Usefulness of New Shear Wave Elastography Technique for Noninvasive Assessment of Liver Fibrosis in Patients with Chronic Hepatitis B: A Prospective Multicenter Study

Abstract

Purpose To explore the usefulness of liver stiffness measurements (LSMs) by sound touch elastography (STE) and sound touch quantification (STQ) in chronic hepatitis B (CHB) patients for staging fibrosis. Methods This prospective multicenter study recruited normal volunteers and CHB patients between May 2018 and October 2019. The volunteers underwent LSM by STE and supersonic shear imaging (SSI) or by STQ and acoustic radiation force impulse imaging (ARFI). CHB patients underwent liver biopsy and LSM by both STE/STQ. The areas under the receiver operating characteristic curves (AUCs) for staging fibrosis were calculated. Results Overall, 97 volunteers and 524 CHB patients were finally eligible for the study. The successful STE and STQ measurement rates were both 100 % in volunteers and 99.4 % in CHB patients. The intraclass correlation coefficients (ICCs) for the intra-observer stability of STE and STQ (0.94; 0.90) were similar to those of SSI and ARFI (0.95; 0.87), respectively. STE and STQ showed better accuracy than the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) (AUC: 0.87 vs 0.86 vs 0.73 vs 0.77) in staging cirrhosis. However, both STE and STQ were not superior to APRI and FIB-4 in staging significant fibrosis (AUC: 0.76 vs 0.73 vs 0.70 vs 0.71, all P-values > 0.05). Conclusion STE and STQ are convenient techniques with a reliable LSM value. They have a similar diagnostic performance and are superior to serum biomarkers in staging cirrhosis in CHB patients.

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

“…Some studies in the field of medical imaging have reported that magnetic resonance elastography has a higher diagnostic performance than transient elastography (TE) in the staging of liver fibrosis; however, its high cost and low accessibility have limited its clinical utility and patient acceptance (7)(8)(9). Ultrasound elastography has gradually become the primary method for the assessment of liver stiffness due to its convenience, high speed, real-time capability, and low cost (10).…”

Use of Sound Touch Elastography and Sound Touch Quantification for the Noninvasive Evaluation of Portal Hypertension in a Rat Model

“…12 The use of elastography techniques is increasing, and various SWE techniques (including those for point and two-dimensional SWE) are available from different vendors. 13,14 Sound touch elastography (STE) is a recently developed ultrasound technology based on the technical principles of two-dimensional SWE. [14][15][16] It employs ultra-wide-beam tracking to create high-quality colorcoded maps of real-time tissue stiffness in a region of interest (ROI), with quantitative analysis.…”

“…13,14 Sound touch elastography (STE) is a recently developed ultrasound technology based on the technical principles of two-dimensional SWE. [14][15][16] It employs ultra-wide-beam tracking to create high-quality colorcoded maps of real-time tissue stiffness in a region of interest (ROI), with quantitative analysis. [14][15][16] Sound touch quantification (STQ) is based on the technical principles of point SWE.…”

“…[14][15][16] It employs ultra-wide-beam tracking to create high-quality colorcoded maps of real-time tissue stiffness in a region of interest (ROI), with quantitative analysis. [14][15][16] Sound touch quantification (STQ) is based on the technical principles of point SWE. 14 It involves the acquisition of multiple tissue stiffness measurements in real time, with gray-scale imaging.…”

“…[14][15][16] Sound touch quantification (STQ) is based on the technical principles of point SWE. 14 It involves the acquisition of multiple tissue stiffness measurements in real time, with gray-scale imaging. 17 STE and STQ can be performed with a single ultrasound system and conventional probe, providing multiple options for SWE performance and making clinical application more convenient.…”