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DOI: 10.1055/s-0036-1587857
Prospective comparison of noninvasive techniques for the assessment of liver stiffness in a cohort of compensated HCV liver cirrhosis
Background: Liver biopsy is the “gold standard” for diagnosing liver fibrosis, but it also can be diagnosed by means of noninvasive techniques, either biological tests or elastographic techniques.
Aim: The aim of this study was to compare the performance of five ultrasound elastographic techniques and FibroTest in diagnosing compensated HCV liver cirrhosis.
Material and Method: We performed a prospective study, including 54 consecutive patients diagnosed with HCV liver cirrhosis. All patients were evaluated by five elastographic techniques-Transient Elastography[(TE)-FibroScan, EchoSens], Virtual Touch Quantification[(VTQ)-Acuson S2000, Siemens], ElastPQ-(Affinity, Philips), 2D Shear Waves Elastography[Aixplorer, Supersonic Imagine (SSI)] and the LOGIC E9[GE Healthcare, Chalfont St. Giles-UK (2D-SWE GE)]-in the same session, while FibroTest was performed within a month.
Results: Our cohort included 54 subjects (34 women and 20 men), mean age of 59.9 ± 7.9. Reliable LSM by means of VTQ, ElastPQ, 2D-SWE.GE were obtained in 54/54subjects, by means of TE in 51/54 subjects (94.4%) and by means of SSI in 49/54 subjects (90.7%), so the final analysis included 46/54 subjects (85.2%). TE elastography had 95.6% accuracy, VTQ – 89.1%, ElastPQ – 82.6%, 2D-SWE.GE – 78.2%, SSI – 86.9%, and FibroTest – 82.6% for the diagnosis of liver cirrhosis. There were no significant statistical differences between FibroTest vs. TE (p = 0.25), FibroTest vs. VTQ (p = 0.55), FibroTest vs. ElastPQ (p = 0.95), FibroTest vs. SSI (p = 0.77), FibroTest vs. 2D-SWE.GE (p = 0.78) respectively. Neither between TE vs. VTQ, ElastPQ, SSI; VTQ vs. ElastPQ, VTQ, SSI, 2D-SWE.GE; ElastPQ vs. SSI, 2D-SWE.GE; SSI vs. 2D-SWE.GE, all p-values were > 0.05. Significant statistical differences were found only between TE and 2D-SWE.GE (95.6% vs. 78.2%, p = 0.03).
Conclusion: In this preliminary study, all ultrasound based elastographic methods had good performance for the diagnosis of compensated liver cirrhosis and this seem to be similar with FibroTest.