Reproducibility of 2‐Dimensional Shear Wave Elastography Assessment of the Liver: A Direct Comparison With Point Shear Wave Elastography in Healthy Volunteers

Fang, Cheng; Konstantatou, Eleni; Romanos, Odyssefs; Yusuf, Gibran Timothy; Quinlan, Daniel J.; Sidhu, Paul S.

doi:10.7863/ultra.16.07018

Cited by 40 publications

(34 citation statements)

References 42 publications

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“…First, an evaluation of interobserver variability could not be conducted, since a single investigator performed the measurements. Although there have been studies with SWE conducted by a single investigator, very high rates of interobserver agreement have been identified in many studies using the SWE method . Second, the elasticity values could not be compared with histopathologic findings in this study, since this study was an in vivo human study, which made histologic evaluation impossible.…”

Section: Discussionmentioning

confidence: 94%

“…Although there have been studies with SWE conducted by a single investigator, 25,26,32 very high rates of interobserver agreement have been identified in many studies using the SWE method. [33][34][35] Second, the elasticity values could not be compared with histopathologic findings in this study, since this study was an in vivo human study, which made histologic evaluation impossible. Third, we did not make additional measurements of the same individuals in subsequent weeks.…”

Section: Used This Methods Inmentioning

confidence: 99%

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Evaluation of Neonatal Brain Parenchyma Using 2‐Dimensional Shear Wave Elastography

Albayrak

Kasap

2017

J of Ultrasound Medicine

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Section: Discussionmentioning

confidence: 94%

Section: Used This Methods Inmentioning

confidence: 99%

Evaluation of Neonatal Brain Parenchyma Using 2‐Dimensional Shear Wave Elastography

Albayrak

Kasap

2017

J of Ultrasound Medicine

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“…The US device used in 28 studies was Aixplorer (Supersonic Imagine, Strasbourg, France) (9101112131516171819202325262728293132333435363738394041). Either LOGIQ E9 (GE Healthcare, Chicago, IL, USA) (8142230) or Aplio 500 (Canon Medical Systems, Otawara, Japan) (2124) was used in the remaining 6 studies.…”

Section: Resultsmentioning

confidence: 99%

“…Although 2D-SWE systems from different manufacturers have custom built-in indicators for better measurement quality and stability, the evidence supporting them are limited (7). Indeed, previous studies evaluating the technical performance of 2D-SWE were generally small-scale studies with low-level evidence (891011121314151617181920212223242526272829303132333435363738394041). To increase the level of evidence and arrive at more evidence-based results, sufficient evidence should be accumulated and summarized.…”

Section: Introductionmentioning

confidence: 99%

Technical Performance of Two-Dimensional Shear Wave Elastography for Measuring Liver Stiffness: A Systematic Review and Meta-Analysis

et al. 2019

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Objective To assess the technical performance of two-dimensional shear wave elastography (2D-SWE) for measuring liver stiffness. Materials and Methods The Ovid-MEDLINE and EMBASE databases were searched for studies reporting the technical performance of 2D-SWE, including concerns with technical failures, unreliable measurements, interobserver reliability, and/or intraobserver reliability, published until June 30, 2018. The pooled proportion of technical failure and unreliable measurements was calculated using meta-analytic pooling via the random-effects model and inverse variance method for calculating weights. Subgroup analyses were performed to explore potential causes of heterogeneity. The pooled intraclass correlation coefficients (ICCs) for interobserver and intraobserver reliability were calculated using the Hedges-Olkin method with Fisher's Z transformation of the correlation coefficient. Results The search yielded 34 articles. From 20 2D-SWE studies including 6196 patients, the pooled proportion of technical failure was 2.3% (95% confidence interval [CI], 1.3–3.9%). The pooled proportion of unreliable measurements from 20 studies including 6961 patients was 7.5% (95% CI, 4.7–11.7%). In the subgroup analyses, studies conducting more than three measurements showed fewer unreliable measurements than did those with three measurements or less, but no intergroup difference was found in technical failure. The pooled ICCs for interobserver reliability (from 10 studies including 517 patients) and intraobserver reliability (from 7 studies including 679 patients) were 0.87 (95% CI, 0.82–0.90) and 0.93 (95% CI, 0.89–0.95), respectively, suggesting good to excellent reliability. Conclusion 2D-SWE shows good technical performance for assessing liver stiffness, with high technical success and reliability. Future studies should establish the quality criteria and optimal number of measurements.

