Quantification of ultrasound imaging in the staging of hepatic fibrosis

The need for a staging of hepatic fibrosis has become particularly urgent in the last few years in order to start new therapeutic treatments. The objective of this study is to identify ultrasound descriptors and achieve a staging of hepatic fibrosis with non-invasive, rapid and inexpensive methods, both as an alternative and a support to the ultrasound elastography examination.

This study evaluated 196 patients under treatment at the Alcohological Regional Center. An image regarding a scanning of the epigastrium with a high-frequency linear probe (7.5-12 MHz) has been selected for quantification. The hyperechogenic line corresponding to the Glisson capsule on the hepatic segment III has been evaluated with the Genoa Line Quantification (GLQ) software. These data have been compared with the shearwave ultrasound elastography.

The best discrimination between patients with medium-advanced fibrosis (F3-F4) and healthy patients or patients with no fibrosis or mild fibrosis (F0-F1) has been achieved using the three parameters of variance and mean of gradient and line continuity. In particular, a sensitivity of 74%, a specificity of 82%, positive predictive value 80.4%, negative predictive value 75.9% and an accuracy of 78% has been obtained.

GQL has allowed a classification, which is well concordant with the ultrasound elastography data. The use of the GQL may also be developed within centers, which are not provided with ultrasound elastography techniques, when an ultrasound elastography examination cannot be performed due to technical problems and as a support to elastography, if the outcome of this examination is not sufficiently clear.