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Two-Dimensional-Shear Wave Elastography with a Propagation Map: Prospective Evaluation of Liver Fibrosis Using Histopathology as the Reference Standard
OBJECTIVE: The aim of this study was to prospectively evaluate whether liver stiffness (LS) assessments, obtained by two-dimensional (2D)-shear wave elastography (SWE) with a propagation map, can evaluate liver fibrosis stage using histopathology as the reference standard. MATERIALS AND METHODS: We...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Radiology
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689142/ https://www.ncbi.nlm.nih.gov/pubmed/32729274 http://dx.doi.org/10.3348/kjr.2019.0978 |
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author | Lee, Dong Ho Lee, Eun Sun Lee, Jae Young Bae, Jae Seok Kim, Haeryoung Lee, Kyung Bun Yu, Su Jong Cho, Eun Ju Lee, Jeong-Hoon Cho, Young Youn Han, Joon Koo Choi, Byung Ihn |
author_facet | Lee, Dong Ho Lee, Eun Sun Lee, Jae Young Bae, Jae Seok Kim, Haeryoung Lee, Kyung Bun Yu, Su Jong Cho, Eun Ju Lee, Jeong-Hoon Cho, Young Youn Han, Joon Koo Choi, Byung Ihn |
author_sort | Lee, Dong Ho |
collection | PubMed |
description | OBJECTIVE: The aim of this study was to prospectively evaluate whether liver stiffness (LS) assessments, obtained by two-dimensional (2D)-shear wave elastography (SWE) with a propagation map, can evaluate liver fibrosis stage using histopathology as the reference standard. MATERIALS AND METHODS: We prospectively enrolled 123 patients who had undergone percutaneous liver biopsy from two tertiary referral hospitals. All patients underwent 2D-SWE examination prior to biopsy, and LS values (kilopascal [kPa]) were obtained. On histopathologic examination, fibrosis stage (F0–F4) and necroinflammatory activity grade (A0–A4) were assessed. Multivariate linear regression analysis was performed to determine the significant factors affecting the LS value. The diagnostic performance of the LS value for staging fibrosis was assessed using receiver operating characteristic (ROC) analysis, and the optimal cut-off value was determined by the Youden index. RESULTS: Reliable measurements of LS values were obtained in 114 patients (92.7%, 114/123). LS values obtained from 2D-SWE with the propagation map positively correlated with the progression of liver fibrosis reported from histopathology (p < 0.001). According to the multivariate linear regression analysis, fibrosis stage was the only factor significantly associated with LS (p < 0.001). The area under the ROC curve of LS from 2D-SWE with the propagation map was 0.773, 0.865, 0.946, and 0.950 for detecting F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The optimal cut-off LS values were 5.4, 7.8, 9.4, and 12.2 kPa for F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The corresponding sensitivity and specificity of the LS value for detecting cirrhosis were 90.9% and 88.4%, respectively. CONCLUSION: The LS value obtained from 2D-SWE with a propagation map provides excellent diagnostic performance in evaluating liver fibrosis stage, determined by histopathology. |
format | Online Article Text |
id | pubmed-7689142 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | The Korean Society of Radiology |
record_format | MEDLINE/PubMed |
spelling | pubmed-76891422020-12-03 Two-Dimensional-Shear Wave Elastography with a Propagation Map: Prospective Evaluation of Liver Fibrosis Using Histopathology as the Reference Standard Lee, Dong Ho Lee, Eun Sun Lee, Jae Young Bae, Jae Seok Kim, Haeryoung Lee, Kyung Bun Yu, Su Jong Cho, Eun Ju Lee, Jeong-Hoon Cho, Young Youn Han, Joon Koo Choi, Byung Ihn Korean J Radiol Gastrointestinal Imaging OBJECTIVE: The aim of this study was to prospectively evaluate whether liver stiffness (LS) assessments, obtained by two-dimensional (2D)-shear wave elastography (SWE) with a propagation map, can evaluate liver fibrosis stage using histopathology as the reference standard. MATERIALS AND METHODS: We prospectively enrolled 123 patients who had undergone percutaneous liver biopsy from two tertiary referral hospitals. All patients underwent 2D-SWE examination prior to biopsy, and LS values (kilopascal [kPa]) were obtained. On histopathologic examination, fibrosis stage (F0–F4) and necroinflammatory activity grade (A0–A4) were assessed. Multivariate linear regression analysis was performed to determine the significant factors affecting the LS value. The diagnostic performance of the LS value for staging fibrosis was assessed using receiver operating characteristic (ROC) analysis, and the optimal cut-off value was determined by the Youden index. RESULTS: Reliable measurements of LS values were obtained in 114 patients (92.7%, 114/123). LS values obtained from 2D-SWE with the propagation map positively correlated with the progression of liver fibrosis reported from histopathology (p < 0.001). According to the multivariate linear regression analysis, fibrosis stage was the only factor significantly associated with LS (p < 0.001). The area under the ROC curve of LS from 2D-SWE with the propagation map was 0.773, 0.865, 0.946, and 0.950 for detecting F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The optimal cut-off LS values were 5.4, 7.8, 9.4, and 12.2 kPa for F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The corresponding sensitivity and specificity of the LS value for detecting cirrhosis were 90.9% and 88.4%, respectively. CONCLUSION: The LS value obtained from 2D-SWE with a propagation map provides excellent diagnostic performance in evaluating liver fibrosis stage, determined by histopathology. The Korean Society of Radiology 2020-12 2020-07-27 /pmc/articles/PMC7689142/ /pubmed/32729274 http://dx.doi.org/10.3348/kjr.2019.0978 Text en Copyright © 2020 The Korean Society of Radiology http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Gastrointestinal Imaging Lee, Dong Ho Lee, Eun Sun Lee, Jae Young Bae, Jae Seok Kim, Haeryoung Lee, Kyung Bun Yu, Su Jong Cho, Eun Ju Lee, Jeong-Hoon Cho, Young Youn Han, Joon Koo Choi, Byung Ihn Two-Dimensional-Shear Wave Elastography with a Propagation Map: Prospective Evaluation of Liver Fibrosis Using Histopathology as the Reference Standard |
title | Two-Dimensional-Shear Wave Elastography with a Propagation Map: Prospective Evaluation of Liver Fibrosis Using Histopathology as the Reference Standard |
title_full | Two-Dimensional-Shear Wave Elastography with a Propagation Map: Prospective Evaluation of Liver Fibrosis Using Histopathology as the Reference Standard |
title_fullStr | Two-Dimensional-Shear Wave Elastography with a Propagation Map: Prospective Evaluation of Liver Fibrosis Using Histopathology as the Reference Standard |
title_full_unstemmed | Two-Dimensional-Shear Wave Elastography with a Propagation Map: Prospective Evaluation of Liver Fibrosis Using Histopathology as the Reference Standard |
title_short | Two-Dimensional-Shear Wave Elastography with a Propagation Map: Prospective Evaluation of Liver Fibrosis Using Histopathology as the Reference Standard |
title_sort | two-dimensional-shear wave elastography with a propagation map: prospective evaluation of liver fibrosis using histopathology as the reference standard |
topic | Gastrointestinal Imaging |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689142/ https://www.ncbi.nlm.nih.gov/pubmed/32729274 http://dx.doi.org/10.3348/kjr.2019.0978 |
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