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“…Interobserver variability is a general problem for US diagnostics. Only a few studies have addressed this issue using small numbers of probands or phantom models . To our knowledge, we addressed this issue for the first time for examiners with different expertise levels in a subgroup of 20 healthy individuals.…”

Section: Discussionmentioning

confidence: 99%

Liver Stiffness Measured by 2‐Dimensional Shear Wave Elastography: Prospective Evaluation of Healthy Volunteers and Patients With Liver Cirrhosis

Petzold¹,

Hofer²,

Ellenrieder³

et al. 2018

J of Ultrasound Medicine

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Objectives-We aimed to establish normal values for liver stiffness measurement, performed by 2-dimensional shear wave elastography (LOGIQ E9; GE Healthcare, Wauwatosa, WI), in healthy volunteers, patients with nonhepatic morbidities, and patients with histologically confirmed liver cirrhosis.Methods-A total of 175 participants were included between July 2016 and February 2018. Three cohorts were analyzed: healthy volunteers (n = 68), patients with healthy livers but nonhepatic morbidities (n = 57), and patients with liver cirrhosis (n = 50). Liver stiffness measurement was performed by 2 observers with different levels of experience to determine interobserver agreement.Results-Of the 175 participants included, 91 were male, and the mean age ± SD was 44.4 ± 19.4 years. The success rate for 175 liver stiffness measurements was 95.4%. The number of unsuccessful measurements was significantly higher in the liver cirrhosis cohort (P = .04). The interobserver agreement was excellent (intraclass correlation coefficient, 0.87). Liver stiffness in the healthy-liver patient cohort (4.93 ± 0.83 kPa) was not significantly different from that in the healthy-volunteer cohort (5.19 ± 1.03 kPa; P = .13). Apart from male sex in the healthy-volunteer cohort, age, body mass index, mild steatosis, and nonhepatic morbidities had no significant impact on liver stiffness. Liver stiffness values in participants without liver disease (healthy volunteers and healthy-liver patients; n = 125) ranged from 3.62 to 7.02 kPa (2.5th-97.5th percentiles). Notably, there was no overlap of liver stiffness measurements between the patients without liver disease and the cirrhosis cohort ).Conclusions-Liver stiffness values in healthy individuals vary widely and are not dependent on age, body mass index, or specific nonhepatic comorbidities. Liver stiffness values within the normal range can noninvasively rule out cirrhosis, as liver stiffness is significantly higher in cirrhotic patients (P < .001). Twodimensional shear wave elastography has excellent interobserver agreement.

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Reproducibility of 2‐Dimensional Shear Wave Elastography Assessment of the Liver: A Direct Comparison With Point Shear Wave Elastography in Healthy Volunteers

Abstract: Two-dimensional SWE using LOGIQ E9 is a reliable and reproducible method for measuring elasticity in healthy volunteers and has a similar degree of reliability as p-SWE using VTQ, but absolute measurements from the two techniques should not be used interchangeably.

Cited by 40 publications

References 42 publications

Evaluation of Neonatal Brain Parenchyma Using 2‐Dimensional Shear Wave Elastography

Evaluation of Neonatal Brain Parenchyma Using 2‐Dimensional Shear Wave Elastography

Technical Performance of Two-Dimensional Shear Wave Elastography for Measuring Liver Stiffness: A Systematic Review and Meta-Analysis

Liver Stiffness Measured by 2‐Dimensional Shear Wave Elastography: Prospective Evaluation of Healthy Volunteers and Patients With Liver Cirrhosis

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