Two-Dimensional Shear-Wave Elastography: Accuracy in Liver Fibrosis Staging Using Magnetic Resonance Elastography as the Reference Standard
<b>Background:</b> The accurate staging of liver fibrosis is crucial for managing chronic liver disease (CLD). Although magnetic resonance elastography (MRE) is the reference standard for noninvasive fibrosis assessment, its cost, specialized hardware, and operational demands restrict ac...
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MDPI AG
2024-12-01
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| author | Puwitch Charoenchue Jiraporn Khorana Taned Chitapanarux Nakarin Inmutto Wittanee Na Chiangmai Amonlaya Amantakul Suwalee Pojchamarnwiputh Apichat Tantraworasin |
| author_facet | Puwitch Charoenchue Jiraporn Khorana Taned Chitapanarux Nakarin Inmutto Wittanee Na Chiangmai Amonlaya Amantakul Suwalee Pojchamarnwiputh Apichat Tantraworasin |
| author_sort | Puwitch Charoenchue |
| collection | DOAJ |
| description | <b>Background:</b> The accurate staging of liver fibrosis is crucial for managing chronic liver disease (CLD). Although magnetic resonance elastography (MRE) is the reference standard for noninvasive fibrosis assessment, its cost, specialized hardware, and operational demands restrict accessibility. In contrast, two-dimensional shear-wave elastography (2D-SWE) is more affordable, accessible, and widely integrated into routine ultrasound systems. <b>Objective:</b> Our aim was to determine the optimal 2D-SWE cut-offs for detecting significant fibrosis (≥F2) and evaluate its diagnostic performance across fibrosis stages. <b>Methods:</b> In this prospective study, 71 patients with suspected CLD underwent same-day MRE and 2D-SWE. MRE-defined cut-offs categorized fibrosis stages (≥3.5 kPa for significant fibrosis). Sensitivity, specificity, area under the receiver operating characteristic curve (AUROC), and likelihood ratios were calculated for various 2D-SWE thresholds. <b>Results:</b> At a 2D-SWE cut-off of 7.0 kPa, sensitivity for detecting ≥F2 fibrosis was 100% with a specificity of 85.7% and a positive likelihood ratio (LR+) of 7.0. Increasing the threshold to 8.0 kPa improved specificity to 91.8% while maintaining a sensitivity of 86.4% and achieving an AUROC of 0.89. For cirrhosis, a cut-off of 11.0 kPa achieved 100% sensitivity and 96.9% specificity. A 5.0 kPa cut-off reliably excluded abnormal stiffness with 89.1% sensitivity. <b>Conclusions:</b> Two-dimensional SWE is a reliable method for staging liver fibrosis. Thresholds of 7.0 kPa for screening significant fibrosis, 8.0 kPa for confirmation, and 11.0 kPa for diagnosing cirrhosis demonstrate high diagnostic accuracy. A 5.0 kPa cut-off effectively excludes abnormal liver stiffness. |
| format | Article |
| id | doaj-art-7d8be389b59f4a82ad59d50e1d443b45 |
| institution | Kabale University |
| issn | 2075-4418 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj-art-7d8be389b59f4a82ad59d50e1d443b452025-01-10T13:16:36ZengMDPI AGDiagnostics2075-44182024-12-011516210.3390/diagnostics15010062Two-Dimensional Shear-Wave Elastography: Accuracy in Liver Fibrosis Staging Using Magnetic Resonance Elastography as the Reference StandardPuwitch Charoenchue0Jiraporn Khorana1Taned Chitapanarux2Nakarin Inmutto3Wittanee Na Chiangmai4Amonlaya Amantakul5Suwalee Pojchamarnwiputh6Apichat Tantraworasin7Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDepartment of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDepartment of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDepartment of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDepartment of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDepartment of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDepartment of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, ThailandDepartment of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand<b>Background:</b> The accurate staging of liver fibrosis is crucial for managing chronic liver disease (CLD). Although magnetic resonance elastography (MRE) is the reference standard for noninvasive fibrosis assessment, its cost, specialized hardware, and operational demands restrict accessibility. In contrast, two-dimensional shear-wave elastography (2D-SWE) is more affordable, accessible, and widely integrated into routine ultrasound systems. <b>Objective:</b> Our aim was to determine the optimal 2D-SWE cut-offs for detecting significant fibrosis (≥F2) and evaluate its diagnostic performance across fibrosis stages. <b>Methods:</b> In this prospective study, 71 patients with suspected CLD underwent same-day MRE and 2D-SWE. MRE-defined cut-offs categorized fibrosis stages (≥3.5 kPa for significant fibrosis). Sensitivity, specificity, area under the receiver operating characteristic curve (AUROC), and likelihood ratios were calculated for various 2D-SWE thresholds. <b>Results:</b> At a 2D-SWE cut-off of 7.0 kPa, sensitivity for detecting ≥F2 fibrosis was 100% with a specificity of 85.7% and a positive likelihood ratio (LR+) of 7.0. Increasing the threshold to 8.0 kPa improved specificity to 91.8% while maintaining a sensitivity of 86.4% and achieving an AUROC of 0.89. For cirrhosis, a cut-off of 11.0 kPa achieved 100% sensitivity and 96.9% specificity. A 5.0 kPa cut-off reliably excluded abnormal stiffness with 89.1% sensitivity. <b>Conclusions:</b> Two-dimensional SWE is a reliable method for staging liver fibrosis. Thresholds of 7.0 kPa for screening significant fibrosis, 8.0 kPa for confirmation, and 11.0 kPa for diagnosing cirrhosis demonstrate high diagnostic accuracy. A 5.0 kPa cut-off effectively excludes abnormal liver stiffness.https://www.mdpi.com/2075-4418/15/1/622D shear-wave elastographymagnetic resonance elastographyliver fibrosisnoninvasive diagnosischronic liver disease |
| spellingShingle | Puwitch Charoenchue Jiraporn Khorana Taned Chitapanarux Nakarin Inmutto Wittanee Na Chiangmai Amonlaya Amantakul Suwalee Pojchamarnwiputh Apichat Tantraworasin Two-Dimensional Shear-Wave Elastography: Accuracy in Liver Fibrosis Staging Using Magnetic Resonance Elastography as the Reference Standard Diagnostics 2D shear-wave elastography magnetic resonance elastography liver fibrosis noninvasive diagnosis chronic liver disease |
| title | Two-Dimensional Shear-Wave Elastography: Accuracy in Liver Fibrosis Staging Using Magnetic Resonance Elastography as the Reference Standard |
| title_full | Two-Dimensional Shear-Wave Elastography: Accuracy in Liver Fibrosis Staging Using Magnetic Resonance Elastography as the Reference Standard |
| title_fullStr | Two-Dimensional Shear-Wave Elastography: Accuracy in Liver Fibrosis Staging Using Magnetic Resonance Elastography as the Reference Standard |
| title_full_unstemmed | Two-Dimensional Shear-Wave Elastography: Accuracy in Liver Fibrosis Staging Using Magnetic Resonance Elastography as the Reference Standard |
| title_short | Two-Dimensional Shear-Wave Elastography: Accuracy in Liver Fibrosis Staging Using Magnetic Resonance Elastography as the Reference Standard |
| title_sort | two dimensional shear wave elastography accuracy in liver fibrosis staging using magnetic resonance elastography as the reference standard |
| topic | 2D shear-wave elastography magnetic resonance elastography liver fibrosis noninvasive diagnosis chronic liver disease |
| url | https://www.mdpi.com/2075-4418/15/1/62 |
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