Comparing point shear wave elastography and transient elastography for the diagnosis of fibrosis stage in non-alcoholic fatty liver disease using liver biopsy as reference standard

Congress:

ECR 2019

Poster Number:

C-2416

Type:

Scientific Exhibit

Keywords:

Liver, Abdomen, Ultrasound, Elastography, Comparative studies, Biopsy, Cirrhosis

Authors:

W. L. Leong¹, L. L. Lai¹, N. R. Nik Mustapha², A. Vijayananthan¹, S. Mahadeva¹, K. Rahmat¹, W. K. Chan¹; ¹Kuala Lumpur/MY, ²Alor Setar/MY

DOI:

10.26044/ecr2019/C-2416

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-2416

Fig. 1: Image of an operator performing pSWE

Fig. 2: Image of an operator performing TE

Fig. 3: Histopathological slides in each fibrosis stage according to NASH Clinical...

Table 1: Patient characteristics

Aims and objectives

Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease and is estimated to affect approximately 25% of general population worldwide. [1] Non-alcoholic steatohepatitis (NASH) the more severe form of NAFLD can progress to fibrosis and cirrhosis. [2] While liver biopsy was used for the assessment of liver fibrosis in chronic liver disease, it is invasive and is associated with possible severe complications. [3] Liver biopsy has been largely replaced by non invasive tests for the assessment of liver...

Methods and materials

Patient population: Consecutive adult patients with NAFLD scheduled for a liver biopsy in University of Malaya Medical Centre were included for this study. We excluded patients with significant alcohol intake, medication usage that can cause fatty liver, viral hepatitis B and C infection and other causes of chronic liver diseases. pSWE: pSWE was performed using Phillips EPIQ 7 ultrasound system with a C5-1 convex probe. Patient is placed in supine position with right arm in maximal abduction and probe placed on right lobe of liver...

Results

Patient characteristics: There were 100 patients giving a total of 400 examinations. We excluded 7 failed or unreliable examinations, 393 examinations were included for analysis. Patient characteristics are shown in Table 1. The mean age of the study population was 57.1 ± 10.2 years and 46.0% were male. The mean BMI of the study population was 30.8 ± 4.8 kg per m² and the mean waist circumference was 100.6 ± 11.4 cm. The prevalence of obesity and central obesity was 92.0% and 97.0%, respectively. The...

Conclusion

TE was good for the diagnosis of all fibrosis stages while SWE was fair for diagnosis of ≥F1 and F4, but poor for diagnosis of ≥F2 and ≥F3. TE was statistically better compared with SWE for diagnosis of ≥F1, ≥F2 and ≥F3. TE and pSWE are highly reliable methods for assessing fibrosis stages with high intra- and inter-observer correlation coefficients.

Personal information

Dr WL Leong University Malaya Medical Centre, University of Malaya, Department of Bio Medical Imaging. University Malaya Medical Centre, Jalan Universiti, Lembah Pantai, 50603 Kuala Lumpur, Federal Territory of Kuala Lumpur. Malaysia. Email: [email protected]

References

1. Younossi Z, Koenig A, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64:73-84. 2. Musso G, Gambino R, Cassader M, Pagano G. Meta-analysis: Natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity. Annals of Medicine. 2010;43:617-649. 3. Piccinino F, Sagnelli E, Pasquale G, Giusti G, Battocchia A, Bernardi M et al. Complications following percutaneous liver biopsy. Journal of Hepatology. 1986;2:165-173. 4....