B. Lapuyade, PESSAC, FR

Intersystem variability in liver stiffness evaluation (LSE) may hinder diffusion and clinical implementation of novel ultrasound methods. Our aim was to assess if bi-dimensional shear wave elastography (2D-SWE) values using Aixplorer (Supersonic Imagine) were comparable to VCTE values.

Material and methods

From a prospective registry, we retrospectively included 1219 consecutive patients with chronic liver disease who had LSE the same day with both VCTE and 2D-SWE. Distribution of LSE values and performances of 2D-SWE to diagnose compensated advanced chronic liver disease (cACLD) according to Baveno VI criteria were assessed.

Results

VCTE and 2D-SWE values were highly correlated (Pearson’s correlation coefficient: 0.882, p<.0001). Failed or unreliable measurements were higher using VCTE than 2D-SWE (11.3% versus 8.3%; p<.0001), whereas very reliable results were higher using 2D-SWE (42.1% versus 30.1%, p<.0001). Median (interquartile range (IQR)) stiffness values were of 6.7 kPa (4.8-11.6) with VCTE and 7.1 kPa (5.4-11.1) with 2D-SWE (p=0.736). The median (IQR) difference between 2D-SWE and VCTE was of 1.5 kPa (0.7 – 2.9). Fifty percent of 2D-SWE values were within 1.5 kPa around VCTE values, and 80% within 3.5 kPa. The areas under the curve (95% confidence interval) of 2D-SWE to predict VCTE values <10kPa and ≥15kPa were of 0.964 (0.952-0.976) and 0.976 (0.963-0.988), with accuracy of 2D-SWE threshold values of 10kPa and 15kPa of 90.8% and 95.1%, respectively.

Conclusion

VCTE and 2D-SWE LSE values are highly comparable. 2D-SWE has excellent accuracy to diagnose cACLD as VCTE according to Baveno VI criteria.These results should greatly accelerate the clinical implementation of the 2D-SWE and its integration in international guidelines.

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