Validation of Shear Wave Elastography Cutoff Values on the Supersonic Aixplorer for Practical Clinical Use in Liver Fibrosis Staging

Dhyani, Manish; Grajo, Joseph R.; Bhan, Atul K.; Corey, Kathleen E.; Chung, Raymond T.; Samir, Anthony E.

doi:10.1016/j.ultrasmedbio.2017.01.022

Cited by 24 publications

(20 citation statements)

References 30 publications

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“…As a result, alternative non-invasive staging methods have been proposed including blood tests (Chin et al 2016; Rosenberg et al 2004), magnetic resonance elastography (MRE)(Dulai et al 2016; Petitclerc et al 2017), and ultrasound elastography (UE)(Crespo et al 2012; Dhyani et al 2015; Sigrist et al 2017). UE approaches that employ acoustic or mechanical force to generate tissue shear waves have been shown to correlate with liver fibrosis stage (Dhyani et al 2017; Ferraioli et al 2012; Li et al 2016; Samir et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Shear Wave Elastography: Variations of Liver Fibrosis Assessment as a Function of Depth, Force and Distance from Central Axis of the Transducer with a Comparison of Different Systems

Dhyani

Xiang

et al. 2018

Ultrasound in Medicine & Biology

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We evaluated variation in fibrosis staging caused by depth, pre-load force and measurement off-axis distance on different ultrasound shear wave elastography (SWE) systems prospectively in 20 patients with diffuse liver disease. Shear wave speed (SWS) was measured with transient elastography, acoustic radiation force impulse (ARFI) and 2-D shear wave elastography (SWE). ARFI and 2-D-SWE measurements were obtained at different depths (3, 5 and 7 cm), with different pre-load forces (4, 7 and 10N and variable) and at 0, 2 and 4cm off the central axis of the transducer. A single, blinded pathologist staged fibrosis using the METAVIR system (F0-F4). Area under the receiver operating characteristic curve was charted to differentiate significant fibrosis (F ≥ 2). Depth was the only factor found to influence ARFI-derived values; no acquisition factors were found to affect 2-D-SWE SWS values. ARFI and 2-D-SWE for diagnosis of significant fibrosis at a depth of 7cm along the central axis had good diagnostic performance (areas under the receiver operating characteristic curve: 0.92 and 0.82, respectively), comparable to that of transient elastography. Further investigation of this finding will likely be of interest.

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Section: Introductionmentioning

confidence: 99%

Ultrasound Shear Wave Elastography: Variations of Liver Fibrosis Assessment as a Function of Depth, Force and Distance from Central Axis of the Transducer with a Comparison of Different Systems

Dhyani

Xiang

et al. 2018

Ultrasound in Medicine & Biology

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“…Earlier SWE studies have proposed various cut-off values to distinguish the staging of fibrosis, such as early fibrosis, no fibrosis, advanced fibrosis, and cirrhosis 44 . Dhyani et al 45 validated the previously established US SWE cut-off values (≥ F2 fibrosis) in a cohort of patients with chronic liver disease. In this previous cross-sectional study, 338 patients undergoing liver biopsy underwent SWE using an Aixplorer US machine (SuperSonic Imagine, Aix-en-Provence, France).…”

Section: Radiological Techniquesmentioning

confidence: 91%

Progress in non-invasive detection of liver fibrosis

Zhang

2018

Cancer Biology & Medicine

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Liver fibrosis is an important pathological precondition for hepatocellular carcinoma. The degree of hepatic fibrosis is positively correlated with liver cancer. Liver fibrosis is a series of pathological and physiological process related to liver cell necrosis and degeneration after chronic liver injury, which finally leads to extracellular matrix and collagen deposition. The early detection and precise staging of fibrosis and cirrhosis are very important for early diagnosis and timely initiation of appropriate therapeutic regimens. The risk of severe liver fibrosis finally progressing to liver carcinoma is >50%. It is known that biopsy is the gold standard for the diagnosis and staging of liver fibrosis. However, this method has some limitations, such as the potential for pain, sampling variability, and low patient acceptance. Furthermore, the necessity of obtaining a tissue diagnosis of liver fibrosis still remains controversial. An increasing number of reliable non-invasive approaches are now available that are widely applied in clinical practice, mostly in cases of viral hepatitis, resulting in a significantly decreased need for liver biopsy. In fact, the non-invasive detection and evaluation of liver cirrhosis now has good accuracy due to current serum markers, ultrasound imaging, and magnetic resonance imaging quantification techniques. A prominent advantage of the non-invasive detection and assessment of liver fibrosis is that liver fibrosis can be monitored repeatedly and easily in the same patient. Serum biomarkers have the advantages of high applicability (>95%) and good reproducibility. However, their results can be influenced by different patient conditions because none of these markers are liver-specific. The most promising techniques appear to be transient elastography and magnetic resonance elastography because they provide reliable results for the detection of fibrosis in the advanced stages, and future developments promise to increase the reliability and accuracy of the staging of hepatic fibrosis. This article aims to describe the recent progress in the development of non-invasive assessment methods for the staging of liver fibrosis, with a special emphasize on computer-aided quantitative and deep learning methods.

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“…For example, for the diagnosis of fibrosis stage F≥2, AUROC value is 0.862, and for early cirrhosis diagnosis, AUROC value is 0.926[46]. Using a cut-off value 7.29 kPa, this technique reaches a sensitivity of 95.4% for fibrosis stage ≥2 [47]. Although the diagnostic ability of the techniques are similar, shear wave speed values obtained from 2D-SWE may show higher stiffness values[48].…”

Section: Clinical Applicationsmentioning

confidence: 99%

Principles of ultrasound elastography

et al. 2018

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Tissue stiffness has long been known to be a biomarker of tissue pathology. Ultrasound elastography measures tissue mechanical properties by monitoring the response of tissue to acoustic energy. Different elastographic techniques have been applied to many different tissues and diseases. Depending on the pathology, patient-based factors, and ultrasound operator-based factors, these techniques vary in accuracy and reliability. In this review, we discuss the physical principles of ultrasound elastography, discuss differences between different ultrasound elastographic techniques, and review the advantages and disadvantages of these techniques in clinical practice.

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Validation of Shear Wave Elastography Cutoff Values on the Supersonic Aixplorer for Practical Clinical Use in Liver Fibrosis Staging

Cited by 24 publications

References 30 publications

Ultrasound Shear Wave Elastography: Variations of Liver Fibrosis Assessment as a Function of Depth, Force and Distance from Central Axis of the Transducer with a Comparison of Different Systems

Ultrasound Shear Wave Elastography: Variations of Liver Fibrosis Assessment as a Function of Depth, Force and Distance from Central Axis of the Transducer with a Comparison of Different Systems

Progress in non-invasive detection of liver fibrosis

Principles of ultrasound elastography

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