Shalini Thapar Laroia1, Shyam Vellore Srinivasan1, Komal Yadav1, Archana Rastogi2, Senthil Kumar3, Guresh Kumar4, Manoj Kumar5. 1. Department of Radiology Institute of Liver and Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India. 2. Department of Clinical and Hepato-Pathology Institute of Liver and Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India. 3. Department of HPB Surgery and Liver Transplantation Institute of Liver & Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India. 4. Department of Research Institute of Liver & Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India. 5. Department of Hepatology Institute of Liver & Biliary Sciences Sector D-1 Vasant Kunj New Delhi 110070 India.
Abstract
PURPOSE: To assess the performance of shear wave ultrasound elastography (SWE) for non-invasive grading of fibrosis in normal BMI patients with varied aetiology chronic liver disease. METHOD: Prospective SWE liver and spleen stiffness (LS, SS respectively) of 124 patients (94 men, mean age 45.4 ± 12.4 years, mean BMI 19.66 ± 1.49) with CLD of mixed aetiology, who underwent liver biopsy, between January 2019-20 was analysed using receiver operating curve (ROC) and classification analysis regression tree (CART) to determine fibrosis cut-off values and nominal logistical regression to quantify fibrosis. RESULTS: Of 124 patients, 50 (40%) had non-alcoholic steatohepatitis (NASH), 31 (25%) chronic hepatitis B (CHB) and 43 (35%) alcoholic liver disease (ALD) on biopsy. Overall mean LS and SS of the study population was 11.81 ± 5.9 and 16.88 ± 10.8 kPa, respectively. LS cut-off value <8 kPa was consistent with F0, 9-14 kPa for F1-F2 and >14.9 kPa for F3-F4 fibrosis on biopsy. On application of CART, LS value < 5.3 kPa was discriminative for NASH, 5.32 to <12.64 kPa for CHB, >12.64 kPa for ALD, SS <15.3 kPa was discriminative for NASH, 15.3-30 kPa for CHB and >30 kPa for ALD in our study population. CONCLUSION: SWE is a viable non-invasive tool for assessment of liver fibrosis grading in a population of mixed aetiology CLD. LS values in conjunction with SS are promising predictors of F2-F3 fibrosis with potential to discriminate select categories like CHB and NASH in such a population.
PURPOSE: To assess the performance of shear wave ultrasound elastography (SWE) for non-invasive grading of fibrosis in normal BMI patients with varied aetiology chronic liver disease. METHOD: Prospective SWE liver and spleen stiffness (LS, SS respectively) of 124 patients (94 men, mean age 45.4 ± 12.4 years, mean BMI 19.66 ± 1.49) with CLD of mixed aetiology, who underwent liver biopsy, between January 2019-20 was analysed using receiver operating curve (ROC) and classification analysis regression tree (CART) to determine fibrosis cut-off values and nominal logistical regression to quantify fibrosis. RESULTS: Of 124 patients, 50 (40%) had non-alcoholic steatohepatitis (NASH), 31 (25%) chronic hepatitis B (CHB) and 43 (35%) alcoholic liver disease (ALD) on biopsy. Overall mean LS and SS of the study population was 11.81 ± 5.9 and 16.88 ± 10.8 kPa, respectively. LS cut-off value <8 kPa was consistent with F0, 9-14 kPa for F1-F2 and >14.9 kPa for F3-F4 fibrosis on biopsy. On application of CART, LS value < 5.3 kPa was discriminative for NASH, 5.32 to <12.64 kPa for CHB, >12.64 kPa for ALD, SS <15.3 kPa was discriminative for NASH, 15.3-30 kPa for CHB and >30 kPa for ALD in our study population. CONCLUSION: SWE is a viable non-invasive tool for assessment of liver fibrosis grading in a population of mixed aetiology CLD. LS values in conjunction with SS are promising predictors of F2-F3 fibrosis with potential to discriminate select categories like CHB and NASH in such a population.
Authors: Eva Herrmann; Victor de Lédinghen; Christophe Cassinotto; Winnie C-W Chu; Vivian Y-F Leung; Giovanna Ferraioli; Carlo Filice; Laurent Castera; Valérie Vilgrain; Maxime Ronot; Jérôme Dumortier; Aymeric Guibal; Stanislas Pol; Jonel Trebicka; Christian Jansen; Christian Strassburg; Rongqin Zheng; Jian Zheng; Sven Francque; Thomas Vanwolleghem; Luisa Vonghia; Emanuel K Manesis; Pavlos Zoumpoulis; Ioan Sporea; Maja Thiele; Aleksander Krag; Claude Cohen-Bacrie; Aline Criton; Joel Gay; Thomas Deffieux; Mireen Friedrich-Rust Journal: Hepatology Date: 2017-11-15 Impact factor: 17.425