Assessing Liver Stiffness by 2-D Shear Wave Elastography in a Healthy Cohort.

The aim of this study was to assess the normal ranges of liver stiffness measurements (LSMs) in participants with healthy livers, using General Electric 2-D shear wave elastography (2-D-SWE-GE) compared with transient elastography (TE). We included 80 participants with healthy livers and without known liver disease, in whom liver stiffness was evaluated in the same session using two elastographic methods, TE and 2-D-SWE-GE. Reliable LSMs were defined for TE as the median of 10 measurements with a success rate of ≥60% and an interquartile range (IQR) < 30%, and for 2-D-SWE-GE, as the median of 10 measurements acquired in a homogenous area and an IQR < 30%. Participants with LSMs > 6.5 kPa by TE were excluded. Reliable LSMs were obtained in 79 participants (98.7%) by means of 2-D-SWE-GE and in 80 participants (100%) by means of TE (p = 0.9). The mean LSM obtained by 2-D-SWE-GE in our cohort of participants with healthy livers was 5.1 ± 1.3 kPa, which was significantly higher than the LSM assessed by TE (4.3 ± 0.9 kPa, p < 0.0001). In 2-D SWE-GE, mean LSMs were significantly higher for men than for women, 5.9 ± 1.2 kPa versus 4.7 ± 1.2 kPa (p = 0.0005). In conclusion, 2-D-SWE-GE has very good feasibility (98.7%) in healthy persons. The mean LSM determined by 2-D-SWE-GE in healthy participants was 5.1 ± 1.3 kPa. LSMs obtained by means of 2-D-SWE-GE were higher than those obtained by TE in participants with healthy livers.

[1]  G. Ferraioli,et al.  Accuracy of real‐time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: A pilot study , 2012, Hepatology.

[2]  J. Fleiss The design and analysis of clinical experiments , 1987 .

[3]  S. Bota,et al.  Comparative study between two point Shear Wave Elastographic techniques: Acoustic Radiation Force Impulse (ARFI) elastography and ElastPQ. , 2014, Medical ultrasonography.

[4]  M. Ziol,et al.  Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. , 2003, Ultrasound in medicine & biology.

[5]  E. Cholongitas,et al.  Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a meta-analysis of diagnostic accuracy. , 2011, Journal of hepatology.

[6]  F. Schaefer,et al.  EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography. Part 1: Basic Principles and Technology , 2013, Ultraschall in der Medizin.

[7]  M. Lupsor,et al.  Performance of Acoustic Radiation Force Impulse imaging for the staging of liver fibrosis: a pooled meta‐analysis , 2012, Journal of viral hepatitis.

[8]  Anil T Ahuja,et al.  Quantitative elastography of liver fibrosis and spleen stiffness in chronic hepatitis B carriers: comparison of shear-wave elastography and transient elastography with liver biopsy correlation. , 2013, Radiology.

[9]  J. Han,et al.  Shear Wave Elastography for Liver Stiffness Measurement in Clinical Sonographic Examinations , 2014, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[10]  Ioan Sporea,et al.  EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, Update 2017 (Long Version) , 2017, Ultraschall in der Medizin - European Journal of Ultrasound.

[11]  V. de Lédinghen,et al.  Pitfalls of liver stiffness measurement: A 5‐year prospective study of 13,369 examinations , 2010, Hepatology.

[12]  Eva Herrmann,et al.  Performance of transient elastography for the staging of liver fibrosis: a meta-analysis. , 2008, Gastroenterology.

[13]  Carmine Tinelli,et al.  Reproducibility of real-time shear wave elastography in the evaluation of liver elasticity. , 2012, European journal of radiology.

[14]  Asociacion Latinoamericana para el Estudio del Higado EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. , 2015, Journal of hepatology.

[15]  Jun Yong Park,et al.  Performance of Transient Elastography for the Staging of Liver Fibrosis in Patients with Chronic Hepatitis B: A Meta-Analysis , 2012, PloS one.

