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Assessment of liver fibrosis in chronic hepatitis B using acoustic structure quantification: quantitative morphological ultrasound

  • Ultrasound
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Abstract

Objectives

To prospectively investigate the usefulness of acoustic structure quantification (ASQ) for noninvasive assessment of liver fibrosis in patients with chronic hepatitis B (CHB).

Methods

Consecutive patients with CHB scheduled for liver biopsy or partial liver resection underwent standardized ASQ examinations. The ASQ parameter, named focal disturbance (FD) ratio, were compared with METAVIR scores. The analysis was based on receiver operating characteristic (ROC) curves and multiple regression analysis.

Results

A total of 114 patients were enrolled in the final analysis. The area under the ROC curve for the FD ratio was 0.84 for significant fibrosis (≥ F2), 0.86 for severe fibrosis (≥ F3), and 0.83 for cirrhosis (= F4). The optimal cutoff values for the FD ratio were 0.25, 0.30 and 0.50 for fibrosis stages ≥ F2, ≥ F3 and = F4, respectively. The prevalence of a difference of at least two stages between the FD ratio and the histological stage was 12.3 % (14 of 114). The fibrosis stage (P < 0.001), degree of steatosis (P < 0.001) were independent factors associated with the FD ratio.

Conclusions

FD ratio should be an effective noninvasive imaging biomarker for the assessment of liver fibrosis in patients with CHB.

Key Points

• Focal disturbance (FD) ratio increased with the increasing histological fibrosis stages.

• FD ratio showed promising diagnostic accuracy in assessing liver fibrosis.

• Degree of fibrosis and steatosis were independent factors associated with FD ratio.

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Abbreviations

CHB:

Chronic hepatitis B

LB:

Liver biopsy

US:

Ultrasound

TE:

Transient elastography

ASQ:

Acoustic structure quantification

FD:

Focal disturbance

HBV:

Hepatitis B virus

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

GGT:

γ glutamyl-transpeptidase

ALP:

Alkaline phosphatase

PT:

Prothrombin time

PLT:

Platelet

BMI:

Body mass index

ROI:

Region of interest

H&E:

Haematoxylin-eosin

SD:

Standard deviation

IQR:

Inter-quartile range

ROC:

Receiver operator characteristic

AUROC:

Area under the ROC

CI:

Confidence interval

PPV:

Positive predictive value

NPV:

Negative predictive value

LR+ :

Positive likelihood ratio

LR− :

Negative likelihood ratio

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Acknowledgments

The scientific guarantor of this publication is Wei Wang. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by the National Nature Science Foundation of China (No: 81271576, No: 81301238 and No: 81471672), and Guangdong Province Medical Research Foundation (No: A2013194), and Guangdong Province S&T Plan Foundation (No: 2013B060500044). No complex statistical methods were necessary for this paper. Institutional review board approval was obtained.

Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic or prognostic study, performed at one institution.

Author information

Authors and Affiliations

  1. Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, NO. 58 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People’s Republic of China

    Yang Huang, Zhu Wang, Jin-Yu Liang, Lu-Yao Zhou, Wei Li, Jin-Ya Liu, Xiao-Yan Xie, Ming-De Lu, Guang-Jian Liu & Wei Wang

  2. Department of Pathology, The First Affiliated Hospital of Sun Yat-Sen University, NO. 58 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People’s Republic of China

    Bing Liao & Fen Wang

  3. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-Sen University, NO. 58 Zhongshan Road 2, Guangzhou, Guangdong, 510080, People’s Republic of China

    Ming-De Lu

Authors
  1. Yang Huang
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  2. Zhu Wang
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  7. Wei Li
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  11. Guang-Jian Liu
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Corresponding authors

Correspondence to Guang-Jian Liu or Wei Wang.

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Huang, Y., Wang, Z., Liao, B. et al. Assessment of liver fibrosis in chronic hepatitis B using acoustic structure quantification: quantitative morphological ultrasound. Eur Radiol 26, 2344–2351 (2016). https://doi.org/10.1007/s00330-015-4056-x

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  • DOI: https://doi.org/10.1007/s00330-015-4056-x

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