Diagnostic accuracy of two-dimensional shear wave elastography for the non-invasive staging of hepatic fibrosis in chronic hepatitis B: a cohort study with internal validation

Zeng, Jie; Liu, Guangjian; Huang, Zeping; Zheng, Jian; Wu, Tao; Zheng, Rongqin; Lü, Ming-De

doi:10.1007/s00330-014-3292-9

Cited by 92 publications

(112 citation statements)

References 32 publications

(39 reference statements)

Supporting

Mentioning

103

Contrasting

Unclassified

Order By: Relevance

“…As the patients held their breath, the 2D SWE was launched, and we placed the stiffness sample box, approximately 4 × 3 cm, at least 1 cm under the liver capsule and in an area of liver parenchyma free of large vessels. Five 2D SWE images were obtained for each patient and the median value of the 5 LSMs was used for the statistical analysis [15,30]. A 2D SWE examination was considered a failure if no valid measurement was obtained in the sample box [30].…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Two-Dimensional Shear Wave Elastography and Real-Time Tissue Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B

Wu¹,

Wang²,

Zhang³

et al. 2016

Dig Dis

Self Cite

View full text Add to dashboard Cite

Background: Noninvasive assessment of liver fibrosis has important clinical significance. Different techniques including two-dimensional shear-wave elastography (2D SWE) and real-time tissue elastography (RTE) are reported to be useful for the noninvasive diagnosis of hepatic fibrosis. All these techniques are affected by many factors. How to choose a reasonable method needs further studies. Purpose: This study was conducted to comparatively assess the diagnostic performance of 2D SWE and RTE in patients with Chronic Hepatitis B (CHB) and influence of inflammation on the stiffness values obtained by both techniques, so as to objectively assess the reasonable choice between these 2 elastography techniques for noninvasive assessment of hepatic fibrosis in clinical practice. Materials and Methods: Four-hundred and thirty-seven patients with CHB meeting the inclusion criteria were enrolled in the study. All patients underwent liver stiffness measurements by using 2D SWE and RTE on the same day. Histologic fibrosis was staged and inflammation activity was graded based on the METAVIR scoring system on liver biopsy specimens. Results: The liver stiffness values by using 2D SWE and RTE both increased in parallel with the degree of liver fibrosis and the grade of inflammation. However, the diagnostic efficacy of significant fibrosis and cirrhosis using 2D SWE was significantly higher than that of RTE. The 2D SWE measurement values were statistically different in different alanine aminotransferase (ALT) levels and METAVIR activity grades; however, no statistically significant differences were observed by using RTE. The diagnostic efficacy of 2D SWE significantly varied with elevated ALT levels compared with RTE. Conclusion: 2D SWE was more accurate than RTE in the assessment of significant fibrosis and cirrhosis in patients with CHB. Compared with RTE, the measurement values and diagnostic performance obtained by 2D SWE were prone to be more easily affected by the inflammation fluctuations.

show abstract

Section: Methodsmentioning

confidence: 99%

“…Two-dimensional shear-wave elastography (2D SWE) is a newly introduced shear-wave elastography. In recent years, an increasing number of studies have confirmed its noninvasive liver fibrosis evaluation capacity [29,30]. As a shear-wave elastography, 2D SWE might also be affected by inflammation or other factors.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Two-Dimensional Shear Wave Elastography and Real-Time Tissue Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B

Wu¹,

Wang²,

Zhang³

et al. 2016

Dig Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…On the other hand, the ability to visually control the elasticity maps in real time and to choose the "proper" one for liver stiffness measurement could be criticized as a potential source of subjectivity. The reliability of real-time two-dimensional SWE for the estimation of liver fibrosis severity appears to be comparable to other SE methods, with somewhat better performance reported for the early stages of liver fibrosis 9,10,[20][21][22][23][24] .…”

Section: Discussionmentioning

confidence: 69%

Assessment of Liver Fibrosis Using Real-time Shear-wave Elastography for Patients with Hepatitis B e Antigen-negative Chronic Hepatitis B and Alanine Transaminase <2 Times the Upper Limit of Normal

Liu

Zou

Chang

et al. 2017

RIC

View full text Add to dashboard Cite

Background:We assessed liver fibrosis using real-time shear-wave elastography (SWE) combined with liver biopsy (LB) for patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) and alanine transaminase < 2 times the upper limit of normal and hepatitis B virus DNA < 2000 IU/ml. Methods: A total of 107 patients met the inclusion criteria. Real-time SWE and ultrasoundassisted liver biopsies were consecutively performed. Fibrosis was staged according to the METAVIR scoring system. Analyses of receiver operating characteristic curve were performed to calculate the optimal area under the receiver operating characteristic curve for F0-F1 versus F2-F4, F0-F2 versus F3-F4, and F0-F3 versus F4 for real-time SWE. Results: The most concurrent liver fibrosis degrees were between F1 and F2 for these HBeAg-negative CHB patients. Liver stiffness increased in parallel with the degree of liver fibrosis using SWE measurements. The area under the receiver operating characteristic curves was 0.881 (95% confidence interval [CI]: 0.704-1.000) for SWE (p = 0.004); 0.912 (95% CI: 0.836-0.987) for SWE (p = 0.000); 0.981 (95% CI: 0.956-1.000) for SWE (p = 0.000); 0.974 (95% CI: 0.936-1.000) for SWE (p = 0.000) when comparing F0 versus F1-F4, F0-F1 versus F2-F4, F0-F2 versus F3-F4, and F0-F3 versus F4, respectively. Conclusions: SWE has the advantage of providing an image of liver stiffness in real-time. As an alternative to LB, the development of all these noninvasive methods for dynamic evaluation of liver fibrosis will decrease the need for LB, making clinical care safer and more convenient for patients with liver diseases.

show abstract

“…The AUROC for ≥F2 varies between 0.85 and 0.91 [58,196], with Young's modulus cut-offs between 7.1 and 8.0 kPa [195,196], while the AUROC for F4 varies between 0.92 and 0.98 [195,197], with optimal cut-offs between 10.1 and 11.7 kPa [58,195]. The best indications of 2D-SWE in HBV are inactive carriers to rule out significant fibrosis and cirrhosis diagnosis.…”

Section: Shear Wave Elastography (2d-swe)mentioning

confidence: 99%

“…A round shape is usually chosen [57,58]. The ROI should be placed over an isoechoic area of liver parenchyma, as seen on the grayscale image (no vessel, no nodule, no other structure), in priority in the middle line of the elastogram (avoiding positioning the Q Box on the edges of the elastogram), while also avoiding SWS artefactual areas (reverberation, noisy areas from rib shadowing).…”

Section: How To Measure?mentioning

confidence: 99%

Untitled

2017

Ultraschall in Med

View full text Add to dashboard Cite

Diagnostic accuracy of two-dimensional shear wave elastography for the non-invasive staging of hepatic fibrosis in chronic hepatitis B: a cohort study with internal validation

Cited by 92 publications

References 32 publications

Comparison of Two-Dimensional Shear Wave Elastography and Real-Time Tissue Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B

Comparison of Two-Dimensional Shear Wave Elastography and Real-Time Tissue Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B

Assessment of Liver Fibrosis Using Real-time Shear-wave Elastography for Patients with Hepatitis B e Antigen-negative Chronic Hepatitis B and Alanine Transaminase <2 Times the Upper Limit of Normal

Untitled

Contact Info

Product

Resources

About