[16]  Ioan Sporea,et al.  Liver stiffness measurements by means of supersonic shear imaging in patients without known liver pathology. , 2013, Ultrasound in medicine & biology.

[17]  I. Sporea,et al.  Transient elastographic evaluation of subjects without known hepatic pathology: does age change the liver stiffness? , 2009, Journal of gastrointestinal and liver diseases : JGLD.

[18]  G. Ferraioli,et al.  Point shear wave elastography method for assessing liver stiffness. , 2014, World journal of gastroenterology.

[19]  Ioan Sporea,et al.  Which are the cut-off values of 2D-Shear Wave Elastography (2D-SWE) liver stiffness measurements predicting different stages of liver fibrosis, considering Transient Elastography (TE) as the reference method? , 2014, European journal of radiology.

[20]  M. Manns,et al.  A comparison of fibrosis progression in chronic liver diseases. , 2003, Journal of hepatology.

[21]  S. Bota,et al.  The mean values of liver stiffness assessed by Acoustic Radiation Force Impulse elastography in normal subjects. , 2011, Medical ultrasonography.

[22]  I. Sporea,et al.  Comparison between the M and XL probes for liver fibrosis assessment by transient elastography. , 2014, Medical ultrasonography.

[23]  S. Colombo,et al.  Normal liver stiffness and its determinants in healthy blood donors. , 2011, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[24]  D A Clevert,et al.  Comparing acoustic radiation force impulse imaging to transient elastography to assess liver stiffness in healthy volunteers with and without valsalva manoeuvre. , 2010, Clinical hemorheology and microcirculation.

[25]  S. Ahn,et al.  Normal liver elasticity values using acoustic radiation force impulse imaging: A prospective study in healthy living liver and kidney donors , 2012, Journal of gastroenterology and hepatology.

[26]  O H Gilja,et al.  EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography.Part 2: Clinical Applications , 2013, Ultraschall in der Medizin.

[27]  S. Bota,et al.  Factors that influence the correlation of acoustic radiation force impulse (ARFI), elastography with liver fibrosis. , 2011, Medical ultrasonography.

[28]  Ioan Sporea,et al.  Meta‐analysis: ARFI elastography versus transient elastography for the evaluation of liver fibrosis , 2013, Liver international : official journal of the International Association for the Study of the Liver.

[29]  I. Sporea,et al.  Performance of 2D-SWE.GE for predicting different stages of liver fibrosis, using Transient Elastography as the reference method. , 2017, Medical ultrasonography.

[30]  Tsuyoshi Shiina,et al.  WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 3: liver. , 2015, Ultrasound in medicine & biology.

[31]  Eva Herrmann,et al.  The efficiency of acoustic radiation force impulse imaging for the staging of liver fibrosis: a meta-analysis , 2013, European Radiology.

[32]  Anne-Claire Vergnaud,et al.  Liver stiffness values in apparently healthy subjects: influence of gender and metabolic syndrome. , 2008, Journal of hepatology.

[33]  O. Gilja,et al.  In Vitro Comparison of Five Different Elastography Systems for Clinical Applications, Using Strain and Shear Wave Technology. , 2016, Ultrasound in medicine & biology.

[34]  Ioan Sporea,et al.  Assessment of biopsy‐proven liver fibrosis by two‐dimensional shear wave elastography: An individual patient data‐based meta‐analysis , 2017, Hepatology.

[35]  A. Pollett,et al.  Feasibility and diagnostic performance of the FibroScan XL probe for liver stiffness measurement in overweight and obese patients , 2012, Hepatology.

[36]  Jie Zeng,et al.  Normal liver stiffness in healthy adults assessed by real-time shear wave elastography and factors that influence this method. , 2014, Ultrasound in medicine & biology.

[37]  Moon‐gyu Lee,et al.  Determination of normal hepatic elasticity by using real-time shear-wave elastography. , 2014, Radiology.

[38]  Man-Fung Yuen,et al.  Viral hepatitis B , 2003, The Lancet.