Liver elasticity in healthy individuals by two novel shear-wave elastography systems—Comparison by age, gender, BMI and number of measurements

Abstract

ObjectiveEstablishing normal liver stiffness (LS) values in healthy livers is a prerequisite to differentiate normal from pathological LS values. Our aim was to define normal LS using two novel elastography methods head-to-head and to assess the number of measurements, variability and reproducibility.Materials and methodsWe evaluated shear wave elastography (SWE) methods integrated in Samsung RS80A and GE S8 by obtaining LS measurements (LSM) in 100 healthy subjects (20–70 years). Transient Elastography (TE) was used as reference method. Data were analyzed according to age, sex, BMI and 5 vs. 10 measurements. All subjects underwent B-mode ultrasound examination and lab tests to exclude liver pathology. Interobserver variation was evaluated in a subset (n = 24).ResultsBoth methods showed excellent feasibility, measuring LS in all subjects. LSM-mean for GE S8 2D-SWE was higher compared to TE (4.5±0.8 kPa vs. 4.2±1.1, p<0.001) and Samsung RS80A (4.1±0.8 kPa, p<0.001). Both methods showed low intra- and interobserver variation. LSM-mean was significantly higher in males than females using 2D-SWE, while a similar trend for Samsung SWE did not reach significance. No method demonstrated statistical significant difference in LSM across age and BMI groups nor between LSM-mean based on 5 vs. 10 measurements.ConclusionLSM was performed with high reproducibility in healthy adult livers. LSM-mean was significantly higher for GE S8 2D-SWE compared to Samsung RS80A and TE in healthy livers. Males had higher LSM than females. No method demonstrated statistical significant difference in LSM-mean across age- and non-obese BMI groups. Our results indicate that five LSM may be sufficient for reliable results.

Profiles of advanced hepatic fibrosis evaluated by FIB‐4 index and shear wave elastography in health checkup examinees

“…We found that higher age was most strongly associated with advanced hepatic fibrosis in both the logistic regression and decision‐tree analyses. However, the previous study showed that age is not associated with an increase in liver stiffness . This result differs from the present result, and this might be attributed to the number and characteristics of enrolled participants.…”

“…However, the previous study showed that age is not associated with an increase in liver stiffness. 26 This result differs from the present result, and this might be attributed to the number and characteristics of enrolled participants. In the previous study, the number of participants was 20 in the group aged ≥61 years, and no participants aged ≥71 years were enrolled.…”

“…Mulabecirovic et al . proposed that hepatic fibrosis might be influenced by various diseases associated with aging . In fact, in the present study, the prevalence of advanced hepatic fibrosis increased along with aging in non‐healthy individuals, supporting this hypothesis.…”

“…In the previous study, the number of participants was 20 in the group aged ≥61 years, and no participants aged ≥71 years were enrolled. 26 Whereas, in the present study, 321 participants were aged ≥61 years, and the oldest participant was aged 89 years. Koehler et al analyzed a larger population database and reported that age is the significant factor related to higher liver stiffness, 1 which is consistent with the present results.…”

“…This result differs from the present result, and this might be attributed to the number and characteristics of enrolled participants. In the previous study, the number of participants was 20 in the group aged ≥61 years, and no participants aged ≥71 years were enrolled . Whereas, in the present study, 321 participants were aged ≥61 years, and the oldest participant was aged 89 years.…”