ACCURACY OF TWO-DIMENSIONAL SHEAR WAVE ELASTOGRAPHY FOR DIAGNOSING LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS C

Authors

  • M SAMAAT Department of Medicine, Mayo Hospital Lahore, Pakistan
  • SI AMIR Department of Medicine, Nishter Medical University and Hospital (NMU & H) Multan, Pakistan
  • A NOOR Department of Medicine, Nishter Medical University and Hospital (NMU & H) Multan, Pakistan
  • J QURESHI Department of Peads, BBH, Rawalpindi, Pakistan
  • WU HASSAN Department of Radiology, Lahore General Hospital Lahore, Pakistan
  • UB SHABBIR Department of Gastroenterology, Sheikh Zayed Hospital Lahore, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.473

Keywords:

Hepatitis C, Liver fibrosis, 2D Shear Wave Elastography

Abstract

The prospective study was conducted in tertiary care hospitals from January 2021 to January 2022 to assess the diagnostic accuracy of two-dimensional shear wave elastography for evaluating liver fibrosis in patients with HCV by using liver biopsy and METAVIR staging as a diagnostic reference. Two hundred fifteen patients who fulfilled the study criteria were included. 2D SWE examination was done by two experienced radiologists, blinded to the clinical and histological data of the participants, independently. The METAVIR scoring system was used for staging liver fibrosis. Biochemical tests for serum liver fibrosis biomarkers were also performed. In addition to patients, 25 healthy controls were included. Results showed that SWE was successfully performed in 97.6% (210/215) cases. In the study group, the median SWV was 1.75 (0.95-2.86) m/s. In the control group, the median SWV was 1.29 (1.04-1.48) m/s. 30 patients had stage F0, 42 had F1, 30 had F2, 40 had F3 and 68 had F4. For necro inflammation, 9 patients had A0, 126 had A1, 71 had A2, and 4 had A3. For stenosis, 169 patients had S0, 35 had S1, 3 had S2 and 4 had S3. The higher fibrosis stages were positively correlated with increased SWV (P<.0001). There was a significant negative correlation between SWV and Alb and Plt and a significant positive correlation between SWV and M2BPGi, IV-c-7S, HA, PT, ALT, AST, and T.Bil. AUCs for 2D SWE were higher than serum biomarkers (P<0.05). In conclusion, 2D SWE has higher diagnostic accuracy than serum liver fibrosis biomarkers and is significantly associated with the severity of fibrosis.

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References

Anstee, Q. M., Castera, L., and Loomba, R. (2022). Impact of non-invasive biomarkers on hepatology practice: past, present and future. Journal of hepatology 76, 1362-1378.

Barr, R. G., Wilson, S. R., Rubens, D., Garcia-Tsao, G., and Ferraioli, G. (2020). Update to the society of radiologists in ultrasound liver elastography consensus statement. Radiology 296, 263-274.

Catanzaro, R., Aleo, A., Sciuto, M., Zanoli, L., Balakrishnan, B., and Marotta, F. (2021). FIB-4 and APRI scores for predicting severe liver fibrosis in chronic hepatitis HCV patients: a monocentric retrospective study. Clinical and Experimental Hepatology 7, 111-116.

Celli, R., Saffo, S., Kamili, S., Wiese, N., Hayden, T., Taddei, T., and Jain, D. (2021). Liver pathologic changes after direct-acting antiviral agent therapy and sustained virologic response in the setting of chronic hepatitis C virus infection. Archives of Pathology & Laboratory Medicine 145, 419-427.

de Souza Pires-Neto, O., Amoras, E. d. S. G., Queiroz, M. A. F., Demachki, S., da Silva Conde, S. R., Ishak, R., Cayres-Vallinoto, I. M. V., and Vallinoto, A. C. R. (2020). Hepatic TLR4, MBL and CRP gene expression levels are associated with chronic hepatitis C. Infection, Genetics and Evolution 80, 104200.

Ezzat, W. M., Shaker, O. G., Abdelaziz, M. S., Farag, A. M., and Abdelrehim, A. Y. (2022). Serum biomarkers and transient elastography versus histopathology for assessment of post living donor liver transplantation (LDLT) Hepatitis C virus recurrence. New Zealand Journal of Medical Laboratory Science 76, 114-119.

Fu, J., Wu, B., Wu, H., Lin, F., and Deng, W. (2020). Accuracy of real-time shear wave elastography in staging hepatic fibrosis: a meta-analysis. BMC Medical Imaging 20, 1-9.

Herlihy, T., Moran, M., Heeney, A., Okhai, H., De Franceso, D., Cronin, C., Feeney, E., Houlihan, D., Stewart, S., and Cotter, A. G. (2023). A comparison of transient elastography with acoustic radiation force impulse elastography for the assessment of liver health in patients with chronic hepatitis C: Baseline results from the TRACER study. Ultrasound, 1742271X221139181.

Indolfi, G., Easterbrook, P., Dusheiko, G., El-Sayed, M. H., Jonas, M. M., Thorne, C., Bulterys, M., Siberry, G., Walsh, N., and Chang, M.-H. (2019). Hepatitis C virus infection in children and adolescents. The lancet Gastroenterology & hepatology 4, 477-487.

Khatun, M., and Ray, R. B. (2019). Mechanisms underlying hepatitis C virus-associated hepatic fibrosis. Cells 8, 1249.

Kumada, T., Toyoda, H., Yasuda, S., Ogawa, S., Gotoh, T., Ito, T., Tada, T., and Tanaka, J. (2022). Liver stiffness measurements by 2D shear-wave elastography: effect of steatosis on fibrosis evaluation. American Journal of Roentgenology 219, 604-612.

Mak, L.-Y., Hui, R. W.-H., Fung, J., Liu, F., Wong, D. K.-H., Cheung, K.-S., Yuen, M.-F., and Seto, W.-K. (2020). Diverse effects of hepatic steatosis on fibrosis progression and functional cure in virologically quiescent chronic hepatitis B. Journal of hepatology 73, 800-806.

Moreno, C., Mueller, S., and Szabo, G. (2019). Non-invasive diagnosis and biomarkers in alcohol-related liver disease. Journal of hepatology 70, 273-283.

Panel, C. P. G., Berzigotti, A., Tsochatzis, E., Boursier, J., Castera, L., Cazzagon, N., Friedrich-Rust, M., Petta, S., Thiele, M., and Liver, E. A. f. t. S. o. t. (2021). EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis–2021 update. Journal of hepatology 75, 659-689.

Wei, H., Jiang, H.-Y., Li, M., Zhang, T., and Song, B. (2020). Two-dimensional shear wave elastography for significant liver fibrosis in patients with chronic hepatitis B: a systematic review and meta-analysis. European Journal of Radiology 124, 108839.

Yang, F., Liu, Y., Zeng, B., Chu, J., Hu, H., Yang, Y., Chen, H., Tian, C., Li, Y., and Lin, S. (2021). Noninvasive assessment of liver fibrosis for predicting acute-on-chronic liver failure in patients with chronic hepatitis B. Hepatology International, 1-9.

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Published

2023-10-17

How to Cite

SAMAAT, M., AMIR, S., NOOR , A., QURESHI, J., HASSAN, W., & SHABBIR, . U. (2023). ACCURACY OF TWO-DIMENSIONAL SHEAR WAVE ELASTOGRAPHY FOR DIAGNOSING LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS C. Biological and Clinical Sciences Research Journal, 2023(1), 473. https://doi.org/10.54112/bcsrj.v2023i1.473