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Reproducibility of liver stiffness measured with two different two-dimensional shear wave elastography systems using the comb-push technique
Hwaseong Ryu2, Jeong Min Lee1, Su Joa Ahn1, Jeong Hee Yoon1
1Seoul National University, Korea, Seoul, Korea
2Pusan National University Yangsan Hospital, Yangsan, Korea
Corresponding Author: Jeong Min Lee ,Tel: 82220723154, Fax: 8227436385, Email: jmsh@snu.ac.kr
Received: August 12, 2018;  Accepted: November 23, 2018.  Published online: November 23, 2018.
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To retrospectively compare the technical success and reliable measurements of two two-dimensional (2D) shear wave elastography (SWE) systems using comb-push technique from the same manufacturer and to assess the inter-system reproducibility of the resultant liver stiffness measurements.
Ninety-four patients with suspected chronic liver diseases were included in this retrospective study. Liver stiffness (LS) measurements were obtained using two 2D-SWE systems (LOGIQ E9, and LOGIQ S8) from the same manufacturer, and transient elastography (TE) serving as the reference standard, on the same day. Technical success rates and reliable measurements of the two 2D-SWE systems were compared. LS values measured using the two 2D-SWE systems and TE were correlated using Spearman correlation coefficients and 95% Bland-Altman limits of agreement. Thereafter, Bland-Altman limits of agreement and intraclass correlation coefficients (ICC) were used to analyze the inter-system reproducibility of LS measurements.
The two 2D-SWE systems showed similar technical success rates (98.9%, respectively) and reliability of LS measurements (92.3% LOGIQ E9, 91.2% LOGIQ S8, p =0.185). Despite excellent correlation (ICC=0.92), the mean LS measurements obtained by the two 2D-SWE systems were significantly different (p =0.018): LOGIQ E9 (6.57 ± 2.33 kPa), and LOGIQ S8 (6.90 ± 6.64 kPa).
Significant inter-system variability was observed in LS measurements of the two 2D-SWE systems. Therefore, even the 2D-SWE systems from the same manufacturer should not be used interchangeably in longitudinal follow-up.
Keywords: Liver fibrosis; Liver stiffness; Ultrasound elastography; Shear wave elastography
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