Reliability Criteria of Two-Dimensional Shear Wave Elastography: Analysis of 4277 Measurements in 788 Patients

Pathil, Anita; Lemoine, S.; Cassinotto, Christophe; Lédinghen, Victor de; Ronot, Maxime; Irlès‐Depé, Marie; Vilgrain, Valérie; Bail, Brigitte Le; Paradis, Valérie; Canivet, Clémence M.; Michalak, Sophie; Rousselet, Marie‐Christine; Rautou, Pierre‐Emmanuel; Lebigot, J.; Hunault, Gilles; Crouan, Anne; Aubé, Christophe; Boursier, Jérôme

doi:10.1016/j.cgh.2020.12.013

Cited by 16 publications

(11 citation statements)

References 23 publications

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“…The limited number of patients prevented us from analyzing the imaging markers separately in hepatitis B and C patients and necessitated the pooling of the patients without or with substantial necro-inflammation (A0/A1 vs. A2/A3) and with no/mild fibrosis (F0/F1) versus moderate fibrosis (F2) and advanced fibrosis (F3/F4). However, similar pooling has been recommended in previous large clinical studies and may have clinical relevance 33 , 36 , 37 . Indeed, substantial necro-inflammation (A2/A3) is considered to be clinically significant 33 and advanced fibrosis (F3/F4) without cirrhotic decompensation is considered to correspond to clinically advanced compensated chronic liver disease 37 .…”

Section: Discussionmentioning

confidence: 96%

Necro-inflammatory activity grading in chronic viral hepatitis with three-dimensional multifrequency MR elastography

Garteiser

Pagé

d’Assignies

et al. 2021

Sci Rep

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The purpose of this study was to assess the diagnostic value of multifrequency MR elastography for grading necro-inflammation in the liver. Fifty participants with chronic hepatitis B or C were recruited for this institutional review board-approved study. Their liver was examined with multifrequency MR elastography. The storage, shear and loss moduli, and the damping ratio were measured at 56 Hz. The multifrequency wave dispersion coefficient of the shear modulus was calculated. The measurements were compared to reference markers of necro-inflammation and fibrosis with Spearman correlations and multiple regression analysis. Diagnostic accuracy was assessed. At multiple regression analysis, necro-inflammation was the only determinant of the multifrequency dispersion coefficient, whereas fibrosis was the only determinant of the storage, loss and shear moduli. The multifrequency dispersion coefficient had the largest AUC for necro-inflammatory activity A ≥ 2 [0.84 (0.71–0.93) vs. storage modulus AUC: 0.65 (0.50–0.79), p = 0.03], whereas the storage modulus had the largest AUC for fibrosis F ≥ 2 [AUC (95% confidence intervals) 0.91 (0.79–0.98)] and cirrhosis F4 [0.97 (0.88–1.00)]. The measurement of the multifrequency dispersion coefficient at three-dimensional MR elastography has the potential to grade liver necro-inflammation in patients with chronic vial hepatitis.

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Section: Discussionmentioning

confidence: 96%

Necro-inflammatory activity grading in chronic viral hepatitis with three-dimensional multifrequency MR elastography

Garteiser

Pagé

d’Assignies

et al. 2021

Sci Rep

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“… 35 VCTE has been shown to be useful for differentiation of fibrosis in NAFLD, although prior studies have suggested that VCTE may be less accurate in distinguishing lower fibrosis stages. 36 , 37 While emerging evidence suggests that 2D-SWE is also accurate in differentiation of hepatic fibrosis, most studies to date have included persons with diverse etiologies of liver disease, 15 – 17 , 20 , 38 highlighting the need for a better understanding of the diagnostic accuracy and optimal diagnostic thresholds of 2D-SWE in adults with NAFLD. Furthermore, prospective studies that directly compare diagnostic accuracy between VCTE and 2D-SWE in adults with NAFLD are limited.…”

Section: Discussionmentioning

confidence: 99%

“… 32 Technical failure was defined as inability to obtain ⩾10 or ⩾3 valid measurements for VCTE and 2D-SWE, respectively. 17 Liver stiffness measurement was considered unreliable when interquartile range (IQR)/median was >0.30 in patients with median ⩾ 7.1 kPa. 33 Patients with a technical failure and/or unreliable examination were excluded from analyses, which included four patients (three unreliable, one technical failure) that met study inclusion criteria (4/118, 3.4%).…”

Section: Methodsmentioning

confidence: 99%

“…15 While recent studies have examined diagnostic performance of SWE methods in chronic liver disease, most have either utilized point SWE instead of 2D-SWE and/or included participants with a diverse range of liver disease etiologies. [15][16][17][18][19][20][21][22][23][24][25] Data on disease-specific accuracy and cutoff values of 2D-SWE for staging hepatic fibrosis in adults with NAFLD, 26 especially when compared with VCTE, [27][28][29] are limited.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of two-dimensional shear wave elastography and transient elastography in nonalcoholic fatty liver disease

