Skip to main content

Advertisement

SpringerLink
Log in

Shear wave elastography and transient elastography in HCV patients after direct-acting antivirals

  • Ultrasonography
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

To compare the ultrasound (US) and pulse shear wave elastography (pSWE, Elast PQ®) methods with transient elastography (TE), clinical scores and laboratory tests, during the follow-up of HCV patients receiving direct-acting antiviral drugs (DAA).

Methods

Our prospective study from June 2016 to December 2017 included 22 consecutively enrolled HCV-positive patients (59.7 ± 12.3 years, 11 male) which were subjected to antiviral therapy. All patients underwent B-mode ultrasound, color-Doppler, pSWE and TE five times: before therapy (T0), at the end of therapy (post-Tx), and at 12, 24, 48 weeks post-therapy. The liver stiffness (LS) values obtained with pSWE and TE and the data coming from US assessment and clinical evaluation were compared.

Results

We obtained a statistically significant reduction of LS values (kPa) measured by pSWE, between T0 (14.3 ± 9.3), post-Tx (11.8 ± 10.5), 12 weeks (7.5 ± 3.3), 24 weeks (8 ± 3.8) and 48 weeks (8.5 ± 4.6) (p = 0.02). The reduction of kPa measured by TE was not significant between T0 (14.7 ± 9.3), post-Tx (12 ± 9.5), 12 weeks (11.6 ± 7.7), 24 weeks (10.3 ± 6) and 48 weeks (10.8 ± 7.5) (p > 0.05). Multivariate baseline analysis showed significant independent association among measurement of TE stiffness with cirrhosis, type of vein hepatic flow and showed significant independent association between delta-pSWE measurement (difference between stiffness measurements at the baseline and 12 months after treatment) with staging of fibrosis (p = 0.006) and sustained virologic response after 12 weeks of treatment (SVR12, p = 0.017).

Conclusion

The pSWE method has shown better ability than TE to identify a reduction in LS. Therefore, pSWE allow to evaluate stiffness reduction in HCV patient during DAA treatment follow-up, which is related to SVR12.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. European Association For The Study Of The Liver; European Organisation For Research And Treatment Of Cancer (2012) EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 56:908–943. https://doi.org/10.1016/j.jhep.2011.12.001

    Article  Google Scholar 

  2. Lurie Y, Webb M, Cytter-Kuint R, Shteingart S, Lederkremer GZ (2015) Non-invasive diagnosis of liver fibrosis and cirrhosis. World J Gastroenterol 21:11567–11583. https://doi.org/10.3748/wjg.v21.i41.11567

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Ricci P, Marigliano C, Cantisani V, Porfiri A, Marcantonio A, Lodise P et al (2013) Ultrasound evaluation of liver fibrosis: preliminary experience with acoustic structure quantification (ASQ) software. Radiol Med 118(6):995–1010. https://doi.org/10.1007/s11547-013-0940-0

    Article  PubMed  Google Scholar 

  4. Lupsor Platon M, Stefanescu H, Feier D, Maniu A, Badea R (2013) Performance of unidimensional transient elastography in staging chronic hepatitis C. Results from a cohort of 1,202 biopsied patients from one single center. J Gastrointestin Liver Dis 22:157–166

    PubMed  Google Scholar 

  5. Chekuri S, Nickerson J, Bichoupan K et al (2016) Liver stiffness decreases rapidly in response to successful hepatitis C treatment and then plateaus. PLoS ONE 11:e0159413. https://doi.org/10.1371/journal.pone.0159413

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Calvaruso V, Cacciola I, Licata A et al (2019) Is transient elastography needed for noninvasive assessment of high-risk varices? The real experience. Am J Gastroenterol 114:1275–1282. https://doi.org/10.14309/ajg.0000000000000266

    Article  PubMed  Google Scholar 

  7. Guibal A, Renosi G, Rode A et al (2016) Shear wave elastography: An accurate technique to stage liver fibrosis in chronic liver diseases. Diagn Interv Imag 97:91–99. https://doi.org/10.1016/j.diii.2015.11.001

    Article  CAS  Google Scholar 

  8. Erman A, Sathya A, Nam A et al (2018) Estimating chronic hepatitis C prognosis using transient elastography-based liver stiffness: A systematic review and meta-analysis. J Viral Hepat 25:502–513. https://doi.org/10.1111/jvh.12846

    Article  CAS  PubMed  Google Scholar 

  9. Castéra L, Foucher J, Bernard PH et al (2010) Pitfalls of liver stiffness measurement: a 5-year prospective study of 13,369 examinations. Hepatology 51:828–835. https://doi.org/10.1002/hep.23425

    Article  PubMed  Google Scholar 

  10. Regev A, Berho M, Jeffers LJ et al (2002) Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol 97:2614–2618. https://doi.org/10.1111/j.1572-0241.2002.06038.x

    Article  PubMed  Google Scholar 

  11. Felicani C, De Molo C, Stefanescu H et al (2018) Point quantification elastography in the evaluation of liver elasticity in healthy volunteers: a reliability study based on operator expertise. J Ultrasound 21:89–98. https://doi.org/10.1007/s40477-018-0300-y

