Multiple elastography techniques effective for diagnosing liver disease

By Kate Madden Yee, AuntMinnie.com staff writer

November 5, 2018 --

Monday, November 26 | 10:30 a.m.-10:40 a.m. | SSC06-01 | Room N229

Several different elastography techniques -- including shear-wave, MR, and transient elastography -- are all effective methods for diagnosing advanced fibrosis in patients with nonalcoholic fatty liver disease, according to researchers from the University of Pittsburgh.

In this Monday morning scientific session, Dr. Alessandro Furlan will present results from a study that included 62 patients, all of whom had biopsy-proven nonalcoholic fatty liver disease (NAFLD). The patients underwent ultrasound shear-wave elastography (SWE), MR elastography (MRE), and transient elastography (TE) within one year of the biopsy. Furlan's group evaluated the performance of each type of imaging exam using area under the receiver operating characteristic (ROC) curve analysis.

The area under the ROC curve was 0.80 for ultrasound shear-wave elastography, 0.85 for MR elastography, and 0.77 for transient elastography -- which suggests that physicians have a variety of tools at their disposal for diagnosing fibrosis in patients with NAFLD, the group wrote.

"2D SWE, MRE, and TE showed high accuracy for the diagnosis of advanced fibrosis in NAFLD with no significant difference at pairwise comparison," Furlan and colleagues concluded.

US ELASTOGRAPHY: REVIEW of TECHNIQUES and CLINICAL APPLICATIONS

Conclusion

Evaluation of diffuse liver disease is the best validated  application of USE and has been widely adopted for non-invasive detection and staging of liver fibrosis as well as monitoring liver treatment response. Focal breast lesion USE has also been well studied and has been incorporated as an associated feature in the 2nd edition of the BI-RADS US lexicon.

There is encouraging data that USE may also be used to assess malignancy of focal liver lesions, thyroid nodules, focal renal masses, and lymph nodes, grade renal fibrosis, and guide TRUS-directed prostate biopsies, but further research with unbiased large scale studies are still required. Also, technique standardization to allow comparison of values between studies and development of new solutions for current technical limitations and biologic/physiologic confounders need to be pursued. USE holds immense potential for various clinical applications, and continued development will lead to widespread clinical adoption in the upcoming years.