Sharpton

Tamaki

Bettencourt

et al. 2021

Therap Adv Gastroenterol

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Introduction: Two-dimensional shear wave elastography (2D-SWE) and vibration-controlled transient elastography (VCTE) provide noninvasive assessment of hepatic fibrosis. We compared performance of 2D-SWE and VCTE for fibrosis detection in nonalcoholic fatty liver disease (NAFLD). Methods: We performed a prospective study of adults with NAFLD who underwent 2D-SWE, VCTE, and liver biopsy analysis (using Nonalcoholic Steatohepatitis Clinical Research Network scoring system). The primary outcome was hepatic fibrosis (stage ⩾ 1); secondary outcomes included dichotomized fibrosis stages. Area under receiver operating characteristic curve (AUROC) analyses were used to compare 2D-SWE and VCTE performance. Results: A total of 114 adults with a median BMI of 31.2 kg/m2 were included. The VCTE was better than 2D-SWE for the detection of fibrosis (AUROC: 0.81 versus 0.72, p = 0.03). The VCTE detected fibrosis stage 2, 3, or 4 with AUROCs of 0.86 (95% CI, 0.80–0.93), 0.91 (95% CI, 0.82–0.99), and 0.96 (95% CI, 0.91–1.00). The 2D-SWE detected fibrosis stage 2, 3, or 4 with AUROCs of 0.84 (95% CI, 0.76–0.92), 0.88 (95% CI, 0.81–0.96), and 0.93 (95% CI, 0.86–0.99). Conclusion: In a prospective study including more than 100 adults with NAFLD, we found VCTE to be more accurate than 2D-SWE in detecting fibrosis; these modalities, however, are comparable in assessing for higher stages of fibrosis.

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“…A technical failure was defined as the inability to obtain at least 3 valid measurements. [14] 4. Operational definitions A chronic liver disease was defined by persistent liver test abnormalities associated with an identified cause (alcohol, virus...) for at least six months.…”

Section: Two Dimensional-shear Wave Elastography (2d-swe)mentioning

confidence: 99%

Fibroscan® and Shear Wave correlated well in hepatic fibrosis evaluation of patients with chronic liver diseases “in real life situation”

et al. 2022

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Background: A new noninvasive medical device based on ultrasound elastography such as the Shear Wave Elastography (SWE) was designed in order to measure the liver hardness. The purpose of this work was to evaluate the correlation of the results of the liver elasticity measurements obtained by Fibroscan® (FS) and SWE for patients with chronic liver diseases. Methods: Between January and October 2017, the patients who were followed during this period of time underwent noninvasive assessments of liver fibrosis by SWE in the intercostal spaces during abdominal ultrasound procedures and/or FS. The correlation between FS and SWE was estimated and tested at a 0.05 significance level. Results: Four hundred and seventy-six patients were included in this study. The main etiologies of chronic liver disease were non alcoholic fatty disease (NAFLD), chronic viral hepatitis B (HBV) and chronic viral hepatitis C (HCV). All patients underwent a SWE and 167 among them underwent a FS procedure. The patients who were followed revealed a median FS measurement of 5.80 kpa (Q25 = 4.90 kPa; Q75 = 8 kPa) and a median SWE measurement of 7.00 kPa (Q25 = 6.10 kPa; Q75 = 8.10 kPa). We could observe a significant correlation between the FS and SWE measurements (0.49; P = .001) in the total cohort. The average absolute difference between the measurements of these 2 methods was of 2.54 kPa (sd = 3.39). There was no significant correlation for patients with NAFLD no matter whether they presented with signs of suspected non alcoholic steatohepatitis (NASH) or not ( R = 0.20; P = .108). All patients intending to perform the examination were able to undergo the SWE, allowing 33.3% of the patients who failed the FS to have a noninvasive evaluation of their fibrosis. Conclusion: The SWE technique proved to be as efficient as the FS one for the evaluation of the liver fibrosis in real life situation.

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Reliability Criteria of Two-Dimensional Shear Wave Elastography: Analysis of 4277 Measurements in 788 Patients

Cited by 16 publications

References 23 publications

Necro-inflammatory activity grading in chronic viral hepatitis with three-dimensional multifrequency MR elastography

Necro-inflammatory activity grading in chronic viral hepatitis with three-dimensional multifrequency MR elastography

Diagnostic accuracy of two-dimensional shear wave elastography and transient elastography in nonalcoholic fatty liver disease

Fibroscan® and Shear Wave correlated well in hepatic fibrosis evaluation of patients with chronic liver diseases “in real life situation”

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