Clinical Application of Shear Wave Elastography With Shear Wave Dispersion Imaging in the Preoperative Evaluation of Hepatic Parenchyma in Patients With Liver Tumors

Abstract

Objectives This study aimed to compare the diagnostic accuracy of shear wave elastography (SWE) with that of shear wave dispersion (SWD) in evaluation of hepatic parenchyma in patients with liver tumors before resection. Methods A total of 174 patients with liver tumors were prospectively enrolled. SWE and SWD examinations were performed. Fibrosis stage and necroinflammatory activity were determined histopathologically according to the Scheuer standard. We compared the diagnostic accuracy of SWE and SWD. Results Both SWE and SWD values of the liver were highly correlated with liver fibrosis stage (P < .05, respectively). Both SWE and SWD values of the liver were moderately correlated with necroinflammatory activity (P < .05, respectively). Both SWE and SWD values of the liver were not correlated with steatosis (P > .05, respectively). Both SWE and SWD values were significantly different among the patients with different stages of liver fibrosis (P < .001, respectively). The area under the receiver operating characteristic (ROC) curve of SWE value was 0.982, 0.977, 0.969, and 0.984 for predicting S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The optimal cutoff SWE values were 6.9, 7.9, 8.7, and 10.6 kPa for S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The area under the ROC curve of SWD value was 0.967, 0.960, 0.925, and 0.954 for predicting S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. The optimal cutoff SWD values were 11.2, 12.0, 13.2, and 16.0 m/s/kHz for S ≥ 1, S ≥ 2, S ≥ 3, and S = 4, respectively. Conclusions SWE and SWD could be noninvasive and accurate for predicting the stage of liver fibrosis in patients with liver tumors before surgery. SWE was more accurate than SWD in predicting severe fibrosis (S ≥ 3) and cirrhosis (S = 4).

Shear Wave Dispersion Slope Measured with Shear Wave Dispersion Imaging Is Associated with Variceal Hemorrhage in Cirrhotic Patients

“…As a novel technique, there are few studies on SWD, and researchers are trying to explore what SWDS represents pathologically. Several published studies have suggested that SWDS may be related to the degree of hepatic inflammation and fibrosis [ 18 , 20 ]. The persistence of hepatic inflammation leads to fibrosis, which is an important factor associated with the development of PH.…”

Ultrasonic surface acoustic wave elastography: A review of basic theories, technical developments, and medical applications

“…Using soft tissue as an example, whose properties are listed in Table 1, 49 the distribution of Rayleigh wave displacements in Equation (11) with increasing depth is shown in Figure 2. Be noted that the wave frequency (f) in this demonstration is chosen as 5 MHz.…”

“…4 By evaluating tissue elasticity, elastography techniques enable the diagnosis of lung diseases like pulmonary fibrosis, 5,6 pulmonary edema, 7 and emphysema, 8 as well as liver conditions such as fibrosis, 9 cirrhosis, 10 and hepatic tumors. 11 In renal disease, elastography aids in the early detection of subclinical renal fibrosis, 12 a major risk factor for chronic kidney disease, offering a valuable tool for preventive intervention. Pancreatic elastography holds promise in differentiating chronic pancreatitis from pancreatic tumors, potentially guiding treatment decisions with increased precision.…”

“…It is also used in treatment monitoring 3 as well as image‐guided therapy 4 . By evaluating tissue elasticity, elastography techniques enable the diagnosis of lung diseases like pulmonary fibrosis, 5,6 pulmonary edema, 7 and emphysema, 8 as well as liver conditions such as fibrosis, 9 cirrhosis, 10 and hepatic tumors 11 . In renal disease, elastography aids in the early detection of subclinical renal fibrosis, 12 a major risk factor for chronic kidney disease, offering a valuable tool for preventive intervention.…”

Shear Wave Dispersion in Chronic Liver Disease: From Physical Principles to Clinical Usefulness

“…Recently, the same authors demonstrated a moderate correlation between SWE and SWDS and inflammatory activity in a similar study comprising benign and malignant liver tumours (hepatocellular carcinoma, intrahepatic cholangiocarcinoma, mixed hepatocellular carcinoma-intrahepatic cholangiocarcinoma, and liver metastases), but multivariate analysis confirmed the absence of an association. Interestingly, they described a significantly higher LS and SWDS of liver parenchyma in primary liver cancer compared to other liver tumours [ 32 ].…”