Open AccessDiagnostic performance of a point shear wave elastography (pSWE) for hepatic fibrosis in patients with autoimmune liver disease
Author(s) -
Dong Won Park,
Yoon Jin Lee,
Won Chang,
Ji Hoon Park,
Kyung Ho Lee,
Young Hoon Kim,
Nak Heon Kang,
Jung Wha Chung,
Hee Yoon Jang,
Soomin Ahn,
Haeryoung Kim,
Sook Hyang Jeong,
Jin Wook Kim,
Eun Sun Jang
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0212771
Subject(s) - medicine , fibrosis , gastroenterology , autoimmune hepatitis , cirrhosis , receiver operating characteristic , transient elastography , hepatic fibrosis , nonalcoholic fatty liver disease , elastography , liver disease , steatosis , pathology , fatty liver , hepatitis , liver fibrosis , disease , radiology , ultrasound
Background & aims Elastography point quantification is a convenient method for measuring liver stiffness. It can be performed simultaneously with conventional ultrasonography. This study aimed to evaluate its diagnostic performance for assessing hepatic fibrosis in patients with autoimmune liver disease (AILD), including autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC). Methods The diagnostic performance of elastography point quantification (ElastPQ) was evaluated and compared with that of serum fibrosis markers, including the aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 (FIB-4), using the receiver operating characteristics analysis with histologic evaluation as the reference standard. Results In 49 AIH patients, sensitivity and specificity of ElastPQ were 93.6% and 44.4%, respectively, for significant fibrosis (≥ F2, cutoff 4.47 kPa), and 63.6% and 86.8% for cirrhosis (F4, cutoff 9.28 kPa). In 41 PBC patients, they were 81.8% and 73.3%, respectively, for significant fibrosis (≥ F2, cutoff 5.56 kPa), and 100% and 81.6%, respectively, for advanced fibrosis (≥ F3, cutoff 6.04 kPa). The areas under the receiver operating characteristic curves of ElastPQ for significant fibrosis (0.77, 95% CI 0.67–0.86) and cirrhosis (0.81, 95% CI 0.65–0.96) were higher than those of APRI and FIB-4 in AILD patients. According to the multivariable analysis, histological activity, steatosis, and body max index (BMI) were not significant factors that influenced the result of ElastPQ. Conclusions ElastPQ exhibited better diagnostic performance–without the influence of confounding factors–for assessing hepatic fibrosis in AILD patients than serum fibrosis markers.