Point Shear Wave Elastography for Assessing Liver Stiffness in Chronic Liver Diseases of Different Etiologies Compared to Biopsy

Isr Med Assoc J. 2021 Apr;23(4):223-228.

Abstract

Background: Point shear-wave elastography (pSWE) is a new method to assess the degree of liver fibrosis. It has been shown to be effective in detecting stiffness in viral hepatitis.

Objectives: To determine the feasibility of pSWE for assessing liver stiffness and fibrosis in liver diseases of different etiologies.

Methods: This prospective single-center study included a population of adult patients with chronic liver diseases from different etiologies, who were scheduled for liver biopsy, and a control group of healthy adults who prospectively underwent pSWE. Ten consecutive pSWE measurements of the liver were performed using a Philips iU22 ultrasound system. Stiffness degree was compared to liver biopsy results. Fibrosis degree was staged according to METAVIR scoring system.

Results: The study group was comprised of 202 patients who underwent liver biopsy and pSWE test and a control group consisting of 14 healthy adults who underwent pSWE for validation. In the study group, the median stiffness was 5.35 ± 3.37 kilopascal (kPa). The median stiffness for F0-1, F2, F3, and F4 as determined by liver biopsy results were 4.9 kPa, 5.4 kPa, 5.7 kPa, and 8 kPa, respectively. The median stiffness in the control group was 3.7 ± 0.6 kPa. Subgroup analyses were conducted for viral hepatitis vs. non-viral hepatitis and steatohepatitis vs. non-steatohepatitis groups.

Conclusions: pSWE is a reproducible method for assessing liver stiffness and is in a linear relationship with fibrosis degree as seen in pathology. Compared with patients with non-significant fibrosis, healthy controls showed significantly lower values.

MeSH terms

  • Biopsy / methods
  • Chronic Disease
  • Elasticity Imaging Techniques* / instrumentation
  • Elasticity Imaging Techniques* / methods
  • Feasibility Studies
  • Female
  • Humans
  • Israel / epidemiology
  • Liver Cirrhosis* / diagnostic imaging
  • Liver Cirrhosis* / etiology
  • Liver Diseases / classification
  • Liver Diseases / diagnosis*
  • Liver Diseases / epidemiology
  • Liver* / diagnostic imaging
  • Liver* / pathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Reproducibility of Results
  • Severity of Illness Index