Liver stiffness quantification in patients with non-alcoholic steatohepatitis: comparison of shear wave elastography and transient elastography with liver biopsy correlation

Purpose: To assess the accuracy of liver stiffness quantification in patientswith non-alcoholic steatohepatitis (NASH) using shear wave elastography(SWE) in comparison with transient elastography (TE).Methods and Materials: This is a prospective study performed in a singleinstitution, including 49 patients with histological diagnosis of NASH. Thestiffness of the right liver lobe was measured on the same day with twotechniques: TE (FibroScan, Echosens), and SWE (RS80A ultrasound system,Samsung Medison). In the SWE evaluation, 11 patients were excluded due tomore than 75% measurements fails. Receiver operating curves (ROC), areasunder the ROC (AUROC) and 95% confidence intervals (CI) were calculated toassess the accuracy of TE and SWE for the diagnosis of significant fibrosis(F2-F4) and advanced fibrosis (F3-F4). Spearman’s rank coefficient (rho) wasused for correlation of TE with SWE. A p<0.05 was considered for statisticalsignificance.Results: 38 patients were included in the final population. Overall 24 (63%)patients had significant fibrosis and 17 (45%) had advanced fibrosis. TE andSWE showed an AUROC of 0.711 (95% CI: 0.545-0.877, p=0.032) and 0.729(95% CI: 0.562-0.896, p=0.020) for the diagnosis of significant fibrosis. TheAUROC for the diagnosis of advanced fibrosis were 0.803 (95% CI: 0.648-0.9580, p=0.002) and 0.811 (95% CI: 0.667-0.955, p=0.001) for TE and SWE,respectively. There was a significant correlation between TE and SWEmeasurements (rho=0.455, p = 0.004).Conclusion: SWE and TE have both a good accuracy, with a significantcorrelation, for the diagnosis of advanced fibrosis in NASH-patients.