Ultraschall Med 2016; 37 - E9_02
DOI: 10.1055/s-0036-1587977

The Value of ElastPQ for the Evaluation of Liver Fibrosis in Patients with B and C Chronic Hepatopathies

R Mare 1, I Sporea 1, A Popescu 1, R Sirli 1, M Danila 1, AM Stepan 1, R Lupusoru 1, F Bende 1
  • 1Department of Gastroenterology and Hepatology, "Victor Babes” University of Medicine and Pharmacy Timisoara, Romania

Purpose: The aim of this study was to evaluate the diagnostic performance of a point shear wave elastography using ARFI technique- ElastPQ, in patients with B and C chronic hepatopathies, using Transient Elastography (TE) as the reference method, since it is a validated method for liver fibrosis assessment.

Methods: The study included 193 consecutive subjects with chronic hepatopathies (32.6% HBV, 67.4% HCV) from whom 42.5% had liver cirrhosis. Liver stiffness (LS) was evaluated in the same session by means of 2 elastographic methods: TE (Fibroscan, Echosens) and ElastPQ (Philips, Affinity) techniques. Reliable LS measurements were defined as follows: for TE – the median value of 10 LS measurements with a success rate≥60% and an interquartile range< 30%. For ElastPQ- the median value of 10 LS measurements in the liver parenchyma, at least 1 cm below the capsule, avoiding large vessels. For TE M and XL probes were used. For differentiating between stages of liver fibrosis we used the following cut-off values for TE – mild fibrosis (F1)-6.1 kPa, moderate fibrosis (F2)- 7.2 kPa, severe fibrosis (F3)-9.6 kPa and for liver cirrhosis (F4) -14.5kPa (1).

Results: Reliable liver stiffness measurements were obtained in 93.8% (181/193) by means of TE and in 98.4% (190/193) with ElastPQ. In our cohort the ElastPQ values ranged from 2.32 to 44.07 kPa (median = 8.37 kPa). Based on TE cut-off values we divided our cohort into 4 groups: F1: 69/181 (38.1%); F2: 10/181 (5.5%) F3: 29/181 (16.1%); F = 4: 73/181 (40.3%). The areas under the receiver operating characteristic curve were: 0.89 ± 0.02 for patients with mild fibrosis (F1), 0.93 ± 0.02 for moderate fibrosis (F2), 0.95 ± 0.01 for severe fibrosis (F3) and 0.95 ± 0.01 for cirrhosis. The best cut-off values for discriminating mild, moderate, severe fibrosis and cirrhosis were 6.5, 7.2, 8.6 and 9.9 kPa respectively.

Conclusion: ElastPQ is a method that seems to be good for the diagnosis of all stages of liver fibrosis with good diagnostic accuracy.