Comparison of Visual Transient Elastography, Vibration Controlled Transient Elastography, Shear Wave Elastography and Sound Touch Elastography in Chronic liver Disease assessment using liver biopsy as 'Gold Standard'

Abstract

Purpose: Chronic liver disease (CLD) is considered one of the main causes of death. Ultrasound Elastography (USE) is a CLD assessment imaging method. This study aims to evaluate a recently introduced commercial alternative of USE, Visual Transient Elastography (ViTE), and to compare it with three established USE methods, Vibration Controlled Transient Elastography (VCTE), Shear Wave Elastography (SWE) and Sound Touch Elastography (STE), using Liver Biopsy (LB) as 'Gold Standard'.

Method: 152 consecutive subjects underwent a liver ViTE, VCTE, SWE and STE examination. A Receiver Operator Characteristic (ROC) analysis was performed on the measured stiffness values of each method. An inter- intra-observer analysis was also performed.

Results: The ViTE, VCTE, SWE and STE ROC analysis resulted in an AUC of 0.9481, 0.9900, 0.9621 and 0.9683 for F ≥ F1, 0.9698, 0.9767, 0.9931 and 0.9834 for F ≥ F2, 0.9846, 0.9651, 0.9835 and 0.9763 for F ≥ F3, and 0.9524, 0.9645, 0.9656, and 0.9509 for F = F4, respectively. ICC scores were 0.98 for Inter-observer and 0.97 for Intra-observer variability analysis.

Conclusion: ViTE performance in CLD stage differentiation is comparable to the performance of VCTE, SWE and STE.

Keywords: Chronic Liver Disease; Fibrosis; Shear Wave Elastography; Sound Touch Elastography; Vibration Controlled Transient Elastography; Visual Transient Elastography.