Comparing 2D-shear wave to transient elastography for the evaluation of liver fibrosis in nonalcoholic fatty liver disease. Issue 9 (19th July 2022)

• Record Type: Journal Article
• Authors: Karagiannakis, Dimitrios S; Markakis, George; Lakiotaki, Dimitra; Cholongitas, Evangelos; Vlachogiannakos, Jiannis; Papatheodoridis, George
• Is Part Of: European journal of gastroenterology & hepatology. Volume 34:Issue 9(2022)
• Page Start: 961
• Page End: 966
• Publication Date: 2022-07-19
• Subjects: liver fibrosis -- nonalcoholic fatty liver -- shear wave elastography -- transient elastography; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000002412
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : Background and aim: The aim of this study is to evaluate the performance of 2D-shear wave elastography (2D-SWE) in patients with nonalcoholic fatty liver disease (NAFLD) and compare it to transient elastography. Methods: Over 6 months, 552 patients with NAFLD underwent liver stiffness measurement (LSM) by both 2D-SWE and transient elastography with controlled attenuation parameter (CAP) at the same visit. Results: LSM was not feasible by transient elastography (M/XL probe) in 18 (3.3%) and by 2D-SWE in 26 (4.7%) patients. The median LSM of transient elastography was 5.5 (2.8–75) kPa and of 2D-SWE 6.2 (3.7–46.2) kPa. LSMs by transient elastography and 2D-SWE were correlated regardless of the obesity status ( r, 0.774; P < 0.001; r, 0.774; P < 0.001; r, 0.75; P < 0.001 in BMI <25, 25–30 and ≥30 kg/m 2 respectively), or the degree of liver steatosis ( r = 0.63; P < 0.001 and r = 0.743; P < 0.001 in mild and moderate/severe steatosis, respectively). According to transient elastography, 88 (15.9%) patients were classified with at least severe fibrosis (≥F3) and 55 (10%) with cirrhosis. By using the 2D-SWE, 85 (15.4%) patients had at least severe fibrosis and 52 (9.4%) cirrhosis. The correlation between the two methods was strong in patients with at least severe fibrosis ( r, 0.84; P < 0.001) or cirrhosis ( r, 0.658; P < 0.001). When transient elastography was used as reference, 2D-SWE showed an excellent accuracy of 98.8 and 99.8% in diagnosing severe fibrosis and cirrhosis, respectively. Conclusions: In NAFLD, 2D-SWE and transient elastography have comparable feasibility and clinical applicability providing LSMs with strong correlation, even in overweight/obese patients, independently of the severity of liver steatosis and fibrosis. Thus, either of the two methods can be effectively used for the assessment of fibrosis in this setting.