Diagnostic Impact of Two-Dimensional Shear Wave Elastography for Liver Fibrosis: A Multicenter Retrospective Study

Two-dimensional shear wave elastography (2D-SWE) is a non-invasive technique for assessing liver fibrosis. However, its clinical utility has not been fully established. This study evaluated the diagnostic accuracy of 2D-SWE using magnetic resonance elastography (MRE) as the reference standard in a retrospective, multicenter, large-scale cohort.

A total of 744 patients with chronic liver disease were included in the analysis. The association between 2D-SWE measurements and fibrosis stages determined by MRE was assessed. The correlation between 2D-SWE and MRE values was analyzed, and the diagnostic performance of 2D-SWE was evaluated using receiver operating characteristic (ROC) curve analysis.

As 2D-SWE and MRE values were not normally distributed, they were log-transformed (Log-2D-SWE and Log-MRE) for analysis. A strong correlation was observed between Log-2D-SWE and Log-MRE values, with a correlation coefficient of 0.764 (p < 0.001). When 2D-SWE values were stratified according to the histological stages of liver fibrosis (F0-F4), based on MRE data, the corresponding median values were 4.61, 5.63, 6.18, 7.44, and 11.64 kPa, respectively (p < 0.001, Jonckheere-Terpstra test). The areas under the ROC curve (AUROCs) and cutoff values for 2D-SWE were 0.872 and 5.47 kPa for ≥ F1 (n = 285), 0.894 and 5.88 kPa for ≥ F2 (n = 217), 0.931 and 6.48 kPa for ≥ F3 (n = 137), and 0.937 and 7.39 kPa for F4 (n = 81), respectively. In subgroup analyses, AUROCs for detecting ≥ F2, ≥F3, and F4 exceeded 0.78, even among patients with elevated body mass index or advanced hepatic steatosis.

2D-SWE represents a highly useful and reliable non-invasive modality for assessing of liver fibrosis.