    Article  PubMed  PubMed Central  Google Scholar 

  12. Fraquelli M, Baccarin A, Casazza G et al (2016) Liver stiffness measurement reliability and main determinants of point shear-wave elastography in patients with chronic liver disease. Aliment Pharmacol Ther 44:356–365. https://doi.org/10.1111/apt.13711

    Article  CAS  PubMed  Google Scholar 

  13. Ferraioli G, Parekh P, Levitov AB, Filice C (2014) Shear wave elastography for evaluation of liver fibrosis. J Ultrasound Med 33:197–203. https://doi.org/10.7863/ultra.33.2.197

    Article  PubMed  Google Scholar 

  14. Dietrich CF, Bamber J, Berzigotti A et al (2017) EFSUMB Guidelines and recommendations on the clinical use of liver ultrasound elastography, update 2017 (long version). Ultraschall Med. 38:e16–e47. https://doi.org/10.1055/s-0043-103952

    Article  PubMed  Google Scholar 

  15. Maruyama H, Yokosuka O (2017) Ultrasonography for noninvasive assessment of portal hypertension. Gut Liver 11:464–473. https://doi.org/10.5009/gnl16078

    Article  PubMed  PubMed Central  Google Scholar 

  16. Gerstenmaier JF, Gibson RN (2014) Ultrasound in chronic liver disease. Insights Imag 5:441–455. https://doi.org/10.1007/s13244-014-0336-2

    Article  CAS  Google Scholar 

  17. Castera L, Forns X, Alberti A (2008) Non-invasive evaluation of liver fibrosis using transient elastography. J Hepatol 48:835–847. https://doi.org/10.1016/j.jhep.2008.02.008

    Article  PubMed  Google Scholar 

  18. Castéra L, Vergniol J, Foucher J et al (2005) Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 128:343–350. https://doi.org/10.1053/j.gastro.2004.11.018

    Article  PubMed  Google Scholar 

  19. Tsochatzis EA, Gurusamy KS, Ntaoula S, Cholongitas E, Davidson BR, Burroughs AK (2011) Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a meta-analysis of diagnostic accuracy. J Hepatol 54:650–659. https://doi.org/10.1016/j.jhep.2010.07.033

    Article  CAS  PubMed  Google Scholar 

  20. Kamath PS, Wiesner RH, Malinchoc M et al (2001) A model to predict survival in patients with end-stage liver disease. Hepatology 33:464–470. https://doi.org/10.1053/jhep.2001.22172

    Article  CAS  PubMed  Google Scholar 

  21. Lin ZH, Xin YN, Dong QJ et al (2011) Performance of the aspartate aminotransferase-to-platelet ratio index for the staging of hepatitis C-related fibrosis: an updated meta-analysis. Hepatology 53:726–736. https://doi.org/10.1002/hep.24105

    Article  PubMed  Google Scholar 

  22. Ren X, Xia S, Ni Z, Zhan W, Zhou J (2018) Analysis of three ultrasound elastography techniques for grading liver fibrosis in patients with chronic hepatitis B. Radiol Med 123:735–741. https://doi.org/10.1007/s11547-018-0905-4

    Article  PubMed  Google Scholar 

  23. Knop V, Hoppe D, Welzel T et al (2016) Regression of fibrosis and portal hypertension in HCV-associated cirrhosis and sustained virologic response after interferon-free antiviral therapy. J Viral Hepat 23:994–1002. https://doi.org/10.1111/jvh.12578

    Article  CAS  PubMed  Google Scholar 

  24. Tada T, Kumada T, Toyoda H et al (2017) Improvement of liver stiffness in patients with hepatitis C virus infection who received direct-acting antiviral therapy and achieved sustained virological response. J Gastroenterol Hepatol 32:1982–1988. https://doi.org/10.1111/jgh.13788

    Article  CAS  PubMed  Google Scholar 

  25. Kohla MAS, Fayoumi AE, Akl M et al (2020) Early fibrosis regression by shear wave elastography after successful direct-acting anti-HCV therapy. Clin Exp Med 20:143–148. https://doi.org/10.1007/s10238-019-00597-0

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departement of Radiological Sciences, A.O.U Ospedali Riuniti di Ancona, Via Conca 71, 60126, Torrette-Ancona, Italy

    Giulio Argalia, Claudio Ventura, Daniele Campioni, Corrado Tagliati, Gian Marco Giuseppetti & Andrea Giovagnoni

  2. Clinic of Gastroenterology and Hepatology, Università Politecnica Delle Marche, Ospedali Riuniti - University Hospital, Via Tronto 10, 60126, Ancona, Italy

    Giuseppe Tarantino, Paola Guardati, Alba Kostandini & Marco Marzioni

Authors
  1. Giulio Argalia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giuseppe Tarantino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Claudio Ventura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniele Campioni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Corrado Tagliati
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paola Guardati
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alba Kostandini
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marco Marzioni
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Gian Marco Giuseppetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Andrea Giovagnoni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Giulio Argalia.

Ethics declarations

Conflict of interest

The authors declared no potential conflicts of interests associated with this study.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Argalia, G., Tarantino, G., Ventura, C. et al. Shear wave elastography and transient elastography in HCV patients after direct-acting antivirals. Radiol med 126, 894–899 (2021). https://doi.org/10.1007/s11547-020-01326-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-020-01326-4

Keywords

Search

Navigation