Comparison of point‐shear wave elastography (ElastPQ) and transient elastography (FibroScan) for liver fibrosis staging in patients with non‐alcoholic fatty liver disease

BACKGROUND AND AIMS ElastPQ is a point shear wave elastography (pSWE) technique used to non-invasively assess liver fibrosis. We compared liver stiffness measurements (LSM) by ElastPQ and Fibroscan Transient Elastography (F-TE) in a cohort of patients with non-alcoholic fatty liver disease (NAFLD). We further evaluated the performance of ElastPQ in a subgroup of patients with available liver histology. MATERIALS AND METHODS We included patients with NAFLD who presented in a dedicated multidisciplinary clinic. Anthropometric parameters, blood tests and elastography measurements were obtained using F-TE and ElastPQ as part of routine clinical care. RESULTS We enrolled 671 patients with NAFLD, mean age 55.8±13 years, BMI 31.5±5.7 kg/m2 , 56.6% males, 41% diabetes, 53.7% hypertension, 68% dyslipidaemia. ElastPQ showed an excellent correlation with F-TE (Spearman's r=0.80, p<0.001), which was better for mild/moderate stages of fibrosis. Independent predictors of a >2kPa discrepancy between the two techniques were a larger waist circumference and F-TE ≥10 kPa. In the subgroup of 159 patients with available histology, ElastPQ showed similar diagnostic accuracy with F-TE in staging liver fibrosis (ElastPQ AUCs 0.83, 0.84, 0.88 and 0.96, for F≥1, F≥2, F≥3 and F=4, respectively). Optimal cut-off values of ElastPQ for individual fibrosis stages were lower than those of F-TE. CONCLUSIONS ElastPQ shows an excellent correlation with F-TE in patients with NAFLD, which was better for lower LSM. The optimal cut-off values of ElastPQ are lower than those of F-TE for individual stages of fibrosis. ElastPQ has similar diagnostic accuracy to F-TE for all stages of fibrosis.