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Elastography point quantification accurately stages fibrosis

Elastography point quantification displayed good to excellent performance as a noninvasive measurement of liver fibrosis staging among patients with chronic liver disease, according to a recently published study.

“This technique provides similar diagnostic performance compared with (transient elastography [TE]) in identification of all stages of fibrosis but, with respect to TE, is implemented on conventional ultrasound systems and has the advantage of B-mode imaging TE,” Fabio Conti, MD, PhD, from the University of Bologna in Italy, and colleagues wrote.

The study comprised 361 patients with chronic liver disease who underwent liver biopsy and had fibrosis measured with both TE and elastography point quantification with the ElastPQ technology (Phillips). Both TE (r = 0.776) and ElastPQ (r = 0.718) showed a strong correlation with histological fibrosis stage.

ElastPQ significantly identified fibrosis stage 2 or higher with a cut-off of 6 kPa (AUROC = 0.856), stage 3 or higher with a cut-off of 6.2 kPa (AUROC = 0.951), and stage 4 with a cut-off of 9.5 kPa (AUROC = 0.965). The cut-offs were similar or lower than those used for TE.

Additionally, the researchers found that the optimal cut-off values of ElastPQ for fibrosis stage 2 or higher, stage 3 or higher and stage 4 were close based on analysis with sensitivity and specificity of at least 90%.

ElastPQ correctly classified 68.4% of patients and TE correctly classified 67.6%. However, both techniques showed a lower rate of correct classification in patients with fibrosis stage 2 compared with higher stages.

“During the last years, the number of ultrasound based elastography techniques has rapidly increased and shear wave elastography devices from several companies are now on the market,” the researchers wrote. “Our data showed that liver stiffness measured with ElastPQ was directly and linearly correlated with the stages of fibrosis, and the values increased with the extent of liver fibrosis.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.