title: Assessment of liver fibrosis with 2-D shear wave elastography in comparison to transient elastography and acoustic radiation force impulse imaging in patients with chronic liver disease.
abstract: Two-dimensional shear wave elastography (2-D SWE) is an ultrasound-based elastography method integrated into a conventional ultrasound machine. It can evaluate larger regions of interest and, therefore, might be better at determining the overall fibrosis distribution. The aim of this prospective study was to compare 2-D SWE with the two best evaluated liver elastography methods, transient elastography and acoustic radiation force impulse (point SWE using acoustic radiation force impulse) imaging, in the same population group. The study included 132 patients with chronic hepatopathies, in which liver stiffness was evaluated using transient elastography, acoustic radiation force impulse imaging and 2-D SWE. The reference methods were liver biopsy for the assessment of liver fibrosis (n = 101) and magnetic resonance imaging/computed tomography for the diagnosis of liver cirrhosis (n = 31). No significant difference in diagnostic accuracy, assessed as the area under the receiver operating characteristic curve (AUROC), was found between the three elastography methods (2-D SWE, transient elastography, acoustic radiation force impulse imaging) for the diagnosis of significant and advanced fibrosis and liver cirrhosis in the "per protocol" (AUROCs for fibrosis stages ≥2: 0.90, 0.95 and 0.91; for fibrosis stage [F] ≥3: 0.93, 0.95 and 0.94; for F = 4: 0.92, 0.96 and 0.92) and "intention to diagnose" cohort (AUROCs for F ≥2: 0.87, 0.92 and 0.91; for F ≥3: 0.91, 0.93 and 0.94; for F = 4: 0.88, 0.90 and 0.89). Therefore, 2-D SWE, ARFI imaging and transient elastography seem to be comparably good methods for non-invasive assessment of liver fibrosis.
authors.affiliation: Department of Internal Medicine 1, J. W. Goethe University Hospital, Frankfurt, Germany. Electronic address: ludmila.gerber@kgu.de.
authors.forename: Ludmila
authors.initials: L
authors.lastname: Gerber
authors.affiliation: Department of Internal Medicine 1, J. W. Goethe University Hospital, Frankfurt, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Kasper
authors.affiliation: Department of Internal Medicine 1, J. W. Goethe University Hospital, Frankfurt, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Fitting
authors.affiliation: Department of Internal Medicine 1, J. W. Goethe University Hospital, Frankfurt, Germany.
authors.forename: Viola
authors.initials: V
authors.lastname: Knop
authors.affiliation: Department of Internal Medicine 1, J. W. Goethe University Hospital, Frankfurt, Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Vermehren
authors.affiliation: Department of Internal Medicine 1, J. W. Goethe University Hospital, Frankfurt, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Sprinzl
authors.affiliation: Institute of Pathology, J. W. Goethe University Hospital, Frankfurt, Germany.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Hansmann
authors.affiliation: Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, J. W. Goethe University, Frankfurt, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Herrmann
authors.affiliation: Department of Internal Medicine 1, J. W. Goethe University Hospital, Frankfurt, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Bojunga
authors.affiliation: Department of Internal Medicine 1, J. W. Goethe University Hospital, Frankfurt, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Albert
authors.affiliation: Department of Internal Medicine 1, J. W. Goethe University Hospital, Frankfurt, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Sarrazin
authors.affiliation: Department of Internal Medicine 1, J. W. Goethe University Hospital, Frankfurt, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Zeuzem
authors.affiliation: Department of Internal Medicine 1, J. W. Goethe University Hospital, Frankfurt, Germany.
authors.forename: Mireen
authors.initials: M
authors.lastname: Friedrich-Rust
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D058625:End Stage Liver Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D033081:Shear Strength; D055815:Young Adult
keywords: 2-D shear wave imaging; Acoustic radiation force impulse imaging; Elastography; Fibroscan; Liver biopsy; Liver fibrosis; Transient elastography