Point Quantification Elastography as a non-invasive technique for quantification of liver fibrosis in patients with viral chronic hepatitis: preliminary results

Purpose: To measure liver stiffness (LS) with point quantification elastography (PQE) in patients (pts) with viral chronic hepatitis (VCH) and to find a correlation with the staging of disease according to liver biopsy (LB).

Material and methods: Between September 2012 and February 2013, 52 pts (27 males, 25 females, mean age 49 ± 14[standard deviation], range12 – 79) with VCH were prospectively evaluated with ultrasound (US) scanning completed by PQE. All pts underwent US-guided percutaneous LB for evaluation of fibrosis (F). Examinations were performed with a iU22 scanner (Philips, Bothell, WA, USA) using a convex probe (C5 – 1). PQE is a new shear wave-based elastography technique. LS is expressed in Young's modulus (kilopascals, kPa). With the patient in dorsal decubitus, quiet breathing stopped, the probe was placed in the intercostal spaces with the best visualization of parenchyma, the same used for needle access. 10 measurements were recorded in 2 different spaces (exploring 5th, 6th or 7th segment); average LS (ALS) was calculated. Staging of LB was classified following Metavir score. Correlation ALS-F was analyzed by using Spearman correlation coefficient (SCC).

Results: 36 pts were HCV positive, 7 HCV-HIV, 7 HBV and 2 HBV-HDV. 2 pts had F0, 35 pts F1, 8 pts F2, 3 pts F3, 4 pts F4. SCC showed a significant correlation between ALS and F (rho = 0.500, p < 0.001). For 23 pts, transient elastography (TE) data were also available, correlation ALS-TE was also significant (rho = 0.755, p < 0.001).

Conclusion: PQE can be a useful tool for a non-invasive evaluation of F in pts with VCH, anyway more cases are needed to confirm these data.