Shear Wave Elastography and Shear Wave Dispersion Imaging in the Assessment of Liver Disease in Alpha1-Antitrypsin Deficiency

Schulz, Marten; Kleinjans, Moritz; Strnad, Pavel; Demir, Münevver; Holtmann, Theresa Maria; Tacke, Frank; Wree, Alexander

doi:10.3390/diagnostics11040629

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…US detection of CFLD is difficult and non-specific unless it is at an advanced stage (11). 2D-SWE is a promising new tool to detect hepatic fibrosis indirectly by measuring liver stiffness and has been shown to be useful in adult CF patients and different chronic liver diseases (11,12). In a study of 125 children with CF with SWE, the LSM was 8.1 kPa (IQR = 6.7-11.9) in CFLD; It was found to be 6.2 kPa (IQR = 5.6-7.0; p<0.0001) in CFnoLD and 5.3 kPa (IQR = 4.9-5.8; p<0.0001) in healthy controls.…”

Section: Discussionmentioning

confidence: 99%

Kistik Fibrozisli Çocuklarda Karaciğer Tutulumunun Shear-Wave Elastografi ile Non-invaziv Değerlendirilmesi

Polat

Hızal

Özsezen

et al. 2023

Türkiye Çocuk Hast Derg

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Objectives: Hepatobiliary complications commonly occur in cystic fibrosis with increasing prevalence due to longer life expectancies and widespread screening efforts. Shear-wave elastography is a novel noninvasive method that involves application of local mechanical compression on soft tissue using focused ultrasonography and acquiring strain images that show tissue response. We aimed to compare abdominal ultrasonography and Shear-wave elastography and also clinical and laboratory findings of children with cystic fibrosis prospectively. Methods: This study is a prospective study conducted in 13 cystic fibrosis patients followed between February 2018 and March 2019. The severity of cystic fibrosis-related liver disease was categorized according to international criteria. Elastography measurement was performed in the same session with the evaluation of the liver by abdominal ultrasonography in the patients. The liver stiffness measurements were compared with clinical data, biochemistry parameters and ultrasound findings. Results: Measurements were performed in 13 cystic fibrosis children (3 boys, 10 girls). The mean kiloPascal values of liver stiffness measurements with shear-wave elastography were 8.68 (4.1-20.2). The median liver stiffness measurement in subjects without cystic fibrosis-related liver disease was 7.79 kiloPascals (n=5); The median liver stiffness measurement in subjects with cystic fibrosis-related liver disease was 9.23 kiloPascals. Conclusion: Cystic fibrosis-related liver disease has a significantly varying disease burden, its prevalence is increasing, and its early recognition is crucial for treatment and follow-up. Although there are no clear range values determined for children in tissue stiffness measurements in Shear-wave elastography, clinical and other laboratory and imaging methods and follow-up and evaluation are important.

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Section: Discussionmentioning

confidence: 99%

Kistik Fibrozisli Çocuklarda Karaciğer Tutulumunun Shear-Wave Elastografi ile Non-invaziv Değerlendirilmesi

Polat

Hızal

Özsezen

et al. 2023

Türkiye Çocuk Hast Derg

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“…In 29 patients with alpha-1 antitrypsin deficiency, SWDS (Aplio i800, Canon, Japan) was higher than the normal value described (14.2 (m/s)/Hz vs. (range 10.3–18.5 (m/s)/Hz vs.) but did not show a correlation with ALT as a necro-inflammation marker [ 39 ]. Similar results were shown in 22 patients with primary biliary cholangitis in which the mean SWDS (Aplio i800, Canon, Japan) value was 13.9 (m/s)/kHz (range, 11.6–21 (m/s)/kHz) and was significantly correlated with ALP and γ-GT [ 35 ].…”

Section: Clinical Studiesmentioning

confidence: 99%

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

Garcovich

Paratore

Ainora

et al. 2023

JPM

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The development of new applications in ultrasound (US) imaging in recent years has strengthened the role of this imaging technique in the management of different pathologies, particularly in the setting of liver disease. Improved B-mode imaging (3D and 4D), contrast-enhanced US (CEUS) and especially US-based elastography techniques have created the concept of multiparametric ultrasound (MP-US), a term borrowed from radiological sectional imaging. Among the new elastography techniques, shear wave dispersion is a newly developed imaging technology which enables the assessment of the shear waves’ dispersion slope. The analysis of the dispersion qualities of shear waves might be indirectly related to the tissue viscosity, thus providing biomechanical information concerning the pathologic state of the liver such as necroinflammation. Some of the most recent US devices have been embedded with software that evaluate the dispersion of shear waves/liver viscosity. In this review, the feasibility and the clinical applications of liver viscosity are reviewed based on the preliminary findings of both animal and human studies.

