Point shear‐wave elastography using acoustic radiation force impulse imaging for the prediction of liver‐related events in patients with chronic viral hepatitis

  • Chronic viral hepatitis is associated with substantial morbidity and mortality worldwide. The aim of our study was to assess the ability of point shear‐wave elastography (pSWE) using acoustic radiation force impulse imaging for the prediction of the following liver‐related events (LREs): new diagnosis of HCC, liver transplantation, or liver‐related death (hepatic decompensation was not included as an LRE). pSWE was performed at study inclusion and compared with liver histology, transient elastography (TE), and serologic biomarkers (aspartate aminotransferase to platelet ratio index, Fibrosis‐4, FibroTest). The performance of pSWE and TE to predict LREs was assessed by calculating the area under the receiver operating characteristic curve and a Cox proportional‐hazards regression model. A total of 254 patients with a median follow‐up of 78 months were included in the study. LRE occurred in 28 patients (11%) during follow‐up. In both patients with hepatitis B virus and hepatitis C virus (HCV), pSWE showed significant correlations with noninvasive tests and TE, and median pSWE and TE values were significantly different between patients with LREs and patients without LREs (both P < 0.0001). In patients with HCV, the area under the receiver operating characteristic curve for pSWE and TE to predict LREs were comparable: 0.859 (95% confidence interval [CI], 0.747‐0.969) and 0.852 (95% CI, 0.737‐0.967) (P = 0.93). In Cox regression analysis, pSWE independently predicted LREs in all patients with HCV (hazard ratio, 17.9; 95% CI, 5.21‐61‐17; P < 0.0001) and those who later received direct‐acting antiviral therapy (hazard ratio, 17.11; 95% CI, 3.88‐75.55; P = 0.0002). Conclusion: Our study shows good comparability between pSWE and TE. pSWE is a promising tool for the prediction of LREs in patients with viral hepatitis, particularly those with chronic HCV. Further studies are needed to confirm our data and assess their prognostic value in other liver diseases.

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Author:Lisa Hernandez Sampere, Johannes VermehrenGND, Victoria Therese MückeORCiDGND, Christiana GrafORCiDGND, Kai-Henrik PeifferORCiDGND, Georg DultzORCiDGND, Stefan ZeuzemORCiDGND, Oliver WaidmannORCiDGND, Natalie FilmannORCiDGND, Jörg BojungaGND, Christoph SarrazinGND, Mireen Friedrich-RustORCiDGND, Marcus Maximilian MückeORCiDGND
URN:urn:nbn:de:hebis:30:3-569488
DOI:https://doi.org/10.1002/hep4.1623
ISSN:2471-254X
Parent Title (English):Hepatology communications
Publisher:Wiley
Place of publication:Hoboken, NJ
Document Type:Article
Language:English
Date of Publication (online):2020/11/12
Date of first Publication:2020/11/12
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/12/10
Volume:2020
Page Number:10
HeBIS-PPN:477679986
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0