Diagnostic performance of a point shear wave elastography (pSWE) for hepatic fibrosis in patients with autoimmune liver disease

• Published in: PloS one Vol. 14; no. 3; p. e0212771
• Main Authors: Park, Dong Won, Lee, Yoon Jin, Chang, Won, Park, Ji Hoon, Lee, Kyoung Ho, Kim, Young Hoon, Kang, Nam Kyu, Chung, Jung Wha, Jang, Hee Yoon, Ahn, Soomin, Kim, Haeryoung, Jeong, Sook-Hyang, Kim, Jin-Wook, Jang, Eun Sun
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11.03.2019; Public Library of Science (PLoS)
• Subjects: Acoustics; Adult; Aged; Aspartate; Aspartate aminotransferase; Aspartate Aminotransferases - blood; Biology and Life Sciences; Biomarkers - blood; Body mass; Cholangitis; Chronic active hepatitis; Cirrhosis; Diagnosis; Diagnostic imaging; Diagnostic systems; Elasticity Imaging Techniques; Female; Fibrosis; Hepatitis; Hepatitis, Autoimmune - blood; Hepatitis, Autoimmune - complications; Hepatitis, Autoimmune - diagnostic imaging; Hepatology; Humans; Internal medicine; Liver; Liver cirrhosis; Liver Cirrhosis - blood; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - etiology; Liver Cirrhosis, Biliary - blood; Liver Cirrhosis, Biliary - complications; Liver Cirrhosis, Biliary - diagnostic imaging; Liver diseases; Male; Markers; Medical diagnosis; Medical research; Medicine; Medicine and Health Sciences; Methods; Middle Aged; Pathology; Patients; Risk factors; Sensitivity analysis; Steatosis; Stiffness; Ultrasonic imaging; Ultrasound; Ultrasound imaging; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0212771

Elastography point quantification is a convenient method for measuring liver stiffness. It can be performed simultaneously with conventional ultrasonography. This study aimed to evaluate its diagnostic performance for assessing hepatic fibrosis in patients with autoimmune liver disease (AILD), including autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC). The diagnostic performance of elastography point quantification (ElastPQ) was evaluated and compared with that of serum fibrosis markers, including the aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 (FIB-4), using the receiver operating characteristics analysis with histologic evaluation as the reference standard. In 49 AIH patients, sensitivity and specificity of ElastPQ were 93.6% and 44.4%, respectively, for significant fibrosis (≥ F2, cutoff 4.47 kPa), and 63.6% and 86.8% for cirrhosis (F4, cutoff 9.28 kPa). In 41 PBC patients, they were 81.8% and 73.3%, respectively, for significant fibrosis (≥ F2, cutoff 5.56 kPa), and 100% and 81.6%, respectively, for advanced fibrosis (≥ F3, cutoff 6.04 kPa). The areas under the receiver operating characteristic curves of ElastPQ for significant fibrosis (0.77, 95% CI 0.67-0.86) and cirrhosis (0.81, 95% CI 0.65-0.96) were higher than those of APRI and FIB-4 in AILD patients. According to the multivariable analysis, histological activity, steatosis, and body max index (BMI) were not significant factors that influenced the result of ElastPQ. ElastPQ exhibited better diagnostic performance-without the influence of confounding factors-for assessing hepatic fibrosis in AILD patients than serum fibrosis markers.