Aim: to analyse the concordance of two elastographic methods, 2-D SWE and TE in the evaluation of patients with severe fibrosis using the cut-off values established in meta-analyses or studies with liver biopsy as gold standard.
Methods: the study group included 192 consecutive subjects with chronic hepatopathies.
All subjects underwent 2D-SWE with an AixplorerTM ultrasound system (SuperSonic
Imagine S.A., Aix-en-Provence, France) and TE using FibroScan® device (EchoSens, Paris, France). In each patient we aimed to perform three liver stiffness measurements by 2D-SWE from which the mean value was calculated and10
valid TE measurements (with a SR≥60% and an IQR <30%),with M probe, a median value being calculated. The results were expressed in kPa for both methods. For TE,we usedfor severe fibrosis the cut offs values from the latest meta-analysis (1): 9.6 kPa for severe fibrosis (F≥3). For 2D-SWE we used the cut offs values published in an article that used liver biopsy as gold standard: F≥3: >8.7 kPa (2).
Results: the study included 192 subjects, 55.7% men and 44.3% women, median age 56 years (between 20-82 years), 28.6% with chronic HCV infection, 22.3% with chronic HBV infection and 49.1% other etiologies. The rate of reliable measurements was similar for TE and 2D-SWE: 79.1% vs 84.3% (p=0.23). The number of patients diagnosed with severe fibrosis was similar for 2D-SWE and TE: 32.2% vs 30% (p=0.7). The concordance of TE and 2D-SWE in establishing the diagnosis of severe fibrosis was 82.4%.
Conclusion: 2D-SWE and TE had a similar feasibility and both elastographic methods are very good in establishing severe fibrosis.
1.Tsochatzis et al. J Hepatol. 2011;54:650-9.
2. Ferraioli et. al. Hepatology.
2012; 56:2125-2133.
