Related Experiment Video
Updated: Mar 21, 2026
Application of Ultrasound and Shear Wave Elastography Imaging in a Rat Model of NAFLD/NASH
Published on: April 20, 2021
Liver Fibrosis Evaluation Using Real-time Shear Wave Elastography in Hepatitis C-Monoinfected and Human
Wim Verlinden1, Stefan Bourgeois2, Pierre Gigase3
1Department of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, BelgiumLaboratory of Experimental Medicine and Pediatrics, University of Antwerp, Edegem, Belgium wim.verlinden@uza.be.
Insights
Shear wave elastography (SWE) effectively predicts liver fibrosis in hepatitis C virus (HCV) patients, including those coinfected with HIV. Combining SWE with the FIB-4 score enhances accuracy for assessing liver fibrosis stages.
Area of Science:
- Hepatology
- Medical Imaging
- Diagnostic Accuracy
Background:
- Chronic hepatitis C virus (HCV) infection can lead to liver fibrosis.
- Previous studies on shear wave elastography (SWE) for liver fibrosis assessment excluded HIV/HCV-coinfected patients.
- Noninvasive methods are crucial for evaluating liver fibrosis in HCV patients.
Purpose of the Study:
- To evaluate the diagnostic performance of SWE for liver fibrosis in HCV patients, including monoinfected and coinfected individuals.
- To compare SWE's accuracy with liver biopsy as the reference standard.
- To assess the utility of combining SWE with the FIB-4 score.
Main Methods:
- Liver stiffness was measured using SWE in 80 patients with HCV undergoing liver biopsy (METAVIR staging).
- Diagnostic performance was assessed using receiver operating characteristic (ROC) curves.
- Cutoff values for different fibrosis stages were determined.
Main Results:
- A significant correlation was found between liver stiffness and fibrosis stage (ρ = 0.685, P < .001).
- High diagnostic accuracy was achieved for distinguishing various fibrosis stages (AUROCs up to 0.975).
- No significant difference in liver stiffness was observed between monoinfected and coinfected patients, suggesting shared cutoff values.
Conclusions:
- Liver SWE is an effective noninvasive tool for predicting liver fibrosis in HCV patients.
- Monoinfected and coinfected patients can utilize the same SWE cutoff values.
- Combining SWE with the FIB-4 score improves accuracy but may increase inconclusive results.
Objectives:
A few studies have evaluated real-time shear wave elastography (SWE) for assessing liver fibrosis by measuring liver stiffness in patients with chronic hepatitis C virus (HCV) infection, but they excluded human immunodeficiency virus/HCV-coinfected patients. We investigated the diagnostic performance of liver stiffness measured by SWE as a noninvasive predictor of liver fibrosis in HCV using liver biopsy as a reference standard, including monoinfected and coinfected patients.
Methods:
We measured liver stiffness in patients with HCV undergoing liver biopsy (METAVIR fibrosis staging).
Results:
Eighty patients (53 monoinfected and 27 coinfected) were included. There was a significant correlation between liver stiffness and fibrosis stage (ρ = 0.685; P < .001). Areas under the receiver operating characteristic curve were 0.841, 0.879, and 0.975 when comparing fibrosis stages F0-F1 versus F2-F4, F0-F2 versus F3-F4, and F0-F3 versus F4, respectively. Suggested cutoff values were 8.5 kPa for F2, 10.4 kPa for F3, and 11.3 kPa for F4, with sensitivity and specificity of 81% and 84%, 81% and 95%, and 100% and 90%. There was no significant difference between the liver stiffness of monoinfected and coinfected patients (P = .453). When combining SWE with the fibrosis-4 score, accuracy increased from 82% to 88% and from 88% to 96%, with incongruent results of 26% and 29%, for F0-F1 versus F2-F4 and F0-F2 versus F3-F4.
Conclusions:
Shear wave elastography of the liver is an effective noninvasive predictor of liver fibrosis in patients with HCV. There was no significant difference between monoinfected and coinfected patients; hence, the same cutoff values can be used for both groups. Combination of SWE with the fibrosis-4 score leads to higher accuracy, although at the expense of inconclusive results in some patients.
More Related Videos
06:09Author Spotlight: Advancing Hepatic Fibrosis Diagnosis Using Magnetic Resonance Elastography and AI
Published on: July 21, 2023
05:56Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
Published on: August 29, 2025
Related Concept Videos
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:25Hepatitis