Jinfen Wang1, Manli Wu1, Runze Linghu2, Jiandong Chang3, Min Wu4, Cheng Feng5, Xinping Ren6, Changzhu Liu7, Jie Lin8, Tao Song9, Jionghui Gu10, Yao Zhang11, Ye Fang12, Sumei Ma13, Pingxiang Hu14, Linsong Wu15, Xue Han16, Kaixuan Chen17, Qiusheng Shi18, Ruifang Zhang19, Qi Zhou20, Ruiqing Du21, Yongyan Gao22, Xiang Jing23, Shunshi Yang24, Chang Zhou25, Jian Zheng26, Ping Liang2, Rong-Qin Zheng1. 1. Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. 2. Ultrasound Department of Fifth Medical Center of Chinese PLA General Hospital, Beijing, China. 3. Department of Ultrasound, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, China. 4. Department of Ultrasound, Nanjing University Medical School Affiliated Nanjing Drum Tower Hospital, Nanjing, China. 5. Department of Ultrasound, National Clinical Research Center for Infectious Disease, Department of Ultrasound, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China. 6. Department of ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China. 7. Department of Ultrasound, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China. 8. Department of Ultrasound, Mianyang Center Hospital, Mianyang, China. 9. Department of abdominal ultrasound, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China. 10. Department of Ultrasound, First Affiliated Hospital, College of medicine, Zhejiang University, Hangzhou, China. 11. Department of Ultrasound, Beijing Ditan Hospital, Capital Medical University, Beijing, China. 12. Department of Ultrasound, Ningbo Yinzhou No 2 Hospital, Ningbo, China. 13. Department of Ultrasound, The First Hospital of Lanzhou University, Lanzhou, China. 14. Ultrasound Imaging Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China. 15. Department of Ultrasound, Fuyang People's Hospital, Fuyang, China. 16. Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin, China. 17. Department of Ultrasound, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China. 18. Department of Medical Ultrasonography, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. 19. Department of Ultrasound, Zhengzhou University First Affiliated Hospital, Zhengzhou, China. 20. Department of Ultrasound, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, China. 21. Ultrasonography, Shijiazhuang Fifth Hospital, Shijiazhuang, China. 22. Ultrasound Department, Third Medical Center of PLA General Hospital, Beijing, China. 23. Department of Ultrasound, The Third Central Hospital of Tianjin, China. 24. Department of Ultrasound, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 25. Department of Ultrasound, Yichang Central People's Hospital, The First College of Clinical Medical Science, China Three Gorges University, Yichang, China. 26. Department of Medical Ultrasound, Third Hospital of Longgang, Shenzhen, China.
Abstract
PURPOSE: To explore the usefulness of liver stiffness measurements (LSMs) by sound touch elastography (STE) and sound touch quantification (STQ) in chronic hepatitis B (CHB) patients for staging fibrosis. METHODS: This prospective multicenter study recruited normal volunteers and CHB patients between May 2018 and October 2019. The volunteers underwent LSM by STE and supersonic shear imaging (SSI) or by STQ and acoustic radiation force impulse imaging (ARFI). CHB patients underwent liver biopsy and LSM by both STE/STQ. The areas under the receiver operating characteristic curves (AUCs) for staging fibrosis were calculated. RESULTS: Overall, 97 volunteers and 524 CHB patients were finally eligible for the study. The successful STE and STQ measurement rates were both 100 % in volunteers and 99.4 % in CHB patients. The intraclass correlation coefficients (ICCs) for the intra-observer stability of STE and STQ (0.94; 0.90) were similar to those of SSI and ARFI (0.95; 0.87), respectively. STE and STQ showed better accuracy than the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) (AUC: 0.87 vs 0.86 vs 0.73 vs 0.77) in staging cirrhosis. However, both STE and STQ were not superior to APRI and FIB-4 in staging significant fibrosis (AUC: 0.76 vs 0.73 vs 0.70 vs 0.71, all P-values > 0.05). CONCLUSION: STE and STQ are convenient techniques with a reliable LSM value. They have a similar diagnostic performance and are superior to serum biomarkers in staging cirrhosis in CHB patients. Thieme. All rights reserved.
PURPOSE: To explore the usefulness of liver stiffness measurements (LSMs) by sound touch elastography (STE) and sound touch quantification (STQ) in chronic hepatitis B (CHB) patients for staging fibrosis. METHODS: This prospective multicenter study recruited normal volunteers and CHB patients between May 2018 and October 2019. The volunteers underwent LSM by STE and supersonic shear imaging (SSI) or by STQ and acoustic radiation force impulse imaging (ARFI). CHB patients underwent liver biopsy and LSM by both STE/STQ. The areas under the receiver operating characteristic curves (AUCs) for staging fibrosis were calculated. RESULTS: Overall, 97 volunteers and 524 CHB patients were finally eligible for the study. The successful STE and STQ measurement rates were both 100 % in volunteers and 99.4 % in CHB patients. The intraclass correlation coefficients (ICCs) for the intra-observer stability of STE and STQ (0.94; 0.90) were similar to those of SSI and ARFI (0.95; 0.87), respectively. STE and STQ showed better accuracy than the aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4) (AUC: 0.87 vs 0.86 vs 0.73 vs 0.77) in staging cirrhosis. However, both STE and STQ were not superior to APRI and FIB-4 in staging significant fibrosis (AUC: 0.76 vs 0.73 vs 0.70 vs 0.71, all P-values > 0.05). CONCLUSION: STE and STQ are convenient techniques with a reliable LSM value. They have a similar diagnostic performance and are superior to serum biomarkers in staging cirrhosis in CHB patients. Thieme. All rights reserved.