Noninvasive Assessment of Liver Fibrosis Using Ultrasound‐Based Shear Wave Measurement and Comparison to Magnetic Resonance Elastography

• Published in: Journal of ultrasound in medicine Vol. 33; no. 9; pp. 1597 - 1604
• Main Authors: Zhao, Heng, Chen, Jun, Meixner, Duane D., Xie, Hua, Shamdasani, Vijay, Zhou, Shiwei, Robert, Jean-Luc, Urban, Matthew W., Sanchez, William, Callstrom, Matthew R., Ehman, Richard L., Greenleaf, James F., Chen, Shigao
• Format: Journal Article
• Language: English
• Published: England American Institute of Ultrasound in Medicine 01.09.2014
• Subjects: Adult; Aged; Aged, 80 and over; Elasticity Imaging Techniques - methods; Female; gastrointestinal ultrasound; Humans; Liver - diagnostic imaging; Liver - pathology; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - pathology; liver fibrosis; magnetic resonance elastography; Magnetic Resonance Imaging - methods; Male; Middle Aged; Reproducibility of Results; ROC Curve; shear wave; ultrasound; Young Adult; shear wave; gastrointestinal ultrasound; liver fibrosis; magnetic resonance elastography; ultrasound
• ISSN: 0278-4297; 1550-9613
• DOI: 10.7863/ultra.33.9.1597

Objectives Magnetic resonance elastography (MRE) has excellent performance in detecting liver fibrosis and is becoming an alternative to liver biopsy in clinical practice. Ultrasound techniques based on measuring the propagation speed of the shear waves induced by acoustic radiation force also have shown promising results for liver fibrosis staging. The objective of this study was to compare ultrasound‐based shear wave measurement to MRE. Methods In this study, 50 patients (28 female and 22 male; age range, 19–81 years) undergoing liver MRE examinations were studied with an ultrasound scanner modified with shear wave measurement functionality. For each patient, 27 shear wave speed measurements were obtained at various locations in the liver parenchyma away from major vessels. The median shear wave speed from all measurements was used to calculate a representative shear modulus (μ) for each patient. Magnetic resonance elastographic data processing was done by a single analyst blinded to the ultrasound measurement results. Results Ultrasound and MRE measurements were correlated (r = 0.86; P < .001). Receiver operating characteristic (ROC) analysis was applied to the ultrasound measurement results with the MRE diagnosis as the “ground truth.” The area under the ROC curve for separating patients with minimum fibrosis (defined as μMRE ≤2.9 kPa) was 0.89 (95% confidence interval, 0.77–0.95), and the area under the ROC curve for separating patients with advanced fibrosis (defined as μMRE ≥5.0 kPa) was 0.96 (95% confidence interval, 0.87–0.99). Conclusions Results indicate that the ultrasound‐based shear wave measurement correlates with MRE and is a promising method for liver fibrosis staging.