Anita Paisant1, Sylvain Lemoine2, Christophe Cassinotto3, Victor de Lédinghen4, Maxime Ronot5, Marie Irlès-Depé4, Valérie Vilgrain5, Brigitte Le Bail6, Valérie Paradis7, Clémence M Canivet8, Sophie Michalak9, Marie-Christine Rousselet9, Pierre-Emmanuel Rautou10, Jérôme Lebigot11, Gilles Hunault12, Anne Crouan2, Christophe Aubé11, Jérôme Boursier8. 1. Département de Radiologie, Centre Hospitalier Universitaire d'Angers, Angers, France; Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France. Electronic address: anita.paisant@chu-angers.fr. 2. Département de Radiologie, Centre Hospitalier Universitaire d'Angers, Angers, France. 3. Département de Radiologie, Hôpital Saint-Eloi Hospital, Centre Hospitalier Universitaire de Montpellier, Montpellier, France. 4. Service d'Hépato-Gastroentérologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France. 5. Service de Radiologie, HUPNSV, Hôpital Beaujon, Clichy, INSERM UMR 1149, Université de Paris, Paris, France. 6. Service d'Anatomopathologie, Hôpital Pellegrin, Centre Hospitalier Universitaire de Bordeaux, Pessac, France. 7. Service d'Anatomopathologie, HUPNSV, Hôpital Beaujon, Clichy, France. 8. Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France; Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire d'Angers, Angers, France. 9. Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France; Département de Pathologie Cellulaire et Tissulaire, Centre Hospitalier Universitaire d'Angers, Angers, France. 10. Service de d'Hépatologie, HUPNSV, Hôpital Beaujon, Clichy, France. 11. Département de Radiologie, Centre Hospitalier Universitaire d'Angers, Angers, France; Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France. 12. Laboratoire HIFIH, UPRES EA3859, SFR 4208, Université d'Angers, Angers, France.
Abstract
BACKGROUND & AIMS: Two-dimensional shear wave elastography (2D-SWE) is an accurate method for the non-invasive evaluation of liver fibrosis. We aimed to determine the reliability criteria and the number of necessary reliable measurements for 2D-SWE. METHODS: 788 patients with chronic liver disease underwent liver biopsy and 2D-SWE examination in three centers. The 4277 2D-SWE measurements performed were 2:1 randomly divided into derivation (n = 2851) and validation (n = 1426) sets. Reliability criteria for a 2D-SWE measurement were defined in the derivation set from the intrinsic characteristics given by the device (mean liver stiffness, standard deviation, diameter of the region of interest), with further evaluation in the validation set. RESULTS: In the whole population of 4277 measurements, AUROC for bridging fibrosis was 0.825 ± 0.006 and AUROC for cirrhosis was 0.880 ± 0.006. Mean stiffness and coefficient of variation (CV) were independent predictors of bridging fibrosis or cirrhosis. From these two parameters, new criteria were derived to define a reliable 2D-SWE measurement: stiffness <8.8 kPa, or stiffness between 8.8-11.9 kPa with CV <0.25, or stiffness ≥12.0 kPa with CV <0.10. In the validation set, AUROC for bridging fibrosis was 0.830 ± 0.013 in reliable measurements vs 0.667 ± 0.031 in unreliable measurements (P < .001). AUROC for cirrhosis was 0.918±0.014 vs 0.714 ± 0.027, respectively (P < .001). The best diagnostic accuracy for a 2D-SWE examination was achieved from three reliable measurements. CONCLUSIONS: Reliability of a 2D-SWE measurement relies on the coefficient of variation and the liver stiffness level. A 2D-SWE examination should include three reliable measurements according to our new criteria.
BACKGROUND & AIMS: Two-dimensional shear wave elastography (2D-SWE) is an accurate method for the non-invasive evaluation of liver fibrosis. We aimed to determine the reliability criteria and the number of necessary reliable measurements for 2D-SWE. METHODS: 788 patients with chronic liver disease underwent liver biopsy and 2D-SWE examination in three centers. The 4277 2D-SWE measurements performed were 2:1 randomly divided into derivation (n = 2851) and validation (n = 1426) sets. Reliability criteria for a 2D-SWE measurement were defined in the derivation set from the intrinsic characteristics given by the device (mean liver stiffness, standard deviation, diameter of the region of interest), with further evaluation in the validation set. RESULTS: In the whole population of 4277 measurements, AUROC for bridging fibrosis was 0.825 ± 0.006 and AUROC for cirrhosis was 0.880 ± 0.006. Mean stiffness and coefficient of variation (CV) were independent predictors of bridging fibrosis or cirrhosis. From these two parameters, new criteria were derived to define a reliable 2D-SWE measurement: stiffness <8.8 kPa, or stiffness between 8.8-11.9 kPa with CV <0.25, or stiffness ≥12.0 kPa with CV <0.10. In the validation set, AUROC for bridging fibrosis was 0.830 ± 0.013 in reliable measurements vs 0.667 ± 0.031 in unreliable measurements (P < .001). AUROC for cirrhosis was 0.918±0.014 vs 0.714 ± 0.027, respectively (P < .001). The best diagnostic accuracy for a 2D-SWE examination was achieved from three reliable measurements. CONCLUSIONS: Reliability of a 2D-SWE measurement relies on the coefficient of variation and the liver stiffness level. A 2D-SWE examination should include three reliable measurements according to our new criteria.
Authors: Honoré Tegwendé Zougmoré; Jean François David Cadranel; Gildas Fantognon; Badia Azzi; Ryad Smadhi; Jean René Ngele Efole; Samir Mrabti; Ratmony Heng; Marie Adrienne Ntsama; Mourad Medmoun; Firouzeh Kazerouni; Tristan Le Magoarou Journal: Medicine (Baltimore) Date: 2022-08-12 Impact factor: 1.817
Authors: Philippe Garteiser; Gwenaël Pagé; Gaspard d'Assignies; Helena S Leitao; Valérie Vilgrain; Ralph Sinkus; Bernard E Van Beers Journal: Sci Rep Date: 2021-09-29 Impact factor: 4.379