Usefulness of noninvasive shear wave elastography for the assessment of hepatic fibrosis in dogs with hepatic disease

Abstract

Background Two‐dimensional shear wave elastography (2D‐SWE) can noninvasively evaluate hepatic elastic modulus as shear wave velocity (SWV). Additionally, it may predict the presence of clinical relevant hepatic fibrosis (≥F2) in dogs with hepatic disease. Objectives To investigate whether SWV measured by 2D‐SWE can differentiate between dogs with (≥F2) and without (F0‐1) clinically relevant hepatic fibrosis. Animals Twenty‐eight client‐owned dogs with hepatic disease and 8 normal healthy Beagle dogs were enrolled. Methods In this cross‐sectional prospective study, SWVs were measured using 2D‐SWE in all dogs. Hepatic fibrosis stages and necroinflammatory activity grades were histopathologically evaluated using a histological scoring scheme that was adapted from the Ishak schema used in human medicine. Results Median SWVs were significantly higher in dogs with clinically relevant hepatic fibrosis (2.04 m/s; range, 1.81‐2.26 m/s) than in healthy dogs (1.51 m/s; range, 1.44‐1.66 m/s; P = .007), and dogs without clinically relevant hepatic fibrosis (1.56 m/s; range, 1.37‐1.67 m/s; P < .001). However, no significant difference was found in the SWVs between dogs without clinically relevant hepatic fibrosis and healthy dogs (P = .99). Furthermore, median SWVs were not significantly different among dogs with necroinflammatory activity, those without necroinflammatory activity, and healthy dogs (Kruskal‐Wallis test, P = .12). Conclusions and Clinical Importance The 2D‐SWE may be useful for predicting the presence of hepatic fibrosis in dogs with hepatic disease.

Liver and spleen elastography of dogs affected by brachycephalic obstructive airway syndrome and its correlation with clinical biomarkers

“…There is no values of liver and spleen stiffness of brachycephalic dogs described, which challenges our data comparison. However, a recent study evaluating liver fibrosis in dogs by shear wave elastography showed that dogs without clinical relevant fibrosis had a median SWV of 1.56 m/s whilst dogs with clinically relevant fibrosis had a median SWV of 2.04 m/s 36 . Although the dogs in the first group were classified without clinically significant liver fibrosis, some were histopathological affected and had similar SWV values to the observed in our brachycephalic dogs.…”

“…The SWV obtained by elastographic studies depends on the tissue stiffness being highly shaped by fibrosis and has a good predictive value for its presence 22 . Thus, the liver SWV increases along the histopathological grades of liver fibrosis in children and adults [40][41][42] as well as in dogs 35,36 . There is no values of liver and spleen stiffness of brachycephalic dogs described, which challenges our data comparison.…”

“…Another important point of discussion is the anatomical location where the quantitative measurements were obtained. Human studies have used the left or right lateral liver lobes for quantitative elastographic evaluations 25,62 and dogs studies have described SWV values of the right lateral liver lobe 36,56 although some reports do not define the exactly liver lobe where the measurements were performed 33,38 . In order to have a complete evaluation of the entire parenchyma, as well as to detect possible focal lesions, our methodology included the evaluation of all liver lobes and three splenic regions, thus ensuring a complete evaluation and facilitating the comparison with future studies.…”

“…In this scenario, ultrasound and elastography techniques have been used to diagnose and evaluate liver disorders in both humans 21,22,[25][26][27][28][29][30][31] and animals [32][33][34][35][36] . Normal values of liver and spleen stiffness in healthy meso and dolichocephalic dogs measured by Acoustic Radiation Force Impulse (ARFI) elastography are already reported in the literature 37,38 and recently higher values of liver stiffness were also described in humans affected by severe OSA 30 .…”

Two-Dimensional Shear Wave Elastography of Normal Soft Tissue Organs in Adult Beagle Dogs; Interobserver Agreement and Sources of Variability

“…In veterinary literature, 2D SWE was applied to distinguish malignant from benign conditions of mammary tumors and lymph nodes and to evaluate the margination and acute changes in stiffness of the ablated liver tissue after radiofrequency ablation in dogs (Glińska-Suchocka et al, 2013;Feliciano et al, 2017;Lee et al, 2018;Silva et al, 2018). Recently, 2D SWE confirmed that the SWS in dogs with clinically relevant hepatic fibrosis was significantly higher compared to those in healthy dogs and dogs without clinically relevant hepatic fibrosis (Tamura et al, 2019b). In addition, 2D SWE revealed the different SWS in dogs with suspected pancreatic diseases and clinically healthy dogs (Avante et al, 2020).…”