Staging of Hepatic Fibrosis: Comparison of Magnetic Resonance Elastography and Shear Wave Elastography in the Same Individuals

Abstract

ObjectiveTo cross-validate liver stiffness (LS) measured on shear wave elastography (SWE) and on magnetic resonance elastography (MRE) in the same individuals.Materials and MethodsWe included 94 liver transplantation (LT) recipients and 114 liver donors who underwent either MRE or SWE before surgery or biopsy. We determined the technical success rates and the incidence of unreliable LS measurements (LSM) of SWE and MRE. Among the 69 patients who underwent both MRE and SWE, the median and coefficient of variation (CV) of the LSM from each examination were compared and correlated. Areas under the receiver operating characteristic curve in both examinations were calculated in order to exclude the presence of hepatic fibrosis (HF).ResultsThe technical success rates of MRE and SWE were 96.4% and 92.2%, respectively (p = 0.17), and all of the technical failures occurred in LT recipients. SWE showed 13.1% unreliable LSM, whereas MRE showed no such case (p < 0.05). There was moderate correlation in the LSM in both examinations (r = 0.67). SWE showed a significantly larger median LSM and CV than MRE. Both examinations showed similar diagnostic performance for excluding HF (Az; 0.989, 1.000, respectively).ConclusionMRE and SWE show moderate correlation in their LSMs, although SWE shows higher incidence of unreliable LSMs in cirrhotic liver.

Incorporation of Noninvasive Measures of Liver Fibrosis Into Clinical Practice: Diagnosis and Prognosis

“…18 In contrast, a recent study in overweight patients showed a lower rate of unreliable examinations. Reliable liver stiffness measurements were reported in 96% of patients using the TE-XL probe and 95% using 2d SWE of the right lobe.…”

“…However, MRE provided significantly more reliable liver stiffness measurements than did SWE shear-wave elastography (100% vs. 86.9%). 18 serum markers prescribe a more superior diagnostic accuracy to radiologic markers. 19 56 In a study comparing serum markers along with TE and 2d SWE, overall non-invasive radiologic markers (TE and SWE) had better performance than non-invasive indirect serum markers of fibrosis such as APRI or FIB-4.…”

“…70 In a recent study comparing MRE and shear wave elastography in the same individual, the rates of unreliable exam were higher with shear wave as compared to MRE (19% versus 0%). 18 Furthermore, MRE is not significantly affected by obesity, rib interspace width, or ascites. …”

Romanian national guidelines and practical recommendations on liver elastography

“…The operator places the region of interest in an area without large vessels, at a depth more than 2 cm, but no further than 8 cm. Until now, there is no consensus regarding the number of measurements that should be performed, three [105], four [106] or five [107][108][109] valid 2D-SWE measurements were performed in different studies. Also, some studies used the mean value of LS measurements [105,106], while in others the median was used [109].…”

Current Possibilities to Assess the Degree of Liver Fibrosis in Patients with Haemophilia Infected with HCV - Review

“…An important advantage of this method is complete independence from the operator, and the ability to make measurements in the whole organ, and not a few selected points. The disadvantages include the long duration of the study, the high price of software and difficulties in availability of this method [20,21].…”