LOGIQ E9 Shear Wave Elastrography for Detection of Liver Fibrosis in Patients with Chronic Hepatitis C Virus. Issue 11 (November 2016)

• Record Type: Journal Article
• Authors: Abrams, Gary A.; Jamal, Hira; Deeter, William T.; Patil, Nirav
• Is Part Of: Southern medical journal. Volume 109:Issue 11(2016)
• Publication Date: 2016-11
• Subjects: Aspartate Aminotransferase-to-Platelet Index -- Fibrosis-4 Index -- hepatitis C virus -- liver fibrosis -- LOGIQ E9 -- shear wave elastography; Medicine -- Periodicals; 610.5
• DOI: 10.14423/SMJ.0000000000000562
• Languages: English
• ISSNs: 0038-4348

Abstract

Abstract : Objectives: Shear wave elastography (SWE) is an emerging technology that assesses hepatic fibrosis. The aim of our study was to determine the diagnostic accuracy of General Electric (GE) Healthcare's LOGIQ E9 SWE in patients with chronic hepatitis C virus using liver biopsy as the reference standard. Methods: The liver stiffness of 43 subjects with hepatitis C virus was assessed using LOGIQ E9 SWE immediately before they underwent liver biopsy. The Fibrosis-4 Index (FIB-4) and Aspartate Aminotransferase-to-Platelet Index (APRI) were calculated, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. Results: Mild hepatic fibrosis (F0–F2) was noted in 30 of the 43 (69.7%) patients and advanced disease (F3–F4) was seen in 13 of the 43 (30.3%) individuals. Using the GE LOGIQ E9 SWE proposed cutoff value of ≥9.4 kPa for advanced fibrosis, the sensitivity, specificity, PPV, and NPV were only 69.2%, 73.3%, 52.9%, and 84.6%, respectively. The post hoc analysis identified best cutoff values of <9.4 and ≥12 kPa, thereby classifying 76% of patients with an NPV of 84.6% and a PPV of 85.7%. The Aminotransferase-to-Platelet Index results were as follows: 83.3%, sensitivity, 95.2% specificity, 83.3% PPV, and 95.2% NPV in 27 of the individuals (37% remained unclassifiable). The FIB-4 Index demonstrated 100% sensitivity, 76.9% specificity, 66.6% PPV, and 100% NPV; however, 24 (56%) of the patients were classified within the indeterminate range. Conclusions: In our cohort, the proposed GE LOGIQ value of ≥9.4 kPa did not adequately discriminate subjects with advanced fibrosis. Further prospective evaluation of our post hoc analyses is warranted to identify the ideal cutoff values for the LOGIQ E9 system. Abstract : Shear wave elastography (SWE) is a validated technique that noninvasively detects hepatic fibrosis. Four manufacturers have launched products that use two-dimensional SWE: SuperSonic Imagine, Siemens Medical Solutions, Toshiba Medical Systems, and General Electric (GE) Healthcare, whose product is called LOGIQ E9. GE investigated 43 patients with hepatitis C virus and reported a 9.4-kPa cutoff value for advanced fibrosis, which is significantly lower than other validated systems. This article determines the diagnostic accuracy of the LOGIQ E9 SWE using liver biopsy as a reference standard.