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“…2D-SWE is a modern, non-invasive US-based technique that allows to assess liver stiffness in an accurate way. It is an established method for detection and quantification of fibrosis in frequent liver diseases such as non-alcoholic fatty liver disease (NAFLD) and has also shown good accuracy in the assessment of less common liver diseases such as hepatic alpha1-antitrypsin deficiency or sinusoidal obstruction syndrome (20)(21)(22). Since it provides real-time visualization of the examined tissue, confounding factors such as ascites, cholestasis, signs of right heart failure or infiltrative malignancies can be excluded which is an advantage over TE.…”

Section: Introductionmentioning

confidence: 99%

Shear wave elastography-based liver fibrosis assessment in patients with chronic hepatitis E displays elevated liver stiffness regardless of previous antiviral therapy

Schulz¹,

Choi²,

Bachmann³

et al. 2022

Quant Imaging Med Surg

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Background: Hepatitis E virus (HEV) infection especially in immunocompromised individuals can lead to chronic hepatitis. Aggressive courses of chronic hepatitis E leading to liver cirrhosis in a short period of time have been described, but evidence on the degree of liver involvement in chronic hepatitis E is rare. We therefore aimed to quantify liver fibrosis in patients with chronic active hepatitis E compared to patients with sustained virological response after ribavirin (RBV) treatment using 2D-shear wave elastography (2D-SWE) to measure liver stiffness.Methods: Patients with chronic hepatitis E underwent 2D-SWE, B-mode and Doppler ultrasound and laboratory testing in order to assess severity of liver involvement. Results:In this cross-sectional study, we included 14 patients of whom 8 had ongoing chronic hepatitis E and 6 patients had been successfully treated for chronic hepatitis E. The most frequent cause for immunosuppression was prior kidney transplantation (n=12), one patient was a multivisceral transplant recipient, one had been treated for lymphoma. Five patients cleared HEV after RBV therapy, one patient reached viral clearance after reduction of his immunosuppressive medication. Using 2D-SWE measurement, 71.4% displayed increased stiffness indicative of liver fibrosis: 57.1% classified as significant fibrosis and 14.3% as severe fibrosis. Liver stiffness did not differ between patients with active chronic hepatitis E and in patients who had cleared HEV (1.59 and 1.54 m/s respectively). Compared with a control group of kidney transplant recipients without hepatitis E (1.44 m/s), the patients with a history of hepatitis E displayed a significantly higher liver stiffness (P=0.04).Conclusions: In our cohort of chronic hepatitis E patients, elevated liver stiffness indicating liver fibrosis was common and significantly higher than in controls. This is consistent with prior sparse reports of the presence of liver fibrosis or cirrhosis in chronic hepatitis E and emphasizes the need for HEV testing, therapy and research on new therapeutic options. As elevated liver stiffness was also present in patients after HEV treatment, continuous liver surveillance including elastography and ultrasound should be considered.

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Shear Wave Elastography and Shear Wave Dispersion Imaging in the Assessment of Liver Disease in Alpha1-Antitrypsin Deficiency

Cited by 5 publications

References 27 publications

Kistik Fibrozisli Çocuklarda Karaciğer Tutulumunun Shear-Wave Elastografi ile Non-invaziv Değerlendirilmesi

Kistik Fibrozisli Çocuklarda Karaciğer Tutulumunun Shear-Wave Elastografi ile Non-invaziv Değerlendirilmesi

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

Shear wave elastography-based liver fibrosis assessment in patients with chronic hepatitis E displays elevated liver stiffness regardless of previous antiviral therapy

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