Shear wave elastography of the liver – review on normal values

Ye, Dong; Şirli, Roxana; Ferraioli, Giovanna; Sporea, Ioan; Chiorean, Liliana; Cui, Xin‐Wu; Fan, Min; Wang, Wen Ping; Gilja, Odd Helge; Sidhu, Paul S.; Dietrich, Christoph F.

doi:10.1055/s-0042-117226

Cited by 38 publications

(26 citation statements)

References 82 publications

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“…In our study, the mean liver stiffness measurement of all persons without liver disease was 5.07 kPa (reference range, 3.62–7.02 kPa). Thus, these results are similar to studies, which also evaluated normal liver stiffness values, performed by TE, point SWE, and 2D SWE, ranging from 4.1 ± 0.9 to 6.4 ± 2.2 kPa . Therefore, considering our results, liver stiffness measurements for individuals without liver disease do not seem to vary considerably between the different methods and manufacturers.…”

Section: Discussionsupporting

confidence: 90%

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Liver Stiffness Measured by 2‐Dimensional Shear Wave Elastography: Prospective Evaluation of Healthy Volunteers and Patients With Liver Cirrhosis

Petzold¹,

Hofer²,

Ellenrieder³

et al. 2018

J of Ultrasound Medicine

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Objectives-We aimed to establish normal values for liver stiffness measurement, performed by 2-dimensional shear wave elastography (LOGIQ E9; GE Healthcare, Wauwatosa, WI), in healthy volunteers, patients with nonhepatic morbidities, and patients with histologically confirmed liver cirrhosis.Methods-A total of 175 participants were included between July 2016 and February 2018. Three cohorts were analyzed: healthy volunteers (n = 68), patients with healthy livers but nonhepatic morbidities (n = 57), and patients with liver cirrhosis (n = 50). Liver stiffness measurement was performed by 2 observers with different levels of experience to determine interobserver agreement.Results-Of the 175 participants included, 91 were male, and the mean age ± SD was 44.4 ± 19.4 years. The success rate for 175 liver stiffness measurements was 95.4%. The number of unsuccessful measurements was significantly higher in the liver cirrhosis cohort (P = .04). The interobserver agreement was excellent (intraclass correlation coefficient, 0.87). Liver stiffness in the healthy-liver patient cohort (4.93 ± 0.83 kPa) was not significantly different from that in the healthy-volunteer cohort (5.19 ± 1.03 kPa; P = .13). Apart from male sex in the healthy-volunteer cohort, age, body mass index, mild steatosis, and nonhepatic morbidities had no significant impact on liver stiffness. Liver stiffness values in participants without liver disease (healthy volunteers and healthy-liver patients; n = 125) ranged from 3.62 to 7.02 kPa (2.5th-97.5th percentiles). Notably, there was no overlap of liver stiffness measurements between the patients without liver disease and the cirrhosis cohort ).Conclusions-Liver stiffness values in healthy individuals vary widely and are not dependent on age, body mass index, or specific nonhepatic comorbidities. Liver stiffness values within the normal range can noninvasively rule out cirrhosis, as liver stiffness is significantly higher in cirrhotic patients (P < .001). Twodimensional shear wave elastography has excellent interobserver agreement.

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Section: Discussionsupporting

confidence: 90%

“…Moreover, we aimed to establish cutoff values for histologically confirmed liver cirrhosis to examine whether it is possible to rule out liver cirrhosis for values within the defined normal range. Concerning 2D SWE, to our knowledge, this process has only been demonstrated with the Aixplorer system (SuperSonic Imagine, Aix‐en‐Provence, France) so far …”

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confidence: 98%

Liver Stiffness Measured by 2‐Dimensional Shear Wave Elastography: Prospective Evaluation of Healthy Volunteers and Patients With Liver Cirrhosis

Petzold¹,

Hofer²,

Ellenrieder³

et al. 2018

J of Ultrasound Medicine

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“…The different types of elastography vary both in the method used to exert the force (stress) and in the measurement of the subsequent tissue displacement (strain), but may be complementary because of their different physical properties, artifacts, limitations and the clinical applications for which they are best suited. The use of shear wave elastography is often preferred for the assessment of liver fibrosis [2][3][4][5][6][7][8][9].…”

Section: What Elastography Techniques Are Used?mentioning

confidence: 99%

Strain Elastography - How To Do It?

Dietrich

Barr

Farrokh

et al. 2017

Ultrasound Int Open

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148

130

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Tissue stiffness assessed by palpation for diagnosing pathology has been used for thousands of years. Ultrasound elastography has been developed more recently to display similar information on tissue stiffness as an image. There are two main types of ultrasound elastography, strain and shear wave. Strain elastography is a qualitative technique and provides information on the relative stiffness between one tissue and another. Shear wave elastography is a quantitative method and provides an estimated value of the tissue stiffness that can be expressed in either the shear wave speed through the tissues in meters/second, or converted to the Young’s modulus making some assumptions and expressed in kPa. Each technique has its advantages and disadvantages and they are often complimentary to each other in clinical practice. This article reviews the principles, technique, and interpretation of strain elastography in various organs. It describes how to optimize technique, while pitfalls and artifacts are also discussed.

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“…Ultrasound elastography is a useful non-invasive tool for the diagnosis of liver fibrosis in adults [1][2][3][4][5][6][7]. It plays a similar role in children, with some differences in the confounding factors and in the etiological spectrum of the liver disease; however, guidelines and recommendations have not been published yet.…”

Section: Introductionmentioning

confidence: 99%

Current Knowledge in Ultrasound-Based Liver Elastography of Pediatric Patients

et al. 2018

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Featured Application: In this review we present and discuss the published literature on the use of ultrasound-based liver elastography in children. The published data show that all the available shear wave elastography techniques are feasible and accurate for the assessment of liver fibrosis in children with diffuse liver disease due to several etiologies. For the assessment of focal liver lesions evidences are limited and no conclusion can be drawn so far.Abstract: Studies performed using transient elastography (TE), point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) have shown that these techniques are all feasible and accurate in children for the evaluation of liver fibrosis due to several etiologies. However, for some specific pediatric pathologies, such as biliary atresia, the evidence is still limited. As shown in adults, inflammation is a confounding factor when assessing fibrosis severity and care should be taken when interpreting the results. Due to the scarce comparative data between serological tests and elastography techniques in children, a definite conclusion regarding which is the best cannot be drawn. Neither non-invasive elastographic techniques nor laboratory scores allow determination of the presence and the degree of inflammation, necrosis, iron or copper deposits.

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Shear wave elastography of the liver – review on normal values

Cited by 38 publications

References 82 publications

Liver Stiffness Measured by 2‐Dimensional Shear Wave Elastography: Prospective Evaluation of Healthy Volunteers and Patients With Liver Cirrhosis

Liver Stiffness Measured by 2‐Dimensional Shear Wave Elastography: Prospective Evaluation of Healthy Volunteers and Patients With Liver Cirrhosis

Strain Elastography - How To Do It?

Current Knowledge in Ultrasound-Based Liver Elastography of Pediatric Patients

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