Assessment of liver fibrosis using two-dimensional shear wave elastography: a prospective study of intra-and inter-observer repeatability, and comparison with point shear wave elastography
Jeongin Yoo, Jeong Min Lee, Ijin Joo, Jeong Hee Yoon
Seoul National University Hospital, Seoul, Korea
Corresponding Author: Jeong Min Lee ,Tel: 1036783860, Fax: 027436385, Email:
Received: February 6, 2019;  Accepted: June 7, 2019.  Published online: June 7, 2019.
To prospectively investigate the intra- and inter-observer repeatability of a new two-dimensional (2D) shear wave elastography (SWE) technique (S-Shearwave) for assessment of liver fibrosis in patients with chronic liver disease, and to compare liver stiffness measurements (LSMs) using 2D-SWE with point SWE (pSWE).
This prospective study was approved by our institutional review board and informed consent was obtained from all patients. Fifty-three patients with chronic liver disease were randomly allocated to either group 1 (for intra-observer repeatability [n=33]) or group 2 (for inter-observer repeatability [n=20]). In group 1, two sessions of 2D-SWE and one session of pSWE were performed by one radiologist. In group 2, one session of 2D-SWE and one session of pSWE was performed by the aforementioned radiologist, and the second session of 2D-SWE by another radiologist, were performed. Intra- and inter-observer repeatability was assessed using intraclass correlation coefficient (ICC). LSMs using 2D-SWE were compared and correlated with those of pSWE using the paired t-test and Pearson’s correlation coefficient, respectively.
LSMs using 2D-SWE demonstrated excellent intra- and inter-observer repeatability (ICC, 0.997 [95% confidence interval, 0.994–0.999]) and 0.995 [0.988–0.998], respectively). LSMs using 2D-SWE were significantly different from those using pSWE (2.1±0.6 m/s versus 1.9±0.6 m/s; P<0.001), although significant correlation was found between LSMs using two techniques (rho=0.836; P<0.001).
S-Shearwave demonstrated excellent intra- and inter-observer repeatability, and strong correlation with pSWE for assessment of liver stiffness. However, because of a significant difference between LSMs assessed using 2D-SWE and pSWE, these methods should not be used interchangeably.
Keywords: Ultrasonography; Elasticity imaging techniques; Liver cirrhosis
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