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Comparative Utility of Transient and 2D Shear Wave Elastography for the Assessment of Liver Fibrosis in Clinical Practice

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Abstract

The aim of the study was to investigate the feasibility and correlation of liver stiffness measurements (LSM) between 2D-shear wave elastography (2D-SWE) and transient elastography (TE) in patients with chronic liver disease. Over 4 months, 421 patients with chronic liver disease of any cause underwent LSM by 2D-SWE and TE (M and/or XL probe) and controlled attenuation parameter at the same visit. LSM was not feasible by TE in 16 (3.8%) and by 2D-SWE in 17 (4.0%) patients. Median LSM were 8.9 and 8.7 kPa with TE and 2D-SWE, respectively, having a strong correlation (r = 0.774, p < 0.001) in the total cohort and in any cause of liver disease (r = 0.747–0.806, p < 0.001). There was a strong agreement on diagnosis of severe fibrosis (k-statistic: 0.841, p < 0.001) or cirrhosis (k-statistic: 0.823, p < 0.001). Both methods had increased failure rates in patients with obesity and/or increased waist circumference. Among 104 obese patients, TE was more feasible than 2D-SWE (92.3% vs 85.6%, p < 0.001]. LSM by 2D-SWE are strongly correlated to LSM by TE independently of the etiology of chronic liver disease, stage of fibrosis, degree of liver steatosis, and patients’ characteristics. TE with the XL probe may be superior in a minority of obese patients.

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Abbreviations

TE:

Transient elastography

2D-SWE:

2D-shear wave elastography

LSM:

Liver stiffness measurements

CAP:

Controlled attenuation parameter

ALD:

Alcoholic liver disease

NAFLD:

Non-alcoholic fatty liver disease

HCC:

Hepatocellular carcinoma

BMI:

Body mass index

ROI:

Region of interest

IQR:

Interquartile range

SD:

Standard deviation

AUROC:

Area under the receiving operating characteristic

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Author information

Authors and Affiliations

  1. Academic Department of Gastroenterology, Medical School of National &, Laiko General Hospital, Kapodistrian University of Athens, Athens, Greece

    Dimitrios S. Karagiannakis, Theodoros Voulgaris, Theodoros Angelopoulos, Panagiota Ioannidou, Jiannis Vlachogiannakos & George V. Papatheodoridis

  2. First Department of Internal Medicine, Medical School of National &, Laiko General Hospital, Kapodistrian University of Athens, Athens, Greece

    Evangelos Cholongitas

Authors
  1. Dimitrios S. Karagiannakis
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  2. Theodoros Voulgaris
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  3. Theodoros Angelopoulos
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  4. Panagiota Ioannidou
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  5. Evangelos Cholongitas
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  6. Jiannis Vlachogiannakos
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  7. George V. Papatheodoridis
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Contributions

All authors have significantly contributed and are in agreement with the content of the manuscript. Specifically, D. Karagiannakis was involved in the design of the trial, performed liver elastographies, and wrote the initial draft. T. Voulgaris performed elastographies as well. T. Aggelopoulos and P. Ioannidou contributed to the collection of the clinical and biochemical data. E. Cholongitas contributed to the collection of clinical data and performed the statistical analysis. J. Vlachogiannakos helped to the designation of the study and reviewed the manuscript. G.V. Papatheodoridis performed the statistical analysis, and was involved in the interpretation of the data, the improvement of the protocol, and in the finalization of the manuscript.

Corresponding author

Correspondence to Dimitrios S. Karagiannakis.

Ethics declarations

Ethics Approval

The study was approved by the local Ethics Committee.

Research Involving Human Participants and/or Animals

The study was conducted in accordance with the Helsinki declaration of 1975 as revised in 1983.

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All subjects provided written informed consent.

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This manuscript has been approved by all authors, has not been previously published, and is not under consideration (in whole or in part) for publication elsewhere. In case of acceptance of the manuscript, the copyright is transferred to the Journal of Digital Imaging.

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The authors declare no competing interests.

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Karagiannakis, D.S., Voulgaris, T., Angelopoulos, T. et al. Comparative Utility of Transient and 2D Shear Wave Elastography for the Assessment of Liver Fibrosis in Clinical Practice. J Digit Imaging 34, 1342–1348 (2021). https://doi.org/10.1007/s10278-021-00521-7

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  • DOI: https://doi.org/10.1007/s10278-021-00521-7

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