Noninvasive liver fibrosis assessment in chronic viral hepatitis C: agreement among 1D transient elastography, 2D shear wave elastography, and magnetic resonance elastography

• Published in: Abdominal imaging 2019-12, Vol.44 (12), p.4011-4021
• Main Authors: Matos, João, Paparo, Francesco, Bacigalupo, Lorenzo, Cenderello, Giovanni, Mussetto, Ilaria, De Cesari, Matteo, Bernardi, Silvia Perugin, Cevasco, Luca, Forni, Gian Luca, Cassola, Giovanni, Rollandi, Gian Andrea
• Format: Article
• Language: English
• Subjects: Agreements; Body mass; Body mass index; Body size; Chronic infection; Correlation analysis; Discordance; Fibrosis; Gastroenterology; Hepatitis; Hepatitis C; Hepatobiliary; Hepatology; Imaging; Imaging techniques; Magnetic resonance; Medicine; Medicine & Public Health; Radiology; Regression analysis; Resonance; Stiffness; Viruses
• ISSN: 2366-004X; 2366-0058
• DOI: 10.1007/s00261-019-02295-7

Purpose To assess the agreement of one-dimensional transient elastography (1D-TE), two-dimensional shear wave elastography (2D-SWE), and magnetic resonance elastography (MRE) in a consecutive cohort of patients affected by hepatitis C virus (HCV) and to understand which patient-related factors are associated with disagreement. Methods Ninety-one consecutive patients with current or previous chronic HCV infection were enrolled between March 2017 and September 2018. We assessed the correlation between stiffness measurements expressed in kilopascals (kPa). After converting kPa values in three groups of increasing fibrosis burden using validated cut-off values, we assessed the agreement among the different techniques. Factors influencing inter-modality disagreement were examined by employing multivariate logistic regression analysis. Results Seventy-seven patients met the inclusion criteria and had reliable measurements by all stiffness imaging techniques. At the quantitative analysis, a strong correlation between stiffness measurements was found (Spearman’s rho values ranging from 0.7 to 0.89 in all pairs of techniques). Complete concordance among MRE, 1D-TE, and 2D-SWE was found in 64.9% of patients, and the agreement was highest between MRE and 1D-TE, with κ value of 0.801. In only 2/77 patients (2.6%), there was complete disagreement. High body mass index (BMI) was the only factor significantly associated with inter-modality discordance. Conclusions MRE, 1D-TE, and 2D-SWE assigned the majority of patients to the same fibrosis group. The agreement was at least good, and there was a strong correlation between kPa values in all three pairs of techniques. Highest agreement was found between MRE and 1D-TE. High BMI was associated with discordance among the techniques.