Comparison of Visual Transient Elastography, Vibration Controlled Transient Elastography, Shear Wave Elastography and Sound Touch Elastography in Chronic liver Disease assessment using liver biopsy as ‘Gold Standard’

Gatos, Ilias; Yarmenitis, Spyros; Theotokas, Ioannis; Koskinas, John; Manesis, Emmanuel; Zoumpoulis, Spyros P.; Zoumpoulis, P.S.

doi:10.1016/j.ejrad.2022.110557

Cited by 8 publications

(12 citation statements)

References 25 publications

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“…We conclude that, for 2D-SWE, experience has minimal influence on the measurement of liver elasticity in patients with chronic liver disease. Our results also suggest an excellent correlation for TE, a result that is in agreement with a study by Gatos et al ( 31 ).…”

Section: Discussionsupporting

confidence: 94%

Two-dimensional shear wave elastography utilized in patients with ascites: a more reliable method than transient elastography for noninvasively detecting the liver stiffness—an original study with 170 patients

H¹,

Liao²,

Zheng³

et al. 2023

Ann Transl Med

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Background Two dimensional shear wave elastography (2D-SWE) is an ultrasound elastography technique based on shear waves implemented on a diagnostic ultrasound system. Transient elastography (TE) uses an ultrasound displacement M-mode and A-mode image produced by the system. So, TE mechanically induced impulse at tissue surface and difficultly across water. This paper compared the reliability and reproducibility of 2D-SWE with that of TE in patients with chronic hepatic disease. Comparisons were made in terms of the success rate, reliability, reproducibility, operation time, and influence of operator experience. Methods A total of 170 patients were included in this study. Participants underwent 2D-SWE and TE performed by 2 different operators (a novice and veteran) on the same day. Nonparametric statistical tests were used to compare the technical success rate and reliable measurement rate, and inter-operator reproducibility was evaluated using intra-class correlation coefficients (ICCs). Results The 2D-SWE technique showed a higher technical success rate than TE. Either 2D-SWE or TE can be utilized in patients with ascites lamella of less than 10 mm or ascites lamella plus skin-capsular distance of less than 25 mm. However, although the reliability rate of liver stiffness measurement with 2D-SWE did not significantly differ between the novice and veteran operators, for TE, there was a significant difference when body mass index (BMI) ≤25 kg/m 2 . When performed by the novice and veteran operators, 2D-SWE and TE both showed excellent inter-operator agreement, with ICCs of 0.968 and 0.973, respectively. Both 2D-SWE and TE displayed reliable measurement and excellent reproducibility in patients with chronic liver disease, were minimally influenced by operator experience. Conclusions 2D-SWE may be a more reliable method for clinical application in noninvasive detecting the liver stiffness.

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Section: Discussionsupporting

confidence: 94%

Two-dimensional shear wave elastography utilized in patients with ascites: a more reliable method than transient elastography for noninvasively detecting the liver stiffness—an original study with 170 patients

H¹,

Liao²,

Zheng³

et al. 2023

Ann Transl Med

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“…The correlation coefficients between ViTE and transient elastography, STE and transient elastography, STQ and transient elastography were 0.863, 0.709, and 0.727, respectively. These results are consistent with previous studies and show reliability in evaluating liver fibrosis in CLD[20,21]. Ilias Gatos et al[20] conducted that ICC among ViTE, STE, and transient elastography was 0.87; rho were 0.92, 0.94 for ViTE and transient elastography, STE and transient elastography, respectively.…”

supporting

confidence: 90%

“…These results are consistent with previous studies and show reliability in evaluating liver fibrosis in CLD[20,21]. Ilias Gatos et al[20] conducted that ICC among ViTE, STE, and transient elastography was 0.87; rho were 0.92, 0.94 for ViTE and transient elastography, STE and transient elastography, respectively. In addition, Ren et al[21] enrolled 227 chronic hepatitis B patients and found correlation coefficients of ViTE, transient elastography, and liver fibrosis stage of 0.852 and 0.813, respectively, which indicated a high correlation.…”

