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Measurement of Liver Stiffness with 2D-Shear Wave Elastography (2D-SWE) in Bariatric Surgery Candidates Reveals Acceptable Diagnostic Yield Compared to Liver Biopsy

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Abstract

Background

Nonalcoholic fatty liver disease (NAFLD) is common among severely obese patients. Two-dimensional shear wave elastography (2D-SWE) has been validated as a noninvasive diagnostic tool for liver stiffness measurement. However, the technical feasibility and accuracy of this method in severely obese patients are still under debate.

Objective

We aimed to assess the diagnostic accuracy of 2D-SWE in bariatric surgery candidates in comparison with the gold standard liver biopsy.

Methods

Ninety severely obese candidates for bariatric surgery were included. Liver stiffness was measured using 2D-SWE 14 days before liver biopsy. Liver biopsy was taken on the day of surgery. The area under the receiver operating curve (AUROC) was calculated for the staging of liver fibrosis.

Results

2D-SWE was performed in 97.3% of patients successfully. Histologic stages of fibrosis (F0-F4) were detected in 34.2%, 36%, 6.3%, 3.6%, and 0.9% of patients, respectively. The AUROC for 2D-SWE was 0.77 for F1, 0.72 for F2, 0.77 for F3, and 0.70 for F4. In univariate analysis, 2D-SWE values were correlated with BMI, waist circumference, NAFLD activity score (NAS), and steatosis, whereas these components did not affect liver stiffness in multivariate analysis.

Conclusion

Two-dimensional shear wave elastography of the liver can be feasible and has good accuracy in severely obese candidates for bariatric surgery. Therefore, 2D-SWE may be a good option for assessing liver fibrosis, especially in the early stages of fibrosis to lessen complications of surgery in this population. However, this method should be applied on a larger scale for late stage of fibrosis.

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Acknowledgments

The results described in this paper formed part of a thesis submitted by the first author for a Ph.D. degree in Nutritional Sciences. The study was supported by the Vice Chancellor for Research at Mashhad University of Medical Sciences.

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Authors and Affiliations

  1. Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran

    Tannaz Jamialahmadi & Zeinab Javid

  2. Biochemistry and Nutrition Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran

    Mohsen Nematy & Reza Rezvani

  3. Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran

    Ali Jangjoo

  4. Department of Gastroenterology and Hepatology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Ladan Goshayeshi

  5. Gastroenterology and Hepatology Research Center, Mashhad University of Medical Sciences, Mashhad, 9177948564, Iran

    Ladan Goshayeshi & Mahtab Zangui

  6. Pathology Department, Education and Research Department, Razavi Hospital, Mashhad, 9177948564, Iran

    Kamran Ghaffarzadegan

  7. Department of Statistics, Faculty of Mathematical Sciences, Ferdowsi University of Mashhad, Mashhad, 9177948944, Iran

    Mehdi Jabbari Nooghabi

  8. Hazrat Zahra Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

    Payman Shalchian

  9. Research Center of Health and Environment, Guilan University of Medical Sciences, Rasht, 1313973476, Iran

    Saeid Doaei

  10. Department of Radiology, Faculty of Medicine, Islamic Azad University-Mashhad Branch, Mashhad, 9137714639, Iran

    Farnood Rajabzadeh

Authors
  1. Tannaz Jamialahmadi
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  2. Mohsen Nematy
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  6. Kamran Ghaffarzadegan
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  12. Farnood Rajabzadeh
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Contributions

Conception and design Nematy M, Jamialahmadi T, Goshayeshi L, Jangjoo A

Analysis and interpretation Jamialahmadi T, Jabbari Nooghabi M, Doaie S

Data collection Jamialahmadi T, Jangjoo A, Nematy M, Rajabzadeh F, Ghaffarzadegan K, Javid Z

Writing the article Jamialahmadi T, Goshayeshi L, Zangui M, Doaie S, Shalchian P, Javid Z

Critical revision Jamialahmadi T, Jangjoo A, Nematy M, Goshayeshi L, Rezvani R, Shalchian P, Zangui M

Final approval Jamialahmadi T, Nematy M, Goshayeshi L, Jangjoo A, Jabbari Nooghabi M, Rezvani R,

Statistical analysis Jabbari Nooghabi M, Jamialahmadi T

Obtained funding Nematy M

Overall responsibility Rajabzadeh F

Corresponding author

Correspondence to Farnood Rajabzadeh.

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Source of Support

This study was supported by the Vice Chancellor for Research of Mashhad University of Medical Sciences (grant number 951586).

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The authors declare that they have no conflicts of interest.

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Jamialahmadi, T., Nematy, M., Jangjoo, A. et al. Measurement of Liver Stiffness with 2D-Shear Wave Elastography (2D-SWE) in Bariatric Surgery Candidates Reveals Acceptable Diagnostic Yield Compared to Liver Biopsy. OBES SURG 29, 2585–2592 (2019). https://doi.org/10.1007/s11695-019-03889-2

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