A study of spleen shear-wave elastography in indirect prediction of liver fibrosis in patients with chronic hepatitis B

Article type: Research Article

Authors: Zheng, Yi^{a; b} | Xia, Shujun^{a; 1} | Ren, Xinping^{a; c; *} | Zhan, Weiwei^{a; *} | Zheng, Zhan^d | Chen, Zhijie^e

Affiliations: [a] Department of Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, China | [b] Department of Ultrasound, Shanghai General Hospital, Shanghai JiaoTong University, Shanghai, China | [c] Department of Ultrasound, Wuxi Branch of Rui Jin Hospital, School of Medicine, Shanghai JiaoTong University, Wuxi, Jiangsu, China | [d] School of Systems Engineering, National University of Defense Technology, Changsha, Hunan, China | [e] Shenzhen Mindary Biomedical Electronics Co., Ltd. Shenzhen, Guang Dong, China

Correspondence: [*] Corresponding author: Xinping Ren, 197 Ruijin NO. 2 Road, Shanghai, 200025, China. Tel.: +86 13818819629; E-mail: 13818819629@163.com; and Weiwei Zhan, shanghairuijin@126.com.

Note: [1] Co-first author: Shujun Xia.

Abstract: PURPOSE:To evaluate the value of spleen shear-wave elastography (sound touch elastography [STE], sound touch quantification [STQ]) in indirect prediction of liver fibrosis in patients with chronic hepatitis B (CHB). METHODS:The Young’s modulus (kPa) of spleen STE, STQ and liver FibroScan were measured in 112 patients with CHB. The final diagnosis was according to histological results from liver biopsy based on Scheure G/S scoring system and liver FibroScan was considered as a reference index of prediction efficiency. Grouped by the stage of liver fibrosis, data were analyzed by Spearman correlation analysis, Mann-Whitney test and receiver operating characteristic curve (ROC). RESULTS:Spleen STE was positively correlated with the degree of liver fibrosis, but spleen STQ was not. STEmean and STEmax of spleen were statistically different between the groups categorized by S = 2, S = 3 and S = 4 (all p < 0.05), respectively. Spleen STEmean had the best predicting performance on staging liver fibrosis. The areas under the ROC (AUC) for spleen STEmean were 0.66 (95% confidence interval [CI], 0.56–0.76) for stage S = 2 or higher, 0.72 (95% CI, 0.60–0.83) for S = 3 or higher, 0.83 (95% CI, 0.74–0.92) for S = 4 (all P < 0.01). The differences between the AUC for spleen STEmean and liver FibroScan in liver fibrosis staging were not statistically significant when the groups categorized by S = 2 and S = 4 (P = 0.146 and P = 0.052). But when categorized by S = 3, the evaluating performance of liver FibroScan was better (P = 0.004). CONCLUSION:STEmean of spleen is applicable in indirect predicting fibrosis stage in patients with CHB.

Keywords: Spleen elastography, shear-wave elastography, transient elastography, chronic hepatitis B, liver fibrosis

DOI: 10.3233/CH-200869

Journal: Clinical Hemorheology and Microcirculation, vol. 76, no. 1, pp. 63-72, 2020