2D shear wave elastography: measurement acquisition and reliability criteria in noninvasive assessment of liver fibrosis.

Purpose: The objective was to evaluate the accuracy of 2D shear wave elastography (SWE) in predicting stages of liver fibrosis using five individual versus grouped measurements and different reliability criteria. Materials and methods: This is a prospective study of 109 patients who underwent hepati...

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Publicado en:Abdominal Radiology Vol. 44; no. 10; pp. 3285 - 3295
Autores principales: Chung, Maggie, Baird, Grayson L., Weiss, Krista E., Beland, Michael D.
Formato: Journal Article
Publicado: Springer Nature Oct2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2019
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00261-019-02183-0
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        atl: 2D shear wave elastography: measurement acquisition and reliability criteria in noninvasive assessment of liver fibrosis.
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        au:
          Chung, Maggie
          Baird, Grayson L.
          Weiss, Krista E.
          Beland, Michael D.
        affil: Department of Radiology and Biomedical Imaging, University of California, San Francisco, Box 0628, 505 Parnassus Ave., Room M391, 94143, San Francisco, CA, USA
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      ab: Purpose: The objective was to evaluate the accuracy of 2D shear wave elastography (SWE) in predicting stages of liver fibrosis using five individual versus grouped measurements and different reliability criteria. Materials and methods: This is a prospective study of 109 patients who underwent hepatic 2D SWE (Canon Aplio 500) prior to liver biopsy for varied indications. Liver fibrosis was staged using the METAVIR scoring system (F = 0–4). Propagation mapping was used to guide ten SWE measurements from the liver parenchyma: five individual measurements and five grouped measurements. IQR/median, SD/median, and SD/mean were examined as quality criteria for patient inclusion at various thresholds (IQR/median ≤ 0.15, 0.2, 0.3, 0.4, 0.5; SD/median ≤ 0.15, 0.2, 0.3; SD/mean ≤ 0.2, 0.3, 0.5). Threshold for clinically significant fibrosis (F ≥ 2) was determined with receiver operating characteristic (ROC) analysis. Results: There was high agreement between individual and grouped measurements without statistically significant differences (intraclass correlation coefficient = 0.82; p = 0.26–0.96). When no quality criterion was used (n = 103), the optimal threshold was 11.3 kPa [AUROC 0.78, 95% CI (0.69, 0.88)] with sensitivity and specificity of 80% and 66%, respectively. All quality criteria were associated with equal or higher AUROC ranging from 0.78 to 0.87. IQR/median ≤ 0.5 (n = 88) achieved the highest sensitivity of 85% and only excluded a small subset of patients. The AUROC and specificity were 0.83 [95% CI (0.74, 0.92)] and 72%, respectively. Significance: Quality criterion IQR/median ≤ 0.5 increases sensitivity and specificity in prediction of clinically significant liver fibrosis while excluding only a small subset of patients. Grouped measurements are comparable to individual measurements and may help increase procedural efficiency.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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