Ruling-in and ruling-out significant fibrosis and cirrhosis in patients with chronic hepatitis C using a shear wave measurement method

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Abstract

Aims: To prospectively assess the cutoff values of a point shear wave measurement (SWM) method for ruling-in and ruling-out significant fibrosis and cirrhosis using transient elastography (TE) as the reference standard. Method: Consecutive patients with chronic hepatitis C were enrolled. Liver stiffness was assessed with the SWM method implemented on the HI VISION Ascendus ultrasound system (Hitachi Ltd, Japan) and with the TE method of the FibroScan® device (Echosens, France). For staging significant fibrosis (F≥2) and cirrhosis (F=4) we used the TE cutoffs of 7.0 and 12.0 kiloPascal (kPa), respectively. The diagnostic performance of SWM was assessed by calculating the area under the receiver operating characteristic (AUROC) curve. Cutoffs with specificity or sensitivity > 90% were chosen to rule-in or rule-out F≥2 and F=4. Results: 445 individuals [235 males, 210 females; mean age, 61.1 (13.3) years] were studied: 190 (42.7%) individuals had F0-F1 fibrosis stage, 82 (18.4%) F2, 46 (10.3%) F3, and 127 (28.6%) F4 fibrosis stage. For ruling-in F≥2 the SWM cutoff was 6.78 kPa [sensitivity, 76.9%(70.6-82.4); specificity, 90.3% (85.0-94.3)] and for ruling-out it was 5.55 kPa [sensitivity, 90.6% (85.8-94.1); specificity, 72.2% (64.9-78.6)]. For ruling-in F=4 the SWM cutoff was 9.15 kPa [sensitivity, 83.3% (74.4-90.2); specificity, 90.1% (86.0-93.2)] and for ruling-out it was 8.41 kPa [sensitivity, 90.6% (82.9-95.6); specificity, 82.2% (77.3-86.4)]. AUROCs were 0.92 (0.89-0.94) for F≥2 and 0.94 (0.91-0.96) for F=4. Conclusions. In clinical practice, the use of a dual cutoff of SWM may increase the confidence in staging liver fibrosis with a non-invasive shear wave elastography technique.

Original languageEnglish
Pages (from-to)139-143
Number of pages5
JournalJournal of Gastrointestinal and Liver Diseases
Volume26
Issue number2
DOIs
Publication statusPublished - Jun 1 2017

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Chronic Hepatitis C
Elasticity Imaging Techniques
Fibrosis
ROC Curve
Liver Cirrhosis
France
Japan
Sensitivity and Specificity
Equipment and Supplies
F 4
Liver

Keywords

  • Chronic hepatitis C
  • Liver cirrhosis
  • Liver stiffness
  • Shear wave elastography
  • Transient elastography

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{c039e6e1439e496d8410c40cfc1afc0b,
title = "Ruling-in and ruling-out significant fibrosis and cirrhosis in patients with chronic hepatitis C using a shear wave measurement method",
abstract = "Aims: To prospectively assess the cutoff values of a point shear wave measurement (SWM) method for ruling-in and ruling-out significant fibrosis and cirrhosis using transient elastography (TE) as the reference standard. Method: Consecutive patients with chronic hepatitis C were enrolled. Liver stiffness was assessed with the SWM method implemented on the HI VISION Ascendus ultrasound system (Hitachi Ltd, Japan) and with the TE method of the FibroScan{\circledR} device (Echosens, France). For staging significant fibrosis (F≥2) and cirrhosis (F=4) we used the TE cutoffs of 7.0 and 12.0 kiloPascal (kPa), respectively. The diagnostic performance of SWM was assessed by calculating the area under the receiver operating characteristic (AUROC) curve. Cutoffs with specificity or sensitivity > 90{\%} were chosen to rule-in or rule-out F≥2 and F=4. Results: 445 individuals [235 males, 210 females; mean age, 61.1 (13.3) years] were studied: 190 (42.7{\%}) individuals had F0-F1 fibrosis stage, 82 (18.4{\%}) F2, 46 (10.3{\%}) F3, and 127 (28.6{\%}) F4 fibrosis stage. For ruling-in F≥2 the SWM cutoff was 6.78 kPa [sensitivity, 76.9{\%}(70.6-82.4); specificity, 90.3{\%} (85.0-94.3)] and for ruling-out it was 5.55 kPa [sensitivity, 90.6{\%} (85.8-94.1); specificity, 72.2{\%} (64.9-78.6)]. For ruling-in F=4 the SWM cutoff was 9.15 kPa [sensitivity, 83.3{\%} (74.4-90.2); specificity, 90.1{\%} (86.0-93.2)] and for ruling-out it was 8.41 kPa [sensitivity, 90.6{\%} (82.9-95.6); specificity, 82.2{\%} (77.3-86.4)]. AUROCs were 0.92 (0.89-0.94) for F≥2 and 0.94 (0.91-0.96) for F=4. Conclusions. In clinical practice, the use of a dual cutoff of SWM may increase the confidence in staging liver fibrosis with a non-invasive shear wave elastography technique.",
keywords = "Chronic hepatitis C, Liver cirrhosis, Liver stiffness, Shear wave elastography, Transient elastography",
author = "Giovanna Ferraioli and Laura Maiocchi and Raffaella Lissandrin and Carmine Tinelli and {De Silvestri}, Annalisa and Carlo Filice and {Liver Fibrosis Study Group}",
year = "2017",
month = "6",
day = "1",
doi = "10.15403/jgld.2014.1121.262.fer",
language = "English",
volume = "26",
pages = "139--143",
journal = "Journal of Gastrointestinal and Liver Diseases",
issn = "1841-8724",
publisher = "Romanian Society of Gastroenterology",
number = "2",

}

TY - JOUR

T1 - Ruling-in and ruling-out significant fibrosis and cirrhosis in patients with chronic hepatitis C using a shear wave measurement method

AU - Ferraioli, Giovanna

AU - Maiocchi, Laura

AU - Lissandrin, Raffaella

AU - Tinelli, Carmine

AU - De Silvestri, Annalisa

AU - Filice, Carlo

AU - Liver Fibrosis Study Group

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Aims: To prospectively assess the cutoff values of a point shear wave measurement (SWM) method for ruling-in and ruling-out significant fibrosis and cirrhosis using transient elastography (TE) as the reference standard. Method: Consecutive patients with chronic hepatitis C were enrolled. Liver stiffness was assessed with the SWM method implemented on the HI VISION Ascendus ultrasound system (Hitachi Ltd, Japan) and with the TE method of the FibroScan® device (Echosens, France). For staging significant fibrosis (F≥2) and cirrhosis (F=4) we used the TE cutoffs of 7.0 and 12.0 kiloPascal (kPa), respectively. The diagnostic performance of SWM was assessed by calculating the area under the receiver operating characteristic (AUROC) curve. Cutoffs with specificity or sensitivity > 90% were chosen to rule-in or rule-out F≥2 and F=4. Results: 445 individuals [235 males, 210 females; mean age, 61.1 (13.3) years] were studied: 190 (42.7%) individuals had F0-F1 fibrosis stage, 82 (18.4%) F2, 46 (10.3%) F3, and 127 (28.6%) F4 fibrosis stage. For ruling-in F≥2 the SWM cutoff was 6.78 kPa [sensitivity, 76.9%(70.6-82.4); specificity, 90.3% (85.0-94.3)] and for ruling-out it was 5.55 kPa [sensitivity, 90.6% (85.8-94.1); specificity, 72.2% (64.9-78.6)]. For ruling-in F=4 the SWM cutoff was 9.15 kPa [sensitivity, 83.3% (74.4-90.2); specificity, 90.1% (86.0-93.2)] and for ruling-out it was 8.41 kPa [sensitivity, 90.6% (82.9-95.6); specificity, 82.2% (77.3-86.4)]. AUROCs were 0.92 (0.89-0.94) for F≥2 and 0.94 (0.91-0.96) for F=4. Conclusions. In clinical practice, the use of a dual cutoff of SWM may increase the confidence in staging liver fibrosis with a non-invasive shear wave elastography technique.

AB - Aims: To prospectively assess the cutoff values of a point shear wave measurement (SWM) method for ruling-in and ruling-out significant fibrosis and cirrhosis using transient elastography (TE) as the reference standard. Method: Consecutive patients with chronic hepatitis C were enrolled. Liver stiffness was assessed with the SWM method implemented on the HI VISION Ascendus ultrasound system (Hitachi Ltd, Japan) and with the TE method of the FibroScan® device (Echosens, France). For staging significant fibrosis (F≥2) and cirrhosis (F=4) we used the TE cutoffs of 7.0 and 12.0 kiloPascal (kPa), respectively. The diagnostic performance of SWM was assessed by calculating the area under the receiver operating characteristic (AUROC) curve. Cutoffs with specificity or sensitivity > 90% were chosen to rule-in or rule-out F≥2 and F=4. Results: 445 individuals [235 males, 210 females; mean age, 61.1 (13.3) years] were studied: 190 (42.7%) individuals had F0-F1 fibrosis stage, 82 (18.4%) F2, 46 (10.3%) F3, and 127 (28.6%) F4 fibrosis stage. For ruling-in F≥2 the SWM cutoff was 6.78 kPa [sensitivity, 76.9%(70.6-82.4); specificity, 90.3% (85.0-94.3)] and for ruling-out it was 5.55 kPa [sensitivity, 90.6% (85.8-94.1); specificity, 72.2% (64.9-78.6)]. For ruling-in F=4 the SWM cutoff was 9.15 kPa [sensitivity, 83.3% (74.4-90.2); specificity, 90.1% (86.0-93.2)] and for ruling-out it was 8.41 kPa [sensitivity, 90.6% (82.9-95.6); specificity, 82.2% (77.3-86.4)]. AUROCs were 0.92 (0.89-0.94) for F≥2 and 0.94 (0.91-0.96) for F=4. Conclusions. In clinical practice, the use of a dual cutoff of SWM may increase the confidence in staging liver fibrosis with a non-invasive shear wave elastography technique.

KW - Chronic hepatitis C

KW - Liver cirrhosis

KW - Liver stiffness

KW - Shear wave elastography

KW - Transient elastography

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U2 - 10.15403/jgld.2014.1121.262.fer

DO - 10.15403/jgld.2014.1121.262.fer

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JO - Journal of Gastrointestinal and Liver Diseases

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SN - 1841-8724

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