Comparison of Sound Touch Elastography, Shear Wave Elastography and Vibration-Controlled Transient Elastography in Chronic Liver Disease Assessment using Liver Biopsy as the “Reference Standard”

Abstract

Chronic liver disease (CLD) is currently a major cause of death. Ultrasound elastography (USE) is an imaging method that has been developed for CLD assessment. Our aim in the study described here was to evaluate and compare a new commercial variant of USE, sound touch elastography (STE), with already established USE methods, shear wave elastography (SWE) and vibration-controlled transient elastography (VCTE), using liver biopsy as the "reference standard." For our study, 139 consecutive patients underwent standard liver STE, SWE and VCTE examinations with the corresponding ultrasound devices. A receiver operator characteristic (ROC) curve analysis was performed on the stiffness values measured with each method. ROC analysis revealed, for SWE, STE and VCTE, areas under the ROC curve of 0.9397, 0.9224 and 0.9348 for fibrosis stage (F), F F1; 0.9481, 0.9346 and 0.9415 for F F2; 0.9623, 0.9591 and 0.9631 for F F3; and 0.9581, 0.9541 and 0.9632 for F = F4, respectively. In conclusion, STE performs similarly to SWE and VCTE in CLD stage differentiation.

Comparison of Visual Transient Elastography and Shear Wave Elastography in Evaluating Liver Fibrosis in Patients with Chronic Liver Disease

“…The three elastography systems performed similarly in the diagnosis of CLD at each stage and were more effective in the diagnosis of F0 ≤stage. The results of this study are similar to those of Gatos et al 11 However, TE and SWE have higher accuracies in the diagnosis of advanced hepatic fibrosis (F3 ≤and =F4) in some studies. [24][25][26][27] Leung et al 28 showed that SWE was superior to TE in the evaluation of F2≤ liver fibrosis, while in this study, the AUC sensitivities of ViTE, SWE and STE for F2≤ liver fibrosis were comparable (0.84 vs 0.84 vs 0.84).…”

“…The examination method was based on the imaging guidelines of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) 5 and the previous literature. [9][10][11] The probe was placed sections of S5 and S6 of the right intercostal space in the right lobe, avoiding the long axis of blood vessels, and the liver parenchyma was clearly displayed on the twohttps://doi.org/10.2147/IJGM.S319101…”

Estimation of liver elasticity using the finite element method and four‐dimensional computed tomography images as a biomarker of liver fibrosis

“…3(a)], the correlation value of our estimated right lobe elasticity was 0.87. In addition, Gatos et al 26 also performed evaluation focused on the right lobe of the patient’s liver, and reported that the diagnostic performance of STE for the diagnosed liver fibrosis stage is comparable to that of UTE and SWE. Therefore, this could allow for the accurate diagnosis of liver fibrosis using our estimated elasticity maps, even in the absence of special devices for elastography.…”

“…MRI and ultrasound may also be used as the bases of a noninvasive technique that is clinically used as a quantitative tool for diagnosing potential liver fibrosis 21 . Ultrasound‐based elastography, such as ultrasound‐based transient elastography (UTE), shear‐wave elastography (SWE), acoustic radiation force impulse (ARFI), real‐time strain elastography (RTE), and sound touch elastography (STE), has been reported as a useful noninvasive diagnostic tool for staging liver fibrosis in patients with chronic liver disease and chronic viral hepatitis 21–26 . In particular, UTE is the most commonly used imaging‐based fibrosis assessment tool as it is characterized by a brief procedure time, immediate results, and excellent inter‐ and intraobserver agreement 27,28 .…”

“…Numerous studies 24,34 have confirmed the efficiency and reproducibility of these techniques in the diagnosis of liver fibrosis and cirrhosis. Several studies 25,35 have reported the diagnostic performance of RTE in assessing severe fibrosis in cases of chronic viral hepatitis B and C. However, Ferraioli et al 25 reported that RTE does not yet have the potential to replace UTE in assessing fibrosis in patients with chronic hepatitis C. Gatos et al 26 evaluated the performance in chronic liver disease diagnosis of STE, a new elastographic method. They reported that STE could be used as an alternative to the already‐established methods, UTE and SWE.…”