Role of Shear Wave Elastography in Evaluating the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B

Gut Liver. 2017 Nov 15;11(6):852-859. doi: 10.5009/gnl16521.


Background/aims: To investigate the use of measurements of liver stiffness (LS) by two-dimensional real-time shear wave elastography (SWE) for predicting the development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB).

Methods: We retrospectively collected data on 291 enrolled patients with CHB whose LS had been measured using SWE.

Results: The mean age of the patients was 46.8 years; males predominated (67%), and 40 of the patients (14%) had clinical cirrhosis. Among the patients, 165 (56.7%) received antiviral treatment. The median LS value was 7.4 kPa, and the median follow-up period was 35.8 months (range, 3.0 to 52.8 months). During follow-up, HCC developed in 13 patients (4.5%), and the cumulative incidence rates of HCC at 1, 2, and 4 years were 1.1%, 3.6%, and 8.4%, respectively. Based on a multivariate analysis, older age (≥50 years) and higher LS value (≥10 kPa) were independently associated with the risk of developing HCC (hazard ratio [HR], 4.53, p=0.023; and HR, 4.08, p=0.022). The cumulative incidence rate of HCC was significantly higher in patients with higher LS values (≥10 kPa) than in those with lower LS values (<10 kPa) (p=0.001).

Conclusions: Increased LS measured by SWE at any time point regardless of antiviral treatment is associated with an increased risk of HCC in patients with CHB.

Keywords: Carcinoma; Elastography; Hepatitis B; Liver stiffness; chronic; hepatocellular; shear wave.

Publication types

  • Evaluation Study

MeSH terms

  • Carcinoma, Hepatocellular / virology*
  • Elasticity Imaging Techniques / methods*
  • Female
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / diagnostic imaging*
  • Humans
  • Liver / diagnostic imaging
  • Liver / pathology
  • Liver / virology
  • Liver Neoplasms / virology*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors