Agreement and accuracy of shear-wave techniques (point shear-wave elastography and 2D-shear-wave elastography) using...

Area of Science:

• Hepatology
• Medical Imaging
• Diagnostic Accuracy

Background:

• Liver fibrosis staging is crucial for managing chronic liver diseases.
• Transient elastography (TE) is a reference standard, but alternative methods are needed.
• Shear-wave elastography (SWE) offers non-invasive liver stiffness measurement (LSM).

Purpose of the Study:

• To compare the diagnostic accuracy of point shear-wave elastography (p-SWE) and 2D-shear-wave elastography (2D-SWE) for liver fibrosis staging.
• To evaluate the agreement between p-SWE, 2D-SWE, and transient elastography (TE).
• To determine optimal cutoffs for p-SWE and 2D-SWE in identifying significant fibrosis stages.

Main Methods:

• Retrospective analysis of data from 289 patients with chronic liver diseases.
• Comparison of liver stiffness measurements (LSM) obtained by TE, p-SWE, and 2D-SWE.
• Fibrosis staging based on TE's 'rule of five' and ROC curve analysis for optimal cutoff identification.

Main Results:

• Both p-SWE and 2D-SWE showed satisfactory correlation with TE (rho=0.69 and 0.59, respectively).
• p-SWE demonstrated significantly higher area under the receiver operating characteristic curves (AUROCs) compared to 2D-SWE for detecting advanced fibrosis (cACLD).
• Optimal p-SWE thresholds were more sensitive and specific for identifying advanced fibrosis (TE ≥ 15 kPa) than 2D-SWE.

Conclusions:

• Liver stiffness measurement by p-SWE and 2D-SWE correlates with TE.
• p-SWE appears more accurate than 2D-SWE in identifying patients with advanced liver fibrosis.
• p-SWE may be a more reliable tool for non-invasive fibrosis staging in chronic liver disease.