Shear-Wave elastography for the estimation of liver fibrosis in chronic liver disease: Determining accuracy and ideal site for measurement

Anthony E. Samir, Manish Dhyani, Abhinav Vij, Atul K. Bhan, Elkan F. Halpern, Jorge Méndez-Navarro, Kathleen E. Corey, Raymond T. Chung

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103 Scopus citations

Abstract

Purpose: To evaluate the accuracy of shear-wave elastography (SWE) for staging liver fibrosis in patients with diffuse liver disease (including patients with hepatitis C virus [HCV]) and to determine the relative accuracy of SWE measurements obtained from different hepatic acquisition sites for staging liver fibrosis. Materials and Methods: The institutional review board approved this single-institution prospective study, which was performed between January 2010 and March 2013 in 136 consecutive patients who underwent SWE before their scheduled liver biopsy (age range, 18-76 years; mean age, 49 years; 70 men, 66 women). Informed consent was obtained from all patients. SWE measurements were obtained at four sites in the liver. Biopsy specimens were reviewed in a blinded manner by a pathologist using METAVIR criteria. SWE measurements and biopsy results were compared by using the Spearman correlation and receiver operating characteristic (ROC) curve analysis. Results: SWE values obtained at the upper right lobe showed the highest correlation with estimation of fibrosis (r = 0.41, P < .001). Inflammation and steatosis did not show any correlation with SWE values except for values from the left lobe, which showed correlation with steatosis (r = 0.24, P = .004). The area under the ROC curve (AUC) in the differentiation of stage F2 fibrosis or greater, stage F3 fibrosis or greater, and stage F4 fibrosis was 0.77 (95% confidence interval [CI]: 0.68, 0.86), 0.82 (95% CI: 0.75, 0.91), and 0.82 (95% CI: 0.70, 0.95), respectively, for all subjects who underwent liver biopsy. The corresponding AUCs for the subset of patients with HCV were 0.80 (95% CI: 0.67, 0.92), 0.82 (95% CI: 0.70, 0.95), and 0.89 (95% CI: 0.73, 1.00). The adjusted AUCs for differentiating stage F2 or greater fibrosis in patients with chronic liver disease and those with HCV were 0.84 and 0.87, respectively. Conclusion: SWE estimates of liver stiffness obtained from the right upper lobe showed the best correlation with liver fibrosis severity and can potentially be used as a noninvasive test to differentiate intermediate degrees of liver fibrosis in patients with liver disease.

Original languageEnglish (US)
Pages (from-to)888-896
Number of pages9
JournalRADIOLOGY
Volume274
Issue number3
DOIs
StatePublished - Mar 1 2015

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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    Samir, A. E., Dhyani, M., Vij, A., Bhan, A. K., Halpern, E. F., Méndez-Navarro, J., Corey, K. E., & Chung, R. T. (2015). Shear-Wave elastography for the estimation of liver fibrosis in chronic liver disease: Determining accuracy and ideal site for measurement. RADIOLOGY, 274(3), 888-896. https://doi.org/10.1148/radiol.14140839