Shear wave elastography and shear wave dispersion imaging in primary biliary cholangitis-a pilot study

Marten Schulz; Anne-Christin B Wilde; Münevver Demir; Tobias Müller; Frank Tacke; Alexander Wree

doi:10.21037/qims-21-657

Shear wave elastography and shear wave dispersion imaging in primary biliary cholangitis-a pilot study

Quant Imaging Med Surg. 2022 Feb;12(2):1235-1242. doi: 10.21037/qims-21-657.

Authors

Marten Schulz^#¹, Anne-Christin B Wilde^#¹, Münevver Demir¹, Tobias Müller¹, Frank Tacke¹, Alexander Wree¹

Affiliation

¹ Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), Berlin, Germany.

^# Contributed equally.

Abstract

Background: Primary biliary cholangitis (PBC) is a chronic liver disease that can lead to liver fibrosis and cirrhosis. Two-dimensional shear wave elastography (2D-SWE) is a modern technique for fibrosis assessment. However, data regarding its performance in PBC is sparse. We aimed to characterize severity of liver disease in PBC patients using non-invasive 2D-SWE and the new methods of attenuation imaging (ATI) and shear wave dispersion imaging (SWD).

Methods: Twenty two PBC patients were examined with 2D-SWE, SWD and ATI, alongside established non-invasive fibrosis and steatosis assessment methods as well as liver function tests.

Results: Median 2D-SWE values were 1.48 m/s (range, 1.14-2.13 m/s) and 6.7 kPa (range, 3.8-14.7 kPa), respectively. Median SWD, ATI, transient elastography (TE) and controlled attenuation parameter (CAP) values were 13.9 m/s/kHz (range, 11.6-21 m/s/kHz), 0.57 dB/cm/MHz (range, 0.5-0.68 dB/cm/MHz), 7 kPa (range, 3.7-14.6 kPa), and 208 dB/m (range, 107-276 dB/m), respectively. 2D-SWE displayed a significant correlation with spleen length, platelet count, non-invasive fibrosis scores (FIB-4, APRI) and with TE. SWD correlated with alkaline phosphatase (ALP) levels, which is a prognostic marker in PBC.

Conclusions: Our findings add further evidence that 2D-SWE is a reliable method for fibrosis assessment in PBC. Even though the cohort size was small, the correlation of SWD with the prognostic marker ALP suggests a potentially valuable role of this new non-invasive method in evaluating liver disease activity in PBC.

Keywords: Primary biliary cholangitis (PBC); attenuation imaging (ATI); liver stiffness measurement (LSM); shear wave dispersion imaging (SWD); transient elastography (TE); two-dimensional shear wave elastography (2D-SWE).