@article{3120161,
    title = "Liver stiffness measurements by 2-dimensional shear wave elastography compared to histological and ultrasound parameters in primary biliary cholangitis",
    author = "Manesis, E.K. and Schina, M. and Vafiadis, I. and Gatos, I. and Theotokas, J. and Zoumpoulis, P. and Drazinos, P. and Ketikoglou, J. and Delladetsima, I.K. and Tiniakos, D.G.",
    journal = "Scandinavian Journal of Gastroenterology",
    year = "2021",
    volume = "56",
    number = "10",
    pages = "1187-1193",
    publisher = "Taylor and Francis Ltd.",
    issn = "0036-5521, 1502-7708",
    doi = "10.1080/00365521.2021.1928277",
    keywords = "alanine aminotransferase;  alkaline phosphatase;  aspartate aminotransferase, adult;  aged;  alanine aminotransferase blood level;  alkaline phosphatase blood level;  Article;  aspartate aminotransferase blood level;  B scan;  cohort analysis;  controlled study;  female;  Greece;  human;  human tissue;  inflammation;  liver biopsy;  liver cirrhosis;  liver fibrosis;  liver histology;  liver stiffness;  major clinical study;  male;  portal fibrosis;  primary biliary cirrhosis;  prognosis;  retrospective study;  right liver lobe;  shear wave elastography;  spleen size;  splenomegaly;  treatment response;  two-dimensional imaging;  biliary cirrhosis;  diagnostic imaging;  elastography, Elasticity Imaging Techniques;  Female;  Humans;  Liver Cirrhosis;  Liver Cirrhosis, Biliary;  Retrospective Studies",
    abstract = "Background and aims: Liver stiffness measurements (LSMs) by 2-dimensional-shear-wave elastography (LSM2D-SWE) are now widely used in hepatology. However, relevant information for primary biliary cholangitis (PBC) is scant. We compare LSM2D-SWE with liver biopsy (LB) in a cohort of PBC patients in Greece. Methods: Data of 68 LBs from 53 PBC patients were retrospectively analyzed and fibrosis stage was compared to LSM2D-SWE. Forty-six patients (86.8%) were females and at the time of LBx median (IQR) age was 62.6 (53.2–72.1). Demographic, UDCA treatment, histological and B-mode ultrasound data were tested for their influence on LSM2D-SWE estimates. Results: Liver fibrosis stages F0–F4 were found in 4, 19, 19, 16 and 10 cases, respectively. Across stages F0–F4, the LSM2D-SWE was 5.6 (5.1–6.1), 7.0 (5.8–7.7), 9.1 (7.3–11.5), 10.8 (9.9–12.2) and 14.5 (11.9–25.7) kPa, respectively, with highly significant difference (p<.001). The LSM2D-SWE differed also significantly between F0 vs. F1 (p=.027), F1 vs. F2 (p=.005) and F3 vs. F4 (p=.017). The discriminatory ability of LSM2D-SWE for mild, significant, severe fibrosis and cirrhosis was highly significant in all comparisons (p<.001), with AUC2D-SWE 95.3%, 87.4%, 85.3% and 95.3% and accuracy 89.7%, 85.3%, 80.9% and 86.8%, respectively. Among 21 parameters tested, significant predictors of LSM2D-SWE by multiple linear regression were fibrosis stage, portal inflammation and parenchymal heterogeneity. The portal inflammation grade accounted for 32.2% of LSM variation with adjusted R 2 0.428. Conclusions: In patients with PBC, LSM measurements by 2D-SWE can reliably discriminate between mild, significant, severe fibrosis and cirrhosis. Measurements are significantly affected by portal inflammation grade. © 2021 Informa UK Limited, trading as Taylor & Francis Group."
}