Liver stiffness measurement reliability and main determinants of point shear‐wave elastography in patients with chronic liver disease

Fraquelli, Mirella; Baccarin, Alessandra; Casazza, Giovanni; Conti, Clara Benedetta; Giunta, M.; Massironi, Sara; Invernizzi, Federica; Donato, Maria Francesca; Maggioni, Marco; Aghemo, Alessio; Conte, Dario; Colombo, Massimo

doi:10.1111/apt.13711

Cited by 41 publications

(32 citation statements)

References 37 publications

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“…In line with our findings, a recent study comparing Philips ElastoPQ technology with Fibroscan having histology as a reference standard, showed an acceptable precision of Philips ElastoPQ (r = 0.67), but the thresholds were lower than those of Fibroscan for the same fibrosis stages [15]. In fact, in that case series of 186 patients, only 4 patients showed ElastoPQ values >20 kPa as compared with 15 patients who underwent Fibroscan.…”

Section: Discussionsupporting

confidence: 90%

Differences in liver stiffness values obtained with new ultrasound elastography machines and Fibroscan: A comparative study

Piscaglia

Salvatore

Mulazzani

et al. 2017

Digestive and Liver Disease

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Section: Discussionsupporting

confidence: 90%

Differences in liver stiffness values obtained with new ultrasound elastography machines and Fibroscan: A comparative study

Piscaglia

Salvatore

Mulazzani

et al. 2017

Digestive and Liver Disease

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“…Echosens, the manufacturer of the FibroScan device, recommends that TE be performed by an experienced operator (> 100 examinations). Using liver biopsy as the reference standard, a recent study has shown that ElastPQ ® matched TE for accuracy after the operator had performed at least 130 examinations [93].…”

Section: Operator Experiencementioning

confidence: 99%

EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Short Version)

et al. 2017

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We present here the first update of the 2013 EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) Guidelines and Recommendations on the clinical use of elastography with a focus on the assessment of diffuse liver disease. The short version provides clinical information about the practical use of elastography equipment and interpretation of results in the assessment of diffuse liver disease and analyzes the main findings based on published studies, stressing the evidence from meta-analyses. The role of elastography in different etiologies of liver disease and in several clinical scenarios is also discussed. All of the recommendations are judged with regard to their evidence-based strength according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. This updated document is intended to act as a reference and to provide a practical guide for both beginners and advanced clinical users.

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“…The latter combines measures of both precision and accuracy to determine how far the observed data deviate from the line of perfect concordance (i.e., the line at 45 degrees on a square scatterplot). Cutoffs different from those of TE have been reported for other pSWE elastography products as well [12][13][14]. We hypothesize that this difference may be due to the difference in the push pulse between the two techniques and to the different direction of the shear wave propagation.…”

Section: Discussionmentioning

confidence: 68%

Ruling-in and Ruling-out Significant Fibrosis and Cirrhosis in Patients with Chronic Hepatitis C Using a Shear Wave Measurement Method

Ferraioli

Maiocchi

Lissandrin

et al. 2017

JGLD

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Aims: To prospectively assess the cutoff values of a point shear wave measurement (SWM) method for ruling-in and ruling-out significant fibrosis and cirrhosis using transient elastography (TE) as the reference standard.Method: Consecutive patients with chronic hepatitis C were enrolled. Liver stiffness was assessed with the SWM method implemented on the HI VISION Ascendus ultrasound system (Hitachi Ltd, Japan) and with the TE method of the FibroScan® device (Echosens, France). For staging significant fibrosis (F≥2) and cirrhosis (F=4) we used the TE cutoffs of 7.0 and 12.0 kiloPascal (kPa), respectively. The diagnostic performance of SWM was assessed by calculating the area under the receiver operating characteristic (AUROC) curve. Cutoffs with specificity or sensitivity > 90% were chosen to rule-in or rule-out F≥2 and F=4.Results: 445 individuals [235 males, 210 females; mean age, 61.1 (13.3) years] were studied: 190 (42.7%) individuals had F0-F1 fibrosis stage, 82 (18.4%) F2, 46 (10.3%) F3, and 127 (28.6%) F4 fibrosis stage. For ruling-in F≥2 the SWM cutoff was 6.78 kPa [sensitivity, 76.9%(70.6-82.4); specificity, 90.3% (85.0-94.3)] and for ruling-out it was 5.55 kPa [sensitivity, 90.6% (85.8-94.1); specificity, 72.2% (64.9-78.6)]. For ruling-in F=4 the SWM cutoff was 9.15 kPa [sensitivity, 83.3% (74.4-90.2); specificity, 90.1% (86.0-93.2)] and for ruling-out it was 8.41 kPa [sensitivity, 90.6% (82.9-95.6); specificity, 82.2% (77.3-86.4)]. AUROCs were 0.92 (0.89-0.94) for F≥2 and 0.94 (0.91-0.96) for F=4.Conclusions. In clinical practice, the use of a dual cutoff of SWM may increase the confidence in staging liver fibrosis with a non-invasive shear wave elastography technique.Abbreviations: ARFI: acoustic radiation force impulse; AUROC: area under the ROC curve; CCC: concordance correlation coefficient; IQR/M: interquartile range/median; LSM: liver stiffness measurement; ROC: receiver operating characteristic; pSWE: point shear wave elastography; SWM: shear wave measurement; TE: transient elastography; US: ultrasound.

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Liver stiffness measurement reliability and main determinants of point shear‐wave elastography in patients with chronic liver disease

Abstract: Point quantification shear-wave elastography reliably and reproducibly evaluates liver stiffness, matching transient elastography for accuracy after a 1-year learning curve or 130 examinations.

Cited by 41 publications

References 37 publications

Differences in liver stiffness values obtained with new ultrasound elastography machines and Fibroscan: A comparative study

Differences in liver stiffness values obtained with new ultrasound elastography machines and Fibroscan: A comparative study

EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Short Version)

Ruling-in and Ruling-out Significant Fibrosis and Cirrhosis in Patients with Chronic Hepatitis C Using a Shear Wave Measurement Method

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