title: Performance of 2-Dimensional Ultrasound Shear Wave Elastography in Liver Fibrosis Detection Using Magnetic Resonance Elastography as the Reference Standard: A Pilot Study.
abstract: OBJECTIVE
  To investigate the correlation between 2-dimensional (2D) ultrasound shear wave elastography (SWE) and magnetic resonance elastography (MRE) in liver stiffness measurement and the diagnostic performance of 2D SWE for liver fibrosis when imaging from different intercostal spaces and using MRE as the reference standard.
  
  
  METHODS
  Two-dimensional SWE was performed on 47 patients. One patient was excluded from the study. Each of the remaining 46 patients underwent same-day MRE for clinical purposes. The study was compliant with the Health Insurance Portability and Accountability Act and approved by the Institutional Review Board. Informed consent was obtained from each patient. Two-dimensional SWE measurements were acquired from the ninth, eighth, and seventh intercostal spaces. The correlation with MRE was calculated at each intercostal space and multiple intercostal spaces combined. The performance of 2D SWE in diagnosing liver fibrosis was evaluated by receiver operating characteristic curve analysis using MRE as the standard.
  
  
  RESULTS
  The 47 patients who initially underwent 2D SWE included 22 female and 25 male patients (age range, 19-77 years). The highest correlation between 2D SWE and MRE was from the eighth and seventh intercostal spaces (r = 0.68-0.76). The ranges of the areas under the receiver operating characteristic curves for separating normal or inflamed livers from fibrotic livers using MRE as the clinical reference were 0.84 to 0.92 when using the eighth and seventh intercostal spaces individually and 0.89 to 0.90 when combined.
  
  
  CONCLUSIONS
  The results suggest that 2D SWE and MRE are well correlated when SWE is performed at the eighth and seventh intercostal spaces. The ninth intercostal space is less reliable for diagnosing fibrosis with 2D SWE. Combining measurements from multiple intercostal spaces does not significantly improve the performance of 2D SWE for detection of fibrosis.
authors.affiliation: Departments of Radiology (P.S., S.P.S., D.D.M., R.M.K., M.R.C., S.C.), Physiology and Biomedical Engineering (D.C.M., M.W.U., A.M., J.F.G.), and Gastroenterology (W.S.), Mayo Clinic, Rochester, Minnesota USA.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Song
authors.affiliation: Departments of Radiology (P.S., S.P.S., D.D.M., R.M.K., M.R.C., S.C.), Physiology and Biomedical Engineering (D.C.M., M.W.U., A.M., J.F.G.), and Gastroenterology (W.S.), Mayo Clinic, Rochester, Minnesota USA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Mellema
authors.affiliation: Departments of Radiology (P.S., S.P.S., D.D.M., R.M.K., M.R.C., S.C.), Physiology and Biomedical Engineering (D.C.M., M.W.U., A.M., J.F.G.), and Gastroenterology (W.S.), Mayo Clinic, Rochester, Minnesota USA.
authors.forename: Shannon P
authors.initials: SP
authors.lastname: Sheedy
authors.affiliation: Departments of Radiology (P.S., S.P.S., D.D.M., R.M.K., M.R.C., S.C.), Physiology and Biomedical Engineering (D.C.M., M.W.U., A.M., J.F.G.), and Gastroenterology (W.S.), Mayo Clinic, Rochester, Minnesota USA.
authors.forename: Duane D
authors.initials: DD
authors.lastname: Meixner
authors.affiliation: Departments of Radiology (P.S., S.P.S., D.D.M., R.M.K., M.R.C., S.C.), Physiology and Biomedical Engineering (D.C.M., M.W.U., A.M., J.F.G.), and Gastroenterology (W.S.), Mayo Clinic, Rochester, Minnesota USA.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Karshen
authors.affiliation: Departments of Radiology (P.S., S.P.S., D.D.M., R.M.K., M.R.C., S.C.), Physiology and Biomedical Engineering (D.C.M., M.W.U., A.M., J.F.G.), and Gastroenterology (W.S.), Mayo Clinic, Rochester, Minnesota USA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Urban
authors.affiliation: Departments of Radiology (P.S., S.P.S., D.D.M., R.M.K., M.R.C., S.C.), Physiology and Biomedical Engineering (D.C.M., M.W.U., A.M., J.F.G.), and Gastroenterology (W.S.), Mayo Clinic, Rochester, Minnesota USA.
authors.forename: Armando
authors.initials: A
authors.lastname: Manduca
authors.affiliation: Departments of Radiology (P.S., S.P.S., D.D.M., R.M.K., M.R.C., S.C.), Physiology and Biomedical Engineering (D.C.M., M.W.U., A.M., J.F.G.), and Gastroenterology (W.S.), Mayo Clinic, Rochester, Minnesota USA.
authors.forename: William
authors.initials: W
authors.lastname: Sanchez
authors.affiliation: Departments of Radiology (P.S., S.P.S., D.D.M., R.M.K., M.R.C., S.C.), Physiology and Biomedical Engineering (D.C.M., M.W.U., A.M., J.F.G.), and Gastroenterology (W.S.), Mayo Clinic, Rochester, Minnesota USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Callstrom
authors.affiliation: Departments of Radiology (P.S., S.P.S., D.D.M., R.M.K., M.R.C., S.C.), Physiology and Biomedical Engineering (D.C.M., M.W.U., A.M., J.F.G.), and Gastroenterology (W.S.), Mayo Clinic, Rochester, Minnesota USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Greenleaf
authors.affiliation: Departments of Radiology (P.S., S.P.S., D.D.M., R.M.K., M.R.C., S.C.), Physiology and Biomedical Engineering (D.C.M., M.W.U., A.M., J.F.G.), and Gastroenterology (W.S.), Mayo Clinic, Rochester, Minnesota USA. chen.shigao@mayo.edu.
authors.forename: Shigao
authors.initials: S
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012015:Reference Standards; D055815:Young Adult
keywords: liver fibrosis; magnetic resonance elastography; shear wave elastography