title: The value of ElastPQ for the evaluation of liver stiffness in patients with B and C chronic hepatopathies.
abstract: The aim of this study was to evaluate the diagnostic performance of a point shear wave elastography using ARFI technique - ElastPQ, in patients with B and C chronic hepatopathies, using Transient Elastography (TE) as the reference method, since it is a validated method for liver fibrosis assessment.
  
  
  
  the study included 228 consecutive subjects with chronic hepatopathies (26% HBV, 74% HCV) from whom 51% had liver cirrhosis. Liver stiffness (LS) was evaluated in the same session by means of 2 elastographic methods: TE (FibroScan, EchoSens) and ElastPQ (Affinity, Philips) techniques. For TE 10 valid LS measurements were performed for each patient and the median value was calculated. Reliable LS measurements by TE (M or XL probe) were considered the median value of 10LS measurements with a success rate ≥60% and an interquartile range <30%. For ElastPQ we calculated the median value of 10LS measurements in the liver parenchyma, at least 1cm below the capsule, avoiding large vessels. For differentiating between stages of liver fibrosis we used the TE cut-off values published in the Tsochatzis meta-analysis: significant fibrosis (F≥2)- 7.0kPa, severe fibrosis (F≥3)- 9.5kPa and for liver cirrhosis (F=4)-12kPa (Tsochatzis et al., 2011). The areas under the receiver operating characteristic curve (AUROCs) were used to assess the diagnostic performance of ElastPQ, correlations between ElastPQ and TE were evaluated.
  
  
  
  Valid LS measurements were obtained in 90.7% (207/228) cases by means of TE and in 98.7% (225/228) cases with ElastPQ. In the final analysis 205 patients were included. The ElastPQ values ranged from 2.32 to 44.07kPa (median=10.42kPa). Based on TE cut-off values (Tsochatzis et al., 2011) we divided our cohort into 4 groups: F0-F1:61/205 (29.8%); F2: 14/205 (6.8%); F3: 15/205 (7.3%); F=4: 115/205 (56.1%). The best cut-off values for discriminating, significant, severe fibrosis and cirrhosis were 7.2, 8.5 and 8.9kPa, respectively. The AUROCs were calculated considering TE as the reference method: 0.94 for significant fibrosis (F≥2), 0.97 for severe fibrosis (F≥3) and 0.97 for cirrhosis (F=4). In our cohort there was a strong correlation between measurements obtained by Transient Elastography and ElastPQ (r=0.85, p<0.001).
  
  
  
  ElastPQ seems to have a good diagnostic accuracy for staging liver fibrosis.
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, 156, Liviu Rebreanu Bv. 300723, Timişoara, Romania.
authors.forename: Ruxandra
authors.initials: R
authors.lastname: Mare
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, 156, Liviu Rebreanu Bv. 300723, Timişoara, Romania.
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, 156, Liviu Rebreanu Bv. 300723, Timişoara, Romania.
authors.forename: Raluca
authors.initials: R
authors.lastname: Lupuşoru
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, 156, Liviu Rebreanu Bv. 300723, Timişoara, Romania. Electronic address: roxanasirli@gmail.com.
authors.forename: Roxana
authors.initials: R
authors.lastname: Şirli
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, 156, Liviu Rebreanu Bv. 300723, Timişoara, Romania.
authors.forename: Alina
authors.initials: A
authors.lastname: Popescu
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, 156, Liviu Rebreanu Bv. 300723, Timişoara, Romania.
authors.forename: Mirela
authors.initials: M
authors.lastname: Danila
authors.affiliation: Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy Timișoara, 156, Liviu Rebreanu Bv. 300723, Timişoara, Romania.
authors.forename: Corina
authors.initials: C
authors.lastname: Pienar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D054459:Elasticity Imaging Techniques; D005260:Female; D019694:Hepatitis B, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology*; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000821:virology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
keywords: Chronic hepatitis B; Chronic hepatitis C; ElastPQ; Liver stiffness; Transient Elastography