Ultrasound Elastography Correlates Treatment Response by Antiviral Therapy in Patients with Chronic Hepatitis C

Abstract

Objective: To investigate the relationship between tissue elasticity before and after antiviral therapy and shear wave as well as strain elastography. Methods: FibroScan and real-time tissue elastography were performed before and after antiviral therapy for chronic hepatitis C, and treatment efficacy and elastographic findings were comparatively analyzed. Elasticity was evaluated by measuring liver stiffness (LS) in kilopascals using FibroScan, and the liver fibrosis index (LFI) was assessed by real-time tissue elastography. Results: LS and LFI correlated well before and after therapy (r = 0.567, p = 0.003 and r = 0.576, p = 0.002, respectively). In the group without a sustained virological response (SVR), LS increased in 4 of 5 patients. Patients with an increase in both LS and LFI were all in the non-SVR group (3/3, 100%). In addition, LS increased in all patients except 1 in the non-SVR group (4/5, 80%). In the SVR group, both LS and LFI decreased in all patients except 1 (18/19, 94.7%). In the patient with an increase in LS despite achieving SVR, LS decreased quickly after alcohol cessation. Conclusions: With a few exceptions, SVR improved LS. All patients with an increase in LFI were in the non-SVR group, even though LFI decreased in 2 patients. Our findings suggest that an LFI increase indicates lack of treatment efficacy with antiviral therapy. LFI may be useful for the assessment of treatment efficacy in patients with worsening of LS despite achieving SVR with antiviral therapy.

Influence of Liver Inflammation on Liver Stiffness Measurement in Patients with Autoimmune Hepatitis Evaluation by Combinational Elastography

“…The procedure was performed after overnight fasting using ultrasound (EUB-8500 or HI VISION Ascendus; Hitachi, Tokyo, Japan) and an EUP-L52 linear type probe (3-7 MHz; Hitachi), by means of a previously reported method [4,6] . The liver fibrosis index (LFI) was calculated using a multiple regression equation with feature values obtained from RTE images, for the diagnosis of liver fibrosis in patients with chronic hepatitis C [1] .…”

A Newly Developed Shear Wave Elastography Modality: With a Unique Reliability Index

“…They have been reported to be useful in the decision of the clinical treatment of hepatic disease, or in the diagnosis of noninvasive liver fibrosis [1,2,3,4,5]. Using elastography, it is also possible to noninvasively predict hepatocarcinogenesis [6,7].…”

Prospective Risk Analysis of Hepatocellular Carcinoma in Patients with Chronic Hepatitis C by Ultrasound Strain Elastography

“…As liver fibrosis progresses, the blue area increases and the image texture becomes increasingly distorted. The multiple regression equation for diagnosis of hepatic fibrosis uses feature values from RTE images to calculate the LFI, and is widely used to analyze RTE color map patterns objectively [13,14,15,16,22]. …”

“…Liver stiffness measured by shear wave imaging is useful not only in diagnosing severe liver fibrosis but also for liver carcinogenesis risk assessment [8,9,10]. We had also found real-time tissue elastography (RTE), a type of strain imaging, to be useful for diagnosing liver fibrosis [11,12,13,14,15,16], but its use in predicting liver cancer prediction has not been reported.…”