Magnitude dependent discordance in liver stiffness measurements using elastography point quantification with...

Area of Science:

• Hepatology
• Medical Imaging
• Diagnostic Performance Evaluation

Background:

• Chronic liver diseases (CLD) necessitate accurate non-invasive methods for staging liver fibrosis.
• Transient elastography (TE) is a common method, but point shear wave elastography (ElastPQ) offers an alternative approach.

Purpose of the Study:

• To evaluate the diagnostic performance of ElastPQ for non-invasive liver fibrosis assessment in CLD patients.
• To compare ElastPQ with TE as a reference standard for liver stiffness measurement (LSM).

Main Methods:

• Liver stiffness was measured using both TE and ElastPQ in 165 CLD patients and 20 healthy volunteers.
• Fibrosis staging by TE served as the reference standard.
• Statistical analyses included correlation, ROC analysis, Bland-Altman plots, and Passing-Bablok regression.

Main Results:

• ElastPQ demonstrated high diagnostic performance for fibrosis stages F≥2 (AUC=0.96), F≥3 (AUC=0.98), and F4 (AUC=0.98).
• While TE and ElastPQ measurements correlated significantly (r=0.86), they were not interchangeable, especially when TE values exceeded 10 kPa.
• Bland-Altman and Passing-Bablok analyses revealed significant differences between the two methods at higher stiffness levels.

Conclusions:

• ElastPQ is a reliable method for liver fibrosis assessment, particularly relevant for non-alcoholic fatty liver disease (NAFLD).
• LSM values from TE and ElastPQ are not interchangeable, with discrepancies increasing above 10 kPa.
• Further research is warranted to explore ElastPQ's utility in sub-classifying compensated advanced chronic liver disease.