Abstract
Background: The aim of this study was to evaluate the usefulness of two different types of 2-dimensional shear wave elastography (2D-SWE) for predicting liver fibrosis stages in comparison to transient elastography (TE), using a histologic METAVIR scoring system as the reference method. Methods: A total of 203 patients with chronic liver disease were prospectively enrolled in the study. Two different 2D-SWEs (LOGIQ S8 and E9 systems, GE Healthcare, Chalfont St Giles, UK) were assessed for liver stiffness in patients with chronic liver diseases. Patients received 2D-SWE examinations with the S8 and E9 systems, and also underwent TE (FibroScan®, Echosens, France) tests and liver biopsies on the same day. Results: The most common etiology of chronic liver disease was non-alcoholic fatty liver disease (28.7%), followed by chronic hepatitis B (25.1%). Liver fibrosis stages consisted of F0 (22.6%), F1 (29.7%), F2 (16.9%), F3 (12.8%) and F4 (17.9%). Overall, S8 and E9 were well correlated with the histologic fibrosis stages. The optimal cut-off values for S8 and E9 to differentiate significant fibrosis (≥F2) were 6.70 kPa and 6.42 kPa, respectively, while the cut-off values for S8 and E9 in distinguishing liver cirrhosis were 9.15 kPa and 8.88 kPa, respectively. Among the 195 patients who had successful measurements in both S8 and E9, liver stiffness showed good inter-equipment correlation (ICC: 0.900, p < 0.001). Regarding diagnostic ability, upon comparison (FibroScan®), there were no significant differences between 2D-SWEs and TE for detecting every stage of liver fibrosis. Conclusion: In comparison to TE, 2D-SWE with LOGIQ S8 and E9 (GE Healthcare) are useful non-invasive tools for predicting significant fibrosis and liver cirrhosis.
Highlights
Chronic liver diseases (CLDs) are a major global health issue that require increased awareness and effort for effective management and treatment [1]
The subjects of this study were patients with chronic liver disease, and their liver stiffness was measured by three methods: S8 2D-shear wave elastography (SWE), E9 2-dimensional shear wave elastography (2D-SWE) and transient elastography Fibroscan®
There was no significant difference in success rates between the 2D-SWE and transient elastography (TE) system
Summary
Chronic liver diseases (CLDs) are a major global health issue that require increased awareness and effort for effective management and treatment [1]. The product of persistent liver damage, is the most important prognostic factor in patients with CLDs [2]. Increases in the prevalence of CLD have given rise to the importance of non-invasive tools for liver fibrosis estimation [3]. Liver biopsy is the gold standard for identifying the stage of fibrosis, it is an invasive method with poor patient acceptance. 2-dimensional shear wave elastography (2D-SWE) for predicting liver fibrosis stages in comparison to transient elastography (TE), using a histologic METAVIR scoring system as the reference method
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