Comparison Of Sound Touch Elastography,sound Touch Quantify With Serum Fibrosis Indexes In Evaluating Liver Fibrosis In Patients With Chronic Hepatitis B

PurposeSound touch elastography and sound touch quantify are both relatively new ultrasound elastography techniques.The aim of this research was to compare the use of shear wave elastography[sound touch elastography(STE)and sound touch quantify(STQ)]and four serum liver fibrosis indexes in the evaluation and staging of chronic hepatitis B(CHB)liver fibrosis.Materials and Methods1.Sound touch elastography is a form of 2-dimensional shear wave elastography,and sound touch quantify is a form of point shear wave elastography.A total of 122 patients with CHB were assessed using STE and STQ,and then Young’s modulus(kPa)was recorded for each.All patients underwent ultrasound-guided liver biopsy on the day after elastography examination,and the degree of liver fibrosis and inflammation activity were grouped using the Scheuer scoring system.2.Serum liver biomarkers were undertaken for each,four serum fibrosis indexes,including aspartate transaminase-to-platelet ratio index(APRI),the fibrosis index based on the 4 factors(FIB-4),the King score,and the forns index.3.In this study,using liver biopsy as the standard test for liver fibrosis,liver stiffness values for each liver fibrosis stage were compared using the 1-way analysis of variance analysis,the Spearman correlation test was used to analyze the correlation between noninvasive testing methods(STE,STQ and serum biomarkers)and pathological fibrosis stages.Receiver operator characteristic(ROC)curves were used to measure the diagnostic performance of the noninvasive methods(STE,STQ and serum biomarkers),and the Delong test was used to compare the areas under the curves(AUCs).Results1