Comparison of Two-Dimensional Shear Wave Elastography and Real-Time Tissue Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B

Abstract

Background: Noninvasive assessment of liver fibrosis has important clinical significance. Different techniques including two-dimensional shear-wave elastography (2D SWE) and real-time tissue elastography (RTE) are reported to be useful for the noninvasive diagnosis of hepatic fibrosis. All these techniques are affected by many factors. How to choose a reasonable method needs further studies. Purpose: This study was conducted to comparatively assess the diagnostic performance of 2D SWE and RTE in patients with Chronic Hepatitis B (CHB) and influence of inflammation on the stiffness values obtained by both techniques, so as to objectively assess the reasonable choice between these 2 elastography techniques for noninvasive assessment of hepatic fibrosis in clinical practice. Materials and Methods: Four-hundred and thirty-seven patients with CHB meeting the inclusion criteria were enrolled in the study. All patients underwent liver stiffness measurements by using 2D SWE and RTE on the same day. Histologic fibrosis was staged and inflammation activity was graded based on the METAVIR scoring system on liver biopsy specimens. Results: The liver stiffness values by using 2D SWE and RTE both increased in parallel with the degree of liver fibrosis and the grade of inflammation. However, the diagnostic efficacy of significant fibrosis and cirrhosis using 2D SWE was significantly higher than that of RTE. The 2D SWE measurement values were statistically different in different alanine aminotransferase (ALT) levels and METAVIR activity grades; however, no statistically significant differences were observed by using RTE. The diagnostic efficacy of 2D SWE significantly varied with elevated ALT levels compared with RTE. Conclusion: 2D SWE was more accurate than RTE in the assessment of significant fibrosis and cirrhosis in patients with CHB. Compared with RTE, the measurement values and diagnostic performance obtained by 2D SWE were prone to be more easily affected by the inflammation fluctuations.

Shear wave elastography (SWE) may be more sensitive and more precise than transient elastography (TE) in predicting significant fibrosis in CHB patients：A prospective comparative study

“…While comparing with SWE, the probe location of TE is the only factor determined by the operator. The results of our study are similar to a previous study on the elastography assessment of liver fibrosis comparing SWE and TE of CHB patients [14,15]. The cut-off value of SWE for identifying significant fibrosis (F>2) in our treatment-naive CHB patients showed 9.05 kPa, which is higher than the reported study [13][14][15], while the mean liver stiffness determined with SWE in the cohort of participants with healthy livers was 5.…”

“…Now, SWE has proven to be one of reliable methods of liver stiffness for chronic liver diseases [8][9][10][11][12]. There are also few studies about SWE in the assessment of liver fibrosis with histologic confirmation for treatment-naïve CHB patients compared with other non-invasive methods [13][14][15]. But there have been no published studies evaluating independent factor of SWE compared with TE in patients with CHB infection.…”

Two-dimensional shear wave elastography for significant liver fibrosis in patients with chronic hepatitis B: A systematic review and meta-analysis

“…After excluding non-original researches, studies not in the field of interest, non-English studies, etc., 27 full-text articles were downloaded for careful screening. Finally, eleven eligible studies with 2623 patients were included for narrative synthesis [27][28][29][30][31][32][33][34][35][36][37] and 9 studies including 1977 patients were selected for meta-analysis [28][29][30][31][32][34][35][36][37]. Table 1 summarizes the basic characteristics of the included studies.…”

“…Table 1 summarizes the basic characteristics of the included studies. Most studies were from China [27][28][29][30][31][33][34][35][36][37], while only 1 study came from Korea [32]. There were six prospective studies [27,30,33,[35][36][37] and 5 retrospective studies [28,29,31,32,34].…”

“…Most studies were from China [27][28][29][30][31][33][34][35][36][37], while only 1 study came from Korea [32]. There were six prospective studies [27,30,33,[35][36][37] and 5 retrospective studies [28,29,31,32,34]. Six studies recruited consecutive patients [27,29,30,34,36,37], while inconsecutive enrollments were found in 5 studies [28,[31][32][33]35].…”