Aims and objectives
The evaluation of liver stiffness (LS) is essential in patients with chronic hepatopathies,
therefore a non-invasive,
risk-free method well accepted by patient is crucial.
The ‘gold standard’ method for the evaluation of LS is liver biopsy,
an invasive method which can cause serious complications [1].
A new era in LS evaluation has begun when liver elastography developed.
Many elastographic techniques have emerged into clinical practice and the usefullness of each elastographic method for non-invasive assessment of liver fibrosis still needs to be determined.
The elastography...
Methods and materials
Three operators with different experience in ultrasound and liver elastography,
performed sessions of four consecutive elastographic measurements in four masses,
using 2D-SWE (AixplorerTM ultrasound system, SuperSonic Imagine S.A.,
Aix-en-Provence,
France) and ARFI (Siemens Acuson S2000 TM ultrasound system, Siemens AG,
Erlangen,
Germany) on a phantom model,
which contains targets of known stiffness (Multi-purpose,
Multi-Tissue Ultrasound Phantom Model 049A GSE,
CIRS,
USA).
The elastography ultrasound phantom contains 8 masses with varying B-mode ultrasound and viscoelastic properties (lesions with varying Young’s Modulus levels),
4 (the larger ones)...
Results
A good interobserver agreement was obtained for 2D-SWE: operator 1 vs operator 2 (ICC=0.89),
operator 1 vs 3 (ICC=0.88) and operator 2 vs 3 (ICC=0.97),
respectively.
Intraobserver reproducibility showed a very good agreement between the measurements for 2D- SWE; ICCs were 0.84,
0.98 and 0.98 for operators 1,
2 and 3,
respectively.
For ARFI,
a good interobserver agreement was obtained: operator 1 vs operator 2 (ICC=0.88),
operator 1 vs 3 (ICC=0.65) and operator 2 vs 3 (ICC=0.65),
respectively.
The intraobserver reproducibility showed a very good...
Conclusion
2D-SWE and ARFI are elastographic techniques with a good intraobserver reproducibility and demonstrate a minimal variability across operators,
especially for 2D-SWE.
References
1.
Rockey DC,
Caldwell SH,
Goodman ZD,
Nelson RC,
Smith AD.
American
association for the study of liver diseases.
Liver biopsy.
Hepatology
2009;49(3):1017–44.