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Journal of Ultrasound

, Volume 20, Issue 3, pp 213–225 | Cite as

Point shear wave ultrasound elastography with Esaote compared to real-time 2D shear wave elastography with supersonic imagine for the quantification of liver stiffness

  • L. Mulazzani
  • V. Salvatore
  • F. Ravaioli
  • G. Allegretti
  • F. Matassoni
  • R. Granata
  • A. Ferrarini
  • H. Stefanescu
  • Fabio Piscaglia
Original Article

Abstract

Purpose

Different shear wave elastography (SWE) machines able to quantify liver stiffness (LS) have been recently introduced by various companies. The aim of this study was to investigate the agreement between point SWE with Esaote MyLab Twice (pSWE.ESA) and 2D SWE with Aixplorer SuperSonic (2D SWE.SSI). Moreover, we assessed the correlation of these machines with Fibroscan in a subgroup of patients.

Methods

A total of 81 liver disease patients and 27 subjects without liver disease accessing the ultrasound lab were considered. Exclusion criteria were liver nodules, BMI >35, and severe comorbidities. LS was sampled from the same intercostal space with both pSWE.ESA and 2D SWE.SSI and values were tested with Lin’s analysis and Bland–Altman analysis (B&A). Agreement between each SWE machine and Fibroscan was assessed in 26 liver disease patients with Spearman correlation.

Results

Precision and accuracy between pSWE.ESA and 2D SWE.SSI were, respectively, 0.839 and 0.999. B&A showed a mean of only −0.2 kPa, with no systematic deviation between the techniques and limits of agreement at −11.6 and 11.3 kPa. Spearman’s rho correlation versus Fibroscan was 0.849 for pSWE.ESA and 0.878 for 2D SWE.SSI. The relationship became less strict in the higher range of LS (≥15.2 kPa), corresponding to cirrhosis.

Conclusion

The overall degree of concordance of pSWE.ESA and 2D SWE.SSI in measuring LS resulted remarkable, also when compared with Fibroscan. The less strict correlation for patients with LS in the higher range would not affect the staging of disease as such patients are anyhow classified as cirrhotic.

Keywords

Shear wave elastography Ultrasound Fibroscan Liver stiffness Liver fibrosis Portal hypertension 

Astratto

Obiettivo

Differenti metodiche di shear wave elastography (SWE) in grado di misurare la rigidità epatica (RE) sono state recentemente implementate su vari ecografi. Questo studio vuole valutare la concordanza fra Esaote MyLab Twice point SWE (pSWE.ESA) e Aixplorer SuperSonic 2DSWE (2DSWE.SSI). Inoltre si è potuto anche valutare la correlazione fra queste macchine e il Fibroscan in un sottogruppo di pazienti.

Metodi

Sono stati arruolati 81 pazienti con epatopatia cronica e 27 soggetti con fegato sano afferenti al laboratorio di ecografia. Sono stati esclusi pazienti con lesioni focali epatiche, BMI >35 kg/m2, severe comorbidità. La RE è stata misurata dallo stesso spazio intercostale sia con pSWE.ESA che 2D SWE.SSI e i valori sono stati confrontati con analisi di Lin ed analisi di Bland–Altman (B&A). La concordanza fra ciascuna metodica SWE e il Fibroscan è stata valutata in 26 pazienti epatopatici tramite correlazione di Spearman.

Risultati

Precisione ed accuratezza sono risultate rispettivamente 0.839 e 0.999. L’analisi di B&A ha mostrato uno scarto medio di soli −0.2 kPa e limiti di concordanza a −11.6 e 11.3 kPa, senza rilevare alcuna deviazione sistematica fra le due macchine. Il coefficiente di correlazione con il Fibroscan è risultato 0.849 per pSWE.ESA e 0.878 per 2D SWE.SSI. Si è osservata una lieve deflessione del coefficiente di concordanza tra le due metodiche per alti valori di RE (all’interno della classe corrispondente alla cirrosi).

Conclusione

La concordanza fra pSWE.ESA e 2DSWE.SSI è risultata globalmente elevata, anche nel confronto con il Fibroscan. La stadiazione dell’epatopatia non viene compromessa dal calo di correlazione ai valori più alti di RE, in quanto tali pazienti verrebbero comunque classificati come cirrotici.

Notes

Compliance with ethical standards

Conflict of interest

Lorenzo Mulazzani, Veronica Salvatore, Giulia Allegretti, Francesca Matassoni, Rocco Granata, Alessia Ferrarini and Horia Stefanescu declare no conflict of interest. Fabio Piscaglia: Bayer (advisory board and speaker bureau), Bracco (speaker honoraria), Eisai (advisory board), Esaote (Research Contract), Meda Pharma (speaker bureau).

Ethical standards

All procedures performed in this study were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

All the individual participants included were informed about the protocol and then they gave their consent to take part in the study.

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Copyright information

© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2017

Authors and Affiliations

  • L. Mulazzani
    • 1
    • 3
  • V. Salvatore
    • 1
    • 3
  • F. Ravaioli
    • 1
    • 3
  • G. Allegretti
    • 1
    • 3
  • F. Matassoni
    • 1
    • 3
  • R. Granata
    • 1
    • 3
  • A. Ferrarini
    • 1
    • 3
  • H. Stefanescu
    • 1
    • 2
    • 3
  • Fabio Piscaglia
    • 1
    • 3
  1. 1.Department of Medical and Surgical SciencesUniversity of BolognaBolognaItaly
  2. 2.Hepatology UnitRegional Institute of Gastroenterology and Hepatology-IRGHCluj-NapocaRomania
  3. 3.Unit of Internal MedicineHospital S.Orsola-MalpighiBolognaItaly

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