Diagnostic accuracy of two-dimensional shear wave elastography and transient elastography in nonalcoholic fatty liver disease

Suzanne R Sharpton; Nobuharu Tamaki; Ricki Bettencourt; Egbert Madamba; Jinho Jung; Amy Liu; Cynthia Behling; Mark A Valasek; Rohit Loomba

doi:10.1177/17562848211050436

Diagnostic accuracy of two-dimensional shear wave elastography and transient elastography in nonalcoholic fatty liver disease

Therap Adv Gastroenterol. 2021 Oct 8:14:17562848211050436. doi: 10.1177/17562848211050436. eCollection 2021.

Authors

Suzanne R Sharpton¹, Nobuharu Tamaki², Ricki Bettencourt², Egbert Madamba², Jinho Jung², Amy Liu², Cynthia Behling³, Mark A Valasek⁴, Rohit Loomba⁵

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
² NAFLD Research Center, University of California San Diego, La Jolla, CA, USA.
³ Department of Pathology, Sharp Health System, San Diego, CA, USA.
⁴ Department of Pathology, University of California San Diego, La Jolla, CA, USA.
⁵ Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Diego, 9500 Gilman Drive, ACTRI Building, 2W202, La Jolla, CA 92093-0887, USA.

Abstract

Introduction: Two-dimensional shear wave elastography (2D-SWE) and vibration-controlled transient elastography (VCTE) provide noninvasive assessment of hepatic fibrosis. We compared performance of 2D-SWE and VCTE for fibrosis detection in nonalcoholic fatty liver disease (NAFLD).

Methods: We performed a prospective study of adults with NAFLD who underwent 2D-SWE, VCTE, and liver biopsy analysis (using Nonalcoholic Steatohepatitis Clinical Research Network scoring system). The primary outcome was hepatic fibrosis (stage ⩾ 1); secondary outcomes included dichotomized fibrosis stages. Area under receiver operating characteristic curve (AUROC) analyses were used to compare 2D-SWE and VCTE performance.

Results: A total of 114 adults with a median BMI of 31.2 kg/m² were included. The VCTE was better than 2D-SWE for the detection of fibrosis (AUROC: 0.81 versus 0.72, p = 0.03). The VCTE detected fibrosis stage 2, 3, or 4 with AUROCs of 0.86 (95% CI, 0.80-0.93), 0.91 (95% CI, 0.82-0.99), and 0.96 (95% CI, 0.91-1.00). The 2D-SWE detected fibrosis stage 2, 3, or 4 with AUROCs of 0.84 (95% CI, 0.76-0.92), 0.88 (95% CI, 0.81-0.96), and 0.93 (95% CI, 0.86-0.99).

Conclusion: In a prospective study including more than 100 adults with NAFLD, we found VCTE to be more accurate than 2D-SWE in detecting fibrosis; these modalities, however, are comparable in assessing for higher stages of fibrosis.

Keywords: elastography; fibrosis; liver stiffness; nonalcoholic fatty liver.

Grants and funding

P30 DK120515/DK/NIDDK NIH HHS/United States