Liver Elastography in Primary Sclerosing Cholangitis Patients Using Three Different Scanner Systems.

Area of Science:

• Hepatology
• Medical Imaging
• Diagnostic Technologies

Background:

• Primary sclerosing cholangitis (PSC) is a chronic liver disease requiring accurate fibrosis assessment.
• Liver stiffness measurement (LSM) using elastography is a non-invasive tool for staging liver fibrosis.
• Different elastography techniques may yield varying results in PSC patients.

Purpose of the Study:

• To characterize and compare three liver elastography methods: Transient Elastography (TE), point Shear Wave Elastography (pSWE), and 2D Shear Wave Elastography (2D-SWE) in PSC patients.
• To evaluate the feasibility and performance of 2D-SWE, a novel technique in PSC, against established methods.
• To assess the correlation of LSMs with biochemical markers of liver fibrosis.

Main Methods:

• Sixty-six adult PSC patients underwent head-to-head liver elastography using TE, pSWE, and 2D-SWE after B-mode ultrasonography and blood tests.
• Liver stiffness measurements (LSMs) were obtained and compared across the three techniques.
• Correlation analyses were performed between LSMs from different methods and with the Enhanced Liver Fibrosis (ELF) test.

Main Results:

• pSWE yielded lower LSMs than TE, while 2D-SWE showed a less steep slope but was not significantly different from TE.
• Excellent correlation was observed between pSWE and TE (ICC=0.92).
• Moderate correlation for 2D-SWE with pSWE or TE improved when overweight individuals were excluded; LSMs correlated with the ELF test across all systems.

Conclusions:

• LSM using TE, pSWE, and 2D-SWE is feasible in PSC patients.
• 2D-SWE may underestimate liver stiffness compared to TE in this cohort.
• Further research is needed to validate 2D-SWE for routine use in PSC management.