Value of shear wave elastography for predicting hepatocellular carcinoma and esophagogastric varices in patients with chronic liver disease.

Abstract

To assess the value of shear wave elastography (SWE) for predicting the presence of hepatocellular carcinoma (HCC) and esophagogastric varices (EGV) in patients with chronic liver disease. Liver tissue stiffness, as well as various other parameters potentially associated with HCC and portal hypertension, was measured by SWE in 273 patients with chronic liver disease. Among these patients, HCC was present in 89 and absent in 184, and EGV were present in 16 and absent in 257. The diagnostic performance of liver tissue stiffness and other clinical parameters in predicting the presence of HCC and EGV was evaluated using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUROC). With regard to HCC, liver tissue stiffness was significantly higher in patients with HCC (18.65 ± 10.78 kPa) than in those without HCC (10.64 ± 8.04 kPa; P < 0.0001). Significant differences in patient age (P < 0.0001), albumin (P < 0.0001), platelet count (P < 0.0001), AFP (P < 0.0001), and DCP (P < 0.0001) were also observed between patients with and without HCC. Liver tissue stiffness showed the largest AUROC (0.791). With regard to EGV, liver tissue stiffness was significantly higher in patients with EGV (22.65 ± 10.19 kPa) than in those without EGV (12.67 ± 9.45 kPa; P < 0.0001). Significant differences in albumin (P < 0.0001) and platelet count (P < 0.0001) were also observed between patients with and without EGV. Liver tissue stiffness measured by SWE is an independent factor for predicting the presence of HCC and EGV in patients with chronic liver disease.