Real time shear wave elastography in chronic liver diseases: accuracy for predicting liver fibrosis, in comparison with serum markers.
AIM
To evaluate the correlation between liver stiffness measurement (LSM) by real-time shear wave elastography (SWE) and liver fibrosis stage and the accuracy of LSM for predicting significant and advanced fibrosis, in comparison with serum markers.


METHODS
We consecutively analyzed 70 patients with various chronic liver diseases. Liver fibrosis was staged from F0 to F4 according to the Batts and Ludwig scoring system. Significant and advanced fibrosis was defined as stage F ≥ 2 and F ≥ 3, respectively. The accuracy of prediction for fibrosis was analyzed using receiver operating characteristic curves.


RESULTS
Seventy patients, 15 were belonged to F0-F1 stage, 20 F2, 13 F3 and 22 F4. LSM was increased with progression of fibrosis stage (F0-F1: 6.77 ± 1.72, F2: 9.98 ± 3.99, F3: 15.80 ± 7.73, and F4: 22.09 ± 10.09, P < 0.001). Diagnostic accuracies of LSM for prediction of F ≥ 2 and F ≥ 3 were 0.915 (95%CI: 0.824-0.968, P < 0.001) and 0.913 (95%CI: 0.821-0.967, P < 0.001), respectively. The cut-off values of LSM for prediction of F ≥ 2 and F ≥ 3 were 8.6 kPa with 78.2% sensitivity and 93.3% specificity and 10.46 kPa with 88.6% sensitivity and 80.0% specificity, respectively. However, there were no significant differences between LSM and serum hyaluronic acid and type IV collagen in diagnostic accuracy.


CONCLUSION
SWE showed a significant correlation with the severity of liver fibrosis and was useful and accurate to predict significant and advanced fibrosis, comparable with serum markers.
['Jeong|Jae Yoon|JY|', 'Kim|Tae Yeob|TY|', 'Sohn|Joo Hyun|JH|', 'Kim|Yongsoo|Y|', 'Jeong|Woo Kyoung|WK|', 'Oh|Young-Ha|YH|', 'Yoo|Kyo-Sang|KS|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D019540:Area Under Curve D015415:Biomarkers D001706:Biopsy D002648:Child D002908:Chronic Disease D054459:Elasticity Imaging Techniques D005260:Female D006801:Humans D008099:Liver D008103:Liver Cirrhosis D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D012372:ROC Curve D056910:Republic of Korea D012189:Retrospective Studies D012720:Severity of Illness Index D055815:Young Adult
Elastography Liver fibrosis Serum markers Liver stiffness Liver biopsy