Value of Hitachi Shear Wave Elastography for non-invasive evaluation of liver fibrosis and complication of cirrhosis

Aim:

To assess the value of the Hitachi SWE for the non-invasive evaluation of liver fibrosis and its complications.

Methods:

Our study included 179 persons with or without liver disease. Liver stiffness (LS) was measured with Hitachi SWE (AriettaV70) and Transient Elastography (TE) (FibroScan Echosens). TE was used for classification of the degree of fibrosis. The following TE cutoff values were used (Tsochatzis et al – JHepatol2011;54:650 – 659):

F≥2: 7kPa, F≥3: 9.5kPa, F4: 12kPa. Reliable LS Measurements with both methods were defined as median value of ten valid measurements expressed in kPa with an IQR/Med< 30%.

Results:

Our cohort included 37 healthy volunteers, 94 patients with chronic liver disease and 48 patients with clinical signs of liver cirrhosis.

The rate of reliable LS measurements was significantly higher for Hitachi SWE than TE: 97.7% vs. 86.5%, p = 0.0002.

Hitachi SWE has very good reproducibility: the Concordance correlation coefficient (CCC) was 0.75 and 0.72 for intra- and interoperators.

Mean LS in healthy volunteers was 4 ± 0.9 kPa (median 3.8 kPa).

The mean LS values in patients with chronic liver disease were: F0/1 (n = 45) 4.7 ± 1.1 kPa, F2 (n = 14) 6.3 ± 1.9 kPa, F3 (n = 6) 8 ± 1.5 kPa, F4 (n = 20) 9.7 ± 2.7 kPa.

The cutoff value of Hitachi SWE > 5.1 kPa had 97.5% Se, 75.6% Sp, 78% PPV, 97% NPV and 85.8% accuracy for predicting the presence of F ≥2 (AUC 0.93).

The cutoff value of Hitachi SWE < 7.1 kPa had 89.2% Se, 85% Sp, 95% PPV, 70.8% NPV and 88.2% accuracy to rule out the presence of cirrhosis (AUC 0.92).

LS values assessed by Hitachi SWE (kPa) were similar in patients with and without esophageal varices: 14.9 ± 7.1 vs. 12.6 ± 4.1, p = 0.13 and significantly higher in patients with ascites than without: 17.1 ± 8.1 vs. 12.1 ± 3.1, p = 0.01.

Conclusions:

Hitachi SWE seems to be a good method for non-invasive evaluations of liver fibrosis.