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Comparative analysis of vibration-controlled transient elastography and EUS-shear wave elastography for liver stiffness measurement in cirrhosis

Abstract:

Abstract – Background and Objectives – Chronic liver inflammation leads to fibrosis and cirrhosis. To avoid portal hypertension-related complications, fibrosis' early detection is imperative. Biopsy remains the gold standard, but magnetic resonance elastography (MRE) and EUS-guided elastography are noninvasive procedures currently used for liver stiffness measurement (LSM). Two-dimensional EUS-guided shear-wave elastography (EUS-SWE) represents a more-every-day used technique. The aim of this study is to correlate LSM determined by vibration-controlled transient elastography (VCTE) and EUS-SWE and determine the measurements' accuracy in diagnosing cirrhosis. Methods – A single-center, nested case-control study was performed between March 2020 and November 2021. Patients were classified into 2 study groups: the cirrhosis group and the control group. Patients from both groups underwent VCTE and EUS-SWE for LSM. A P value < 0.05 was considered statistically significant. Results – Of the 59 participants included (mean age 63.5 years; 71.1% female), 29 had cirrhosis (49.15%) and 30 were controls (50.84%). In cirrhosis patients, liver fibrosis (F) was staged as F3–4 by VCTE in 82.8%, with a median LSM of 17.8 kPa; through EUS-SWE, 27 kPa in the right hepatic lobe (RHL) and 25 kPa in the left hepatic lobe (LHL). Controls fibrosis was staged as F0–2 by VCTE in 30/30 (100%), with a median LSM of 4.6 kPa (P < 0.001); through EUS-SWE, 5.6 kPa in the RHL (P < 0.001) and 6.5 kPa in the LHL (P < 0.001). The observed agreement was 91.5% for VCTE, 93.2% for RHL-EUS-SWE, and 96.6% for LHL-EUS-SWE. The AUROCs for EUS-SWE and VCTE were over 0.95. Conclusions – VCTE and EUS-SWE are comparable techniques for diagnosing cirrhosis; however, EUS-SWE had a higher agreement than VCTE, especially in LHL assessment.