supporting

confidence: 90%

A comparative study of three ultrasound techniques for liver fibrosis staging

Shen,

Zhang,

Yang

et al. 2024

European Journal of Gastroenterology &Amp; Hepatology

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The aim of this study is to assess the agreement and performance of visual transient elastography (ViTE), sound touch elastography (STE), and sound touch quantification (STQ) for liver fibrosis staging using transient elastography (TE) as a standard. We finally enrolled 252 subjects with chronic liver disease (CLD) who underwent ViTE, STE, STQ, and TE examinations simultaneously in our hospital from October 2022 to July 2023. We evaluated the correlation and agreement between various technologies. And also evaluated the performances and optimal cutoffs of ViTE, STE, and STQ . The correlation coefficients of ViTE and TE, STE and TE, STQ and TE were 0.863, 0.709, and 0.727, respectively. The ICC among ViTE, STE, STQ, and TE was 0.911. The area under the receiver operating characteristics (AUROCs) of ViTE, STE, and STQ for detection of TE of ≥5 kPa, ≥10 kPa, ≥15 kPa, and ≥20 kPa were 0.867, 0.771, 0.804; 0.972, 0.935, 0.933; 0.998, 0.973, 0.968; and 1.000, 0.960, 0.954, respectively. The AUROCs of ViTE for detection of lower stages (TE≥5 kPa and ≥10 kPa) were significantly higher than STE and STQ in the overall cohort (ViTE vs. STE: Z = 2.766, for TE ≥5 kPa; ViTE vs. STE: Z = 2.145, ; ViTE vs. STQ: Z = 2.587, for TE ≥10 kPa) (all P < 0.05). These methods all have coincided with performance in more advanced stages (TE ≥15 kPa and ≥20 kPa) (all P > 0.05). These methods showed excellent correlation and agreement. ViTE performance in more advanced fibrosis differentiation is comparable to the STE and STQ while ViTE is more accurate than STE and STQ to identify patients with mild CLD stage, and can more effectively rule out compensated advanced CLD.

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“…Therefore, a correct diagnosis is of paramount importance in the attempt to draw a correct risk profile for each patient. To this aim, liver elastography is definitely an ideal method, 27,28 and it can be used as a reliable test for the detection of fibrosis even in severely obese patients, as in a multicentre study performed in France, Malaysia and Hong Kong in individuals with NAFLD. 29 In this study, all the surrogate measures of fibrosis and LS performed equally well in non-obese and obese patients, allowing the use of the same cut-offs with similar or higher sensitivities and specificities.…”

Section: Discussionmentioning

confidence: 99%

Simple proxies of insulin resistance identify obese metabolic dysfunction‐associated fatty liver disease subjects with advanced liver disease

Petralli,

Salvati,

Tricò

et al. 2023

Diabetes Metabolism Res

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AimsInsulin resistance (IR) plays a pivotal role in the pathogenesis of Metabolic dysfunction‐Associated Fatty Liver Disease (MAFLD), which can progress to liver fibrosis. We examined the relationship of different IR scores with markers of MAFLD severity in obese individuals.Materials and MethodsIn this retrospective observational study, 346 non‐diabetic, overweight/obese individuals with newly diagnosed MAFLD (age 50.2 ± 13.3 years, 34% females, BMI 30.8 ± 4.4 kg/m2) underwent liver stiffness (LS) and controlled attenuation parameter (CAP) measurements by Fibroscan® to assess liver fibrosis and steatosis. Biochemical data were collected to calculate surrogate markers of IR (Homoeostasis model assessment ‐ insulin resistance index [HOMA‐IR], triglyceride‐glucose index, triglyceride by HDL ratio), liver fibrosis (Nonalcoholic Fatty Liver Diseases fibrosis score, fibrosis‐4 score, Aspartate aminotransferase to platelet ratio index) and steatosis (fatty liver index, hepatic steatosis index).ResultsAll three IR scores were associated with CAP, while only HOMA‐IR positively correlated with LS (r = 0.275, p < 0.0001), independent of age and sex, BMI, transaminases, and fibrosis markers. Insulin‐resistant individuals (HOMA‐IR >2.5, n = 165) had higher liver enzymes, CAP and LS, with a 4‐fold increased risk of severe liver disease (LS >9.7 kPa, OR 4.42[1.95–10.01], p = 0.0002). Among HOMA‐IR components, fasting plasma insulin (FPI) was independently associated with LS (r = 0.270, p < 0.0001). ROC AUC for HOMA‐IR and FPI to predict severe liver disease were virtually identical (0.748 and 0.758, respectively).ConclusionsHOMA‐IR is independently associated with non‐invasive markers of MAFLD severity in overweight/obese individuals. This relationship is largely mediated by hyperinsulinemia, regardless of BMI. Measuring insulin levels in MAFLD individuals might be useful to identify those at risk of liver fibrosis.

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Comparison of Visual Transient Elastography, Vibration Controlled Transient Elastography, Shear Wave Elastography and Sound Touch Elastography in Chronic liver Disease assessment using liver biopsy as ‘Gold Standard’

Cited by 8 publications

References 25 publications

Two-dimensional shear wave elastography utilized in patients with ascites: a more reliable method than transient elastography for noninvasively detecting the liver stiffness—an original study with 170 patients

Two-dimensional shear wave elastography utilized in patients with ascites: a more reliable method than transient elastography for noninvasively detecting the liver stiffness—an original study with 170 patients

A comparative study of three ultrasound techniques for liver fibrosis staging

Simple proxies of insulin resistance identify obese metabolic dysfunction‐associated fatty liver disease subjects with advanced liver disease

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