Comparison of 2D Shear Wave Elastography, Transient Elastography, and MR Elastography for the Diagnosis of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease

Furlan, Alessandro; Tublin, Mitchell; Yu, Lan; Chopra, Kapil; Lippello, Anita; Behari, Jaideep

doi:10.2214/ajr.19.21267

Cited by 91 publications

(83 citation statements)

References 25 publications

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“…Alternative cutoffs calculated in order to achieve high sensitivity or specificity (≥90%) of liver stiffness measurements by TE and SWE-10, SWE-5, or SWE-3 for the diagnosis of significant (F2-F4) and advanced fibrosis (F3-F4) [12,17,20,21]. Our results are concordant with those of Furlan et al [20], who reported comparable diagnostic accuracy of SWE to conventional TE for the identification of significant and advanced fibrosis in NAFLD patients. In our study, the optimal cutoffs of ≥8.4 kPa and ≥9.1 kPa obtained by SWE-10 provided a sensitivity of 74.0% and a specificity of 73.7% for the diagnosis of significant fibrosis, and a sensitivity of 72.2% and a specificity of 78.5% for the diagnosis of advanced fibrosis, respectively.…”

Section: A)supporting

confidence: 90%

Liver stiffness quantification in biopsy-proven nonalcoholic fatty liver disease patients using shear wave elastography in comparison with transient elastography

Taibbi¹,

Petta

Matranga

et al. 2021

Ultrasonography

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This study prospectively assessed the performance of liver stiffness measurements using point shear-wave elastography (p-SWE) in comparison with transient elastography (TE) in patients with biopsy-proven nonalcoholic fatty liver disease (NAFLD). Methods: Fifty-six consecutive adult patients with a histological diagnosis of NAFLD prospectively underwent TE and p-SWE on the same day. The median of 10 measurements (SWE-10), the first five (SWE-5), and the first three (SWE-3) measurements were analyzed for p-SWE. Liver biopsy was considered as the reference standard for liver fibrosis grade. Receiver operating characteristic (ROC) curves and areas under the ROC curves (AUROCs) were calculated to assess the performance of TE and p-SWE for the diagnosis of significant (F2-F4) and advanced fibrosis (F3-F4). Results: Forty-six patients (27 men, 19 women; mean age, 54.7±9.1 years) had valid p-SWE and TE measurements. Twenty-seven patients (58.7%) had significant fibrosis and 18 (39.1%) had advanced fibrosis.

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Section: A)supporting

confidence: 90%

Liver stiffness quantification in biopsy-proven nonalcoholic fatty liver disease patients using shear wave elastography in comparison with transient elastography

Taibbi¹,

Petta

Matranga

et al. 2021

Ultrasonography

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“…Anyway, this is a cost and time-consuming method, with limited availability. Some new modules of elastography are used in clinical practice with similar diagnostic accuracy for fibrosis 22 . However, they do not have the same validity and approved quality criteria as TE 3,17 and do not provide any information on steatosis quantification.…”

Section: Discussionmentioning

confidence: 99%

Microbiota analysis and transient elastography reveal new extra-hepatic components of liver steatosis and fibrosis in obese patients

Lanthier

Rodriguez

Nachit

et al. 2021

Sci Rep

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Obesity could lead to metabolic dysfunction-associated fatty liver disease (MAFLD), which severity could be linked to muscle and gut microbiota disturbances. Our prospective study enrolled 52 obese patients whose MAFLD severity was estimated by transient elastography. Patients with severe steatosis (n = 36) had higher ALAT values, fasting blood glucose levels as well as higher visceral adipose tissue area and skeletal muscle index evaluated by computed tomography. Patients with fibrosis (n = 13) had higher ASAT values, increased whole muscle area and lower skeletal muscle density index. In a multivariate logistic regression analysis, myosteatosis was the strongest factor associated with fibrosis. Illumina sequencing of 16S rRNA gene amplicon was performed on fecal samples. The relative abundance of fecal Clostridium sensu stricto was significantly decreased with the presence of liver fibrosis and was negatively associated with liver stiffness measurement and myosteatosis. In addition, 19 amplicon sequence variants were regulated according to the severity of the disease. Linear discriminant analysis effect size (LEfSe) also highlighted discriminant microbes in patients with fibrosis, such as an enrichment of Enterobacteriaceae and Escherichia/Shigella compared to patients with severe steatosis without fibrosis. All those data suggest a gut-liver-muscle axis in the pathogenesis of MAFLD complications.

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“…Furthermore, in a recent comparison study on 62 biopsy-proven NAFLD subjects, 2D-SWE did not demonstrate lower diagnostic accuracy than MRE for detection of AF. Nevertheless, even if this technique gave promising results, it needs further validation in NAFLD settings [140].…”

Section: D-swementioning

confidence: 99%

The diagnostic conundrum in non-alcoholic fatty liver disease

Rosato

Masarone

Aglitti

et al. 2020

Exploration of Medicine

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Non-alcoholic fatty liver disease (NAFLD) has become the most common liver alteration worldwide. It encompasses a spectrum of disorders that range from simple steatosis to a progressive form, defined non-alcoholic steatohepatitis (NASH), that can lead to advanced fibrosis and eventually cirrhosis and hepatocellular carcinoma. On liver histology, NASH is characterized by the concomitant presence of significant fat accumulation and inflammatory reaction with hepatocellular injury. Until now, liver biopsy is still required to differentiate simple steatosis from NASH and evaluate the degree of liver fibrosis. Unfortunately, this technique has well-known limitations, including invasiveness and expensiveness. Moreover, it may be biased by sampling error and intra- or inter-observed variability. Furthermore, due to the increasing prevalence of NAFLD worldwide, to program a systematic screening with liver biopsy is not imaginable. In recent years, different techniques were developed and validated with the aim of non-invasively identifying NASH and assess liver fibrosis degrees. The non-invasive tests range from simple blood-tests analyses to composite scores and complex imaging techniques. Nevertheless, even if they could represent cost-effective strategies for diagnosing NASH, advanced fibrosis and cirrhosis, their accuracy and consequent usefulness are to be discussed. With this aim, in this review the authors summarize the current state of non-invasive assessment of NAFLD. In particular, in addition to the well-established tests, the authors describe the future perspectives in this field, reporting the latest tests based on OMICS, gut-miocrobioma and micro-RNAs. Finally, the authors provide an accurate assessment of how these non-invasive tools perform in clinical practice depending on the clinical context, with the aim of giving the clinicians a useful tool to try to resolve the diagnostic conundrum of NAFLD.

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Comparison of 2D Shear Wave Elastography, Transient Elastography, and MR Elastography for the Diagnosis of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease

Cited by 91 publications

References 25 publications

Liver stiffness quantification in biopsy-proven nonalcoholic fatty liver disease patients using shear wave elastography in comparison with transient elastography

Liver stiffness quantification in biopsy-proven nonalcoholic fatty liver disease patients using shear wave elastography in comparison with transient elastography

Microbiota analysis and transient elastography reveal new extra-hepatic components of liver steatosis and fibrosis in obese patients

The diagnostic conundrum in non-alcoholic fatty liver disease

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