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Abdominal Radiology

, Volume 44, Issue 10, pp 3285–3294 | Cite as

2D shear wave elastography: measurement acquisition and reliability criteria in noninvasive assessment of liver fibrosis

  • Maggie ChungEmail author
  • Grayson L. Baird
  • Krista E. Weiss
  • Michael D. Beland
Hepatobiliary
  • 32 Downloads

Abstract

Purpose

The objective was to evaluate the accuracy of 2D shear wave elastography (SWE) in predicting stages of liver fibrosis using five individual versus grouped measurements and different reliability criteria.

Materials and methods

This is a prospective study of 109 patients who underwent hepatic 2D SWE (Canon Aplio 500) prior to liver biopsy for varied indications. Liver fibrosis was staged using the METAVIR scoring system (F = 0–4). Propagation mapping was used to guide ten SWE measurements from the liver parenchyma: five individual measurements and five grouped measurements. IQR/median, SD/median, and SD/mean were examined as quality criteria for patient inclusion at various thresholds (IQR/median ≤ 0.15, 0.2, 0.3, 0.4, 0.5; SD/median ≤ 0.15, 0.2, 0.3; SD/mean ≤ 0.2, 0.3, 0.5). Threshold for clinically significant fibrosis (F ≥ 2) was determined with receiver operating characteristic (ROC) analysis.

Results

There was high agreement between individual and grouped measurements without statistically significant differences (intraclass correlation coefficient = 0.82; p = 0.26–0.96). When no quality criterion was used (n = 103), the optimal threshold was 11.3 kPa [AUROC 0.78, 95% CI (0.69, 0.88)] with sensitivity and specificity of 80% and 66%, respectively. All quality criteria were associated with equal or higher AUROC ranging from 0.78 to 0.87. IQR/median ≤ 0.5 (n = 88) achieved the highest sensitivity of 85% and only excluded a small subset of patients. The AUROC and specificity were 0.83 [95% CI (0.74, 0.92)] and 72%, respectively.

Significance

Quality criterion IQR/median ≤ 0.5 increases sensitivity and specificity in prediction of clinically significant liver fibrosis while excluding only a small subset of patients. Grouped measurements are comparable to individual measurements and may help increase procedural efficiency.

Keywords

Two-dimensional shear wave Elastography Liver cirrhosis Ultrasonography 

Notes

Compliance with ethical standards

Conflict of interest

Michael Beland: Received an equipment grant from Canon Medical Systems Corporation. All the other authors declare that they have no conflict of interest.

Ethical approval

IRB: This study was a prospective, single-center study approved by the Institutional Review Board.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Radiology and Biomedical ImagingUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Lifespan Biostatistics Core, Rhode Island HospitalProvidenceUSA
  3. 3.Department of Diagnostic ImagingWarren Alpert Medical School of Brown University, Rhode Island HospitalProvidenceUSA

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