Comparison of 2-D Shear Wave Elastography and Point Shear Wave Elastography for Assessing Liver Fibrosis

Abstract

Progressive liver fibrosis may result in cirrhosis, portal hypertension and increased risk of hepatocellular carcinoma. We performed a meta-analysis to compare liver fibrosis staging in chronic liver disease patients using 2-D shear wave elastography (2-D SWE) and point shear wave elastography (pSWE). The PubMed, Web of Science and Cochrane Library databases were searched until May 31, 2020 for studies evaluating the diagnostic performance of 2-D SWE and pSWE in assessing liver fibrosis. Pooled sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratios and area under receiver operating characteristic curve were estimated using the bivariate random effects model. As a result, 71 studies with 11,345 patients were included in the analysis. The pooled sensitivities of 2-D SWE and pSWE significantly differed for the detection of significant fibrosis (F 2; 0.84 vs. 0.76, p < 0.001) and advanced fibrosis (F 3; 0.90 vs. 0.83, p = 0.003), but not for detection of cirrhosis (F = 4; 0.89 vs. 0.85, p = 0.090). The pooled specificities of 2-D SWE and pSWE did not significantly differ for detection of F 2 (0.81 vs. 0.79, p = 0.753), F 3 (0.87 vs. 0.83, p = 0.163) or F = 4 (0.87 vs. 0.84, p = 0.294). Both 2-D SWE and pSWE have high sensitivity and specificity for detecting each stage of liver fibrosis. Two-dimensional SWE has higher sensitivity than pSWE for detection of significant fibrosis and advanced fibrosis.

Effects of Confounding Factors on Liver Stiffness in Two-Dimensional Shear Wave Elastography in Beagle Dogs

“…This is in contrast to previous human studies that reported higher liver stiffness in expiration than in normal gentle inspiration (21,22). However, these studies utilized transient elastography and point shear wave elastography, which have lower reliability and accuracy for measuring liver stiffness compared with 2D-SWE that was used in the present study (33)(34)(35)(36)(37). In contrast to transient elastography that lacks a Bmode image and point shear wave elastography that does not provide an image of stiffness, 2D-SWE provides both these images by presenting anatomical and tissue stiffness information through visualization of a color box on a B-mode image (6).…”

Diagnostic Modalities of Non-Alcoholic Fatty Liver Disease: From Biochemical Biomarkers to Multi-Omics Non-Invasive Approaches

“…Two-dimensional SWE has been reported to demonstrate higher sensitivity than pSWE in detecting each stage of liver fibrosis in patients with chronic liver disease. However, evidence on the role of pSWE as a diagnostic modality in NAFLD is still limited, as no meta-analysis has been available to date [ 203 ]. A recent prospective study involving 114 NAFLD patients showed a moderate to high diagnostic accuracy of 2D SWE with AUROCs of 0.84, 0.88 and 0.93 for detection of fibrosis stages 2, 3 and 4, respectively [ 204 ].…”

Carotid Plaque Characterization Using Quantitative Shear Wave Elastography: A Pilot Study

“…While both 2dSWE and pSWE have demonstrated good sensitivity and specificity in liver fibrosis evaluation, there is scant data regarding the use of either method in atherosclerosis assessment. 7 There are technical limitations of applying SWE methods to focal arterial plaques that should be noted. The YM values are calculated under the assumption that the tissue being sampled is isotropic with homogeneous composition.…”

“…While both 2dSWE and pSWE have demonstrated good sensitivity and specificity in liver fibrosis evaluation, there is scant data regarding the use of either method in atherosclerosis assessment. 7…”