Liver stiffness quantification in biopsy-proven nonalcoholic fatty liver disease patients using shear wave elastography in comparison with transient elastography

Purpose: This study prospectively assessed the performance of liver stiffness measurementsusing point shear-wave elastography (p-SWE) in comparison with transient elastography (TE) inpatients with biopsy-proven nonalcoholic fatty liver disease (NAFLD).Methods: Fifty-six consecutive adult patients with a histological diagnosis of NAFLD prospectivelyunderwent TE and p-SWE on the same day. The median of 10 measurements (SWE-10), the firstfive (SWE-5), and the first three (SWE-3) measurements were analyzed for p-SWE. Liver biopsywas considered as the reference standard for liver fibrosis grade. Receiver operating characteristic(ROC) curves and areas under the ROC curves (AUROCs) were calculated to assess the performanceof TE and p-SWE for the diagnosis of significant (F2-F4) and advanced fibrosis (F3-F4).Results: Forty-six patients (27 men, 19 women; mean age, 54.7±9.1 years) had valid p-SWE andTE measurements. Twenty-seven patients (58.7%) had significant fibrosis and 18 (39.1%) hadadvanced fibrosis. For significant fibrosis, both SWE-10 (AUROC, 0.787; P=0.002) and SWE-5 (AUROC, 0.809; P=0.001) provided higher diagnostic performance than TE (AUROC, 0.719;P=0.016) and SWE-3 (AUROC, 0.714; P=0.021), albeit without statistical significance (P=0.301).For advanced fibrosis, SWE-5 showed higher diagnostic performance (AUROC, 0.809; P<0.001)than TE (AUROC, 0.799; P<0.001), SWE-10 (AUROC, 0.797; P<0.001), and SWE-3 (AUROC,0.736; P=0.003), although the differences were not statistically significant (P=0.496). Theoptimal SWE-10 and SWE-5 cutoff values were ≥8.4 and ≥7.8 for significant fibrosis, and ≥9.1and ≥8.8 for advanced fibrosis, respectively.Conclusion: TE and p-SWE showed similar performance for the diagnosis of significant andadvanced fibrosis in NAFLD patients.