Assessment of Fibrosis in Liver Transplant Recipients: Diagnostic Performance of Shear Wave Elastography (SWE) and Correlation of SWE Findings With Biopsy Results

Deurdulian, Corinne; Grant, Edward G.; Tchelepi, Hisham; Latterman, Paul T.; Paluch, Jeremy; Chopra, Shefali; Kazmierski, Brittany; Kahn, Jeffrey; Malhi, Harshawn; Cen, Steven

doi:10.2214/ajr.19.21160

Cited by 14 publications

(14 citation statements)

References 33 publications

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“…In addition, the sensitivity, specificity, and AUC area of SWE in diagnosing fibrosis in patients with chronic liver disease were analyzed using the subject operating curve. e results showed that the AUC area was 0.866, the sensitivity was 89.59%, and the specificity was 76.49%, which is consistent with the results of 77% sensitivity and 79% specificity obtained by Deurdulian et al [17] in 147 American SWE tests on the degree of liver fibrosis in 111 adult liver transplantation patients. It also has higher sensitivity, indicating SWE's reliability in diagnosing fibrosis in patients with chronic liver disease.…”

Section: Discussionsupporting

confidence: 88%

Receiver Operator Characteristics (ROC) Analysis of Real-Time Shear Wave Elastography Information Health Monitoring in Liver Fibrosis with Chronic Hepatitis B Virus Infection

Zhao

Chen

Zhang

et al. 2021

Scientific Programming

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To investigate the effectiveness of shear-wave elastography (SWE) based on e-health in diagnosing liver fibrosis in patients infected with hepatitis B virus (HBV) and provide theoretical basis for early diagnosis and treatment of patients with chronic HBV infection, in this study, 73 patients with chronic HBV infection who underwent e-health SWE examination were divided into chronic hepatitis B group (51 cases) and hepatitis B cirrhosis group (22 cases), and another 20 healthy volunteers were introduced as control. The contents of second liver two half-and-half, hyaluronic acid (HA) of liver fibrosis, laminin (LN), pAUVollagen III N terminal peptide (PIII NP), collage type IV (CIV), and HBV-DNA were detected. SWE was used to measure the elastic modulus in the S2 and S3 segments of the left outer lobe of the liver, S4 segment of the left inner lobe of the liver, S5 and S8 segments of the right anterior lobe of the liver, and S6 and S7 segments of the right posterior lobe of the liver. Finally, the correlations between the four examination results of liver fibrosis and the elastic modulus values were compared, and the receiver operator characteristic curve (ROC) for SWE technical diagnosis was drawn. The results showed that there was no significant difference in HBV-DNA content between the two groups ( P > 0.05 ); the contents of alanine transaminase (ALT) and aspartate aminotransferase (AST) in the blood of chronic hepatitis B group were significantly higher than those in the liver cirrhosis group ( P < 0.05 ); HA, PIII NP, and CIV contents were significantly lower than the liver cirrhosis group ( P < 0.05 ); the success rates of SWE detection in S5 and S6 segments of the two groups were 100.00%, and the elastic modulus of the hepatitis B cirrhosis group was significantly higher than that of the chronic hepatitis B group ( P < 0.05 ); correlation results showed HA, PIII NP, and CIV of two groups of patients and elastic modulus value in S5 and S6 segments showed positive correlation ( P < 0.05 ); ROC curve analysis showed that AUC (area under the curve) was 0.866, the sensitivity was 89.59%, and the specificity was 76.49%, which indicated that the liver elastic modulus value measured by e-health SWE technology can quantitatively show liver fibrosis in patients with chronic HBV infection, and its application in the diagnosis of clinical liver fibrosis was real and feasible.

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Section: Discussionsupporting

confidence: 88%

Receiver Operator Characteristics (ROC) Analysis of Real-Time Shear Wave Elastography Information Health Monitoring in Liver Fibrosis with Chronic Hepatitis B Virus Infection

Zhao

Chen

Zhang

et al. 2021

Scientific Programming

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“…Six of our patients were assessed in the early postoperative period after transplantation (< 1 month after LTX), when elevation of liver stiffness can be a sign of acute rejection, inflammation, or hepatic outflow obstruction [5][6][7][8][9][10]. Four children prone to chronic changes like post-transplant fibrosis or chronic rejection associated with increased elastography values were evaluated during the later follow-up phase [5][6][7][8][9][10]. Quantitative longitudinal measurements of liver stiffness are seen as especially useful for monitoring disease activity in a variety of disorders including liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

“…The appropriate method depends on the clinical situation. 2D-SWE is used widely for the evaluation of liver transplantations, including left-lateral split transplantations (LTXs), which account for the majority of pediatric transplants [6,7,13], and has been shown to be more accurate than pSWE for the evaluation of liver fibrosis in children [14].…”

Section: Introductionmentioning

confidence: 99%

Impact of probe-induced abdominal compression on two-dimensional shear wave elastography measurement of split liver transplants in children

Groth

Fischer

Herden

et al. 2023

Rofo

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Purpose To evaluate the effect of probe-induced abdominal compression of split liver transplants (SLT) in children on 2D-shear wave elastography (SWE) values. Materials and Methods Data from 11 children (4.7 ± 4.8 years) who had undergone SLT and SWE were evaluated retrospectively. Elastograms were obtained with probes placed in an epigastric, midline position on the abdominal wall, with no and slight compression, using convex and linear transducers. For each identically positioned probe and condition, 12 serial elastograms were obtained and the SLT diameter was measured. Liver stiffness and degree of SLT compression were compared. Results Slight probe pressure resulted in SLT compression, with a shorter distance between the cutis and the posterior margin of the liver transplant than in the measurement with no pressure (curved array, 5.0 ± 1.1 vs. 5.9 ± 1.3 cm, mean compression 15 %± 8 %; linear array, 4.7 ± 0.9 vs. 5.3 ± 1.0 cm, mean compression 12 %± 8 %; both p < 0.0001). The median liver stiffness was significantly greater with slight pressure than with no pressure (curved transducer, 13.38 ± 3.0 vs. 7.02 ± 1.7 kPa, p < 0.0001; linear transducer, 18.53 ± 7.1 vs. 9.03 ± 1.5 kPa, p = 0.0003). Conclusion Slight abdominal compression can significantly increase SWE values in children with left-lateral SLT. To obtain meaningful results and reduce operator dependency in free-hand examinations, probe pressure must be controlled carefully. Key points: Citation Format

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“…The specificity and sensitivity of elastography in fibrosis classification were 79% and 77%, respectively. The auth ors concluded that in the elastography examination performed after liver transplantation, patients with an elastography value<1.76 do not have significant fibrosis and the biopsy procedure can be postponed [22].…”

Section: Discussionmentioning

confidence: 99%

The role of sonoelastography in the evaluation of hepatic fibrosis in pediatric patients

Bilgin¹,

Bilgin²,

Oktar³

2021

Journal of Surgery and Medicine

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Assessment of Fibrosis in Liver Transplant Recipients: Diagnostic Performance of Shear Wave Elastography (SWE) and Correlation of SWE Findings With Biopsy Results

Cited by 14 publications

References 33 publications

Receiver Operator Characteristics (ROC) Analysis of Real-Time Shear Wave Elastography Information Health Monitoring in Liver Fibrosis with Chronic Hepatitis B Virus Infection

Receiver Operator Characteristics (ROC) Analysis of Real-Time Shear Wave Elastography Information Health Monitoring in Liver Fibrosis with Chronic Hepatitis B Virus Infection

Impact of probe-induced abdominal compression on two-dimensional shear wave elastography measurement of split liver transplants in children

The role of sonoelastography in the evaluation of hepatic fibrosis in pediatric patients

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