Staging liver fibrosis in patients with chronic hepatitis B using two-dimensional shear wave elastography based on histopathological findings: a prospective multicenter study

Abstract

Background: With the rapid development of shear wave elastography technology, the clinical application prospect of two-dimensional shear wave elastography (2D SWE) for non-invasive monitoring of liver fibrosis is extremely promising. This study aimed to evaluate the diagnostic performance of ElastQ, a noval 2D SWE method, in the staging of liver fibrosis in patients with chronic hepatitis B with histopathological results as the reference standard.Methods: Between August 2020 and December 2021, a prospective multicenter study of 602 consecutive patients with chronic hepatitis B was conducted in 14 hospitals. All patients underwent liver biopsy and 2D SWE examination. The patients were divided into a training cohort and a validation cohort. The area under the receiver operating characteristic curve (AUROC) was calculated, and the optimal cut-off values for ElastQ were obtained.Results: Overall, 2D SWE values showed a strong correlation with fibrosis stage (r=0.71, P<0.001). In the training cohort, the AUROCs of ElastQ for diagnosing fibrosis stages ≥S1