Ruling-in and Ruling-out Significant Fibrosis and Cirrhosis in Patients with Chronic Hepatitis C Using a Shear Wave Measurement Method

Ferraioli, Giovanna; Maiocchi, Laura; Lissandrin, Raffaella; Tinelli, Carmine; Silvestri, Annalisa De; Fı̀lice, Carlo

doi:10.15403/jgld.2014.1121.262.fer

Cited by 16 publications

(11 citation statements)

References 12 publications

(12 reference statements)

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“…In this study, we evaluated a consecutive cohort of difficult patients in a nonacademic outpatient setting to determine the time to perform the examination and determine the range of LS, attenuation coefficient, and shear wave dispersion slopes by US. SWE is maturing with several organizations providing recommendations for performing and interpreting LS results [7,[24][25][26][27][28]. Guidelines have recommended not using Metavir cut-off values but the probability of cACLD as this is what is clinically important as these are the patients who are at risk for the complications of CLD including portal hypertension, liver failure, and hepatocellular carcinoma [22].…”

Section: Discussionmentioning

confidence: 99%

Assessment of chronic liver disease by multiparametric ultrasound: results from a private practice outpatient facility

2021

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Purpose To assess chronic liver disease (CLD) using multiparametric US in a private practice setting in a cohort of patients with increased skin-to-liver distance. Methods 110 consecutive patients with increased skin-to-liver distance scheduled for US assessment of CLD were reviewed for study completion time, liver stiffness values (LS), attenuation imaging, and shear wave dispersion slope. The ROI was placed 2 cm below the liver capsule. The study included patients with NAFLD/NASH (68), hepatitis C (30), prior Fontan surgery (1), elevated liver function tests (5), alcohol abuse (3), hepatitis B (2), and primary biliary cirrhosis (1). IQR/M values were obtained. Comparison of less experienced sonographers (LES) and more experienced sonographers (MES) were evaluated through Student's t test for independent data. Pearson coefficient r of correlation among quantitative variables was calculated. ResultsThe mean time to perform the exam was 129.7 ± 62.1 s. There was a statistically significant difference between LES and MES. The mean IQR/M for LS was 12.3 ± 5.5% m/s. Overall, in a cohort of difficult patients, 4.5% of LS values were not reliable. Fat quantification using attenuation imaging had a mean value of 0.60 ± 0.15 dB/cm/MHz (range 0.35-0.98 cm/dB/ MHz) with an IQR/M of 14.7 ± 9.2%. Less reliable measurements of steatosis were obtained in 4.5% of patients. The mean shear wave dispersion slope was 12.74 ± 4.05 (m/s)/kHz (range 7.7-27.5 (m/s)/kHz) with an IQR/M of 38.7 ± 20.2% (range 3-131%). 20.9% of patients had values suggestive of compensated advanced chronic liver disease (cACLD). Conclusion Multiparametric US can provide assessment of CLD in less than 3 min in most patients and identify patients at risk for cACLD.

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Section: Discussionmentioning

confidence: 99%

Assessment of chronic liver disease by multiparametric ultrasound: results from a private practice outpatient facility

2021

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“…The cut-off values of liver stiffness assessed by point shear wave measurement were 6.78 kPa for a significant fibrosis (F ≥ 2) and 9.15 kPa for cirrhosis (F = 4) in a study made on consecutive patients with chronic HCV infection [63].…”

Section: The Follow-up Of Patients Using Shear Wave Elastographymentioning

confidence: 99%

Liver stiffness in chronic hepatitis C virus infection

Mihăilă

2019

Romanian Journal of Internal Medicine

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Introduction. The severity of liver fibrosis can be assessed noninvasively today by liver stiffness measurements. Vibration-controlled transient elastography, shear wave elastography or magnetic resonance elastography are techniques increasingly used for this purpose. Methods. This article presents the recent advances in the use of new techniques for liver fibrosis assessment in chronic hepatitis C: the correlation between liver stiffness values and liver fibrosis estimated by liver biopsies, the prognosis role of liver stiffness values, their usefulness in monitoring the treatment response, in assessing the severity of portal hypertension and in estimating the presence of esophageal varices. Scientific articles from January 2017 to January 2018 were searched in PubMed and PubMed Central databases, using the terms “liver stiffness” and “hepatitis C”. Results. The median liver stiffness values measured with different techniques are not identical, so that FibroScan thresholds cannot be used on any other elastographic machine. The higher the liver’s stiffness measurement, the higher the liver-related events in patients with chronic hepatitis C. A liver stiffness measurement over 17 kPa could be an independent predictor for the presence of esophageal varices as well as a spleen with a longitudinal span ≥ 15 cm for patients with a value of liver stiffness < 17 kPa. A progressive and persistent decrease in liver stiffness is dependent on sustained virological response achievement. The lack of liver stiffness decrease has been associated with relapsers and a low value of liver stiffness at baseline. Conclusion. Liver stiffness provides clues about the severity and evolution of liver disease.

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“…Even if pSWE is currently implemented in other systems than from Siemens and Philips, published studies are small or missing altogether. pSWE technique implemented on the Hitachi Ascendus system was evaluated by a study published in 2017 [75]. Reliable SWV measurements (SWM) were obtained in 87.2% of the 445 patients included.…”

Section: Point Shear-wave Elastography (Pswe): Perspectivesmentioning

confidence: 99%

Liver Fibrosis Assessment by Point Shear-Wave Elastography Techniques

Şirli¹,

Popescu²,

Sporea³

2020

Ultrasound Elastography

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Point shear-wave elastographic (pSWE) techniques use acoustic radiation force impulse (ARFI) to stimulate the liver tissue and to generate shear waves that propagate into the liver. The shear-wave velocity (SWV) increases with the severity of fibrosis. The first type of pSWE was Virtual Touch Quantification (VTQ) developed by Siemens, followed by ElastPQ by Philips, and nowadays pSWE is available on other systems (Hitachi, Esaote, Samsung). To evaluate liver fibrosis by pSWE, ten valid measurements are performed in the right liver lobe; a median value is calculated, with the results expressed in meters/second or in kilopascals (kPa) (if the operator chooses). VTQ is a reproducible method, the intraclass correlation coefficient (ICC) for inter-and intraobserver measurements ranging from 0.81 to 0.87. Confounding factors for VTQ are non-fasting conditions, elevated aminotransferases, congestive heart failure, and extrahepatic cholestasis. In patients with chronic hepatopathies, the AUROCs for predicting significant fibrosis range between 0.75 and 0.85 and for predicting cirrhosis between 0.85 and 0.95. There were promising results regarding the value of VTQ to predict liver cirrhosis complications, especially portal hypertension. ElastPQ is a newly developed point shearwave elastographic method (from Philips). Only few data were published but with promising results.

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Ruling-in and Ruling-out Significant Fibrosis and Cirrhosis in Patients with Chronic Hepatitis C Using a Shear Wave Measurement Method

Cited by 16 publications

References 12 publications

Assessment of chronic liver disease by multiparametric ultrasound: results from a private practice outpatient facility

Assessment of chronic liver disease by multiparametric ultrasound: results from a private practice outpatient facility

Liver stiffness in chronic hepatitis C virus infection

Liver Fibrosis Assessment by Point Shear-Wave Elastography Techniques

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