shear-wave elastography (SWE) technique, 2-D SWE.GE, and the impact of ultrasound experience in acquiring reliable measurements, as no official recommendations are available for this system. Elastographic measurements (EMs) were obtained in 60 patients using 2-D-SWE with the GE Logiq E9. Three examiners with different levels of experience in ultrasound-based elastography performed 10 valid EMs on each subject: a novice (C.P.) who had no experience in liver elastography and had performed fewer than 50 ultrasound examinations; an elastography expert (A.M.S.) who had more than 1 y of liver elastographic experience in four elastographic methods and had performed more than 1000 ultrasonography examinations; and an ultrasound expert (T.M.) who had no experience in liver elastography and had performed more than 1000 ultrasound examinations. Medians and interquartile ranges were calculated (m/s). We used the inter-class correlation coefficient and Bland-Altman plots with 95% lower and upper limits of agreement to assess the inter- and intra-observer reproducibility of 2-D-SWE.GE measurements. The final study group included 60 patients, 56.7% women and 43.3% men, with a mean age of 33.08 ± 13.83 y and mean body mass index of 22.85 ± 4.04 kg/m². In this group, 73.3% were healthy volunteers and 26.7% had compensated liver cirrhosis. We did not find significant differences between EMs taken by the examiners overall and across study groups. The overall agreement between examiners was excellent: 0.915 (95% confidence interval [CI]: 0.870-0.946). The agreement between the novice and the experienced examiners, respectively, was good to excellent (novice and ultrasound expert: 0.908, 95% CI: 0.846-0.945; novice and elastography expert: 0.885, 95% CI: 0.808-0.931). The intra-observer reproducibility for each of the examiners was excellent; however, the inter-class correlation coefficients were higher for the examiners more experienced in elastography: 0.936 (95% CI: 0.896-0.963) versus 0.966 (95% CI: 0.943-0.980) versus 0.984 (95% CI: 0. 973-0.991). The good ICCs for the median values indicate that 2-D-SWE.GE is a reproducible method. Ultrasound experience did not significantly influence the results.

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Shear wave liver elastography. Abdom Radiol (NY) 2018;43:800-807. [PMID: 29116341 DOI: 10.1007/s00261-017-1375-1] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]

Bende F, Mulabecirovic A, Sporea I, Popescu A, Sirli R, Gilja OH, Vesterhus M, Havre RF. Assessing Liver Stiffness by 2-D Shear Wave Elastography in a Healthy Cohort. ULTRASOUND IN MEDICINE & BIOLOGY 2018;44:332-341. [PMID: 29249457 DOI: 10.1016/j.ultrasmedbio.2017.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/16/2017] [Accepted: 10/26/2017] [Indexed: 06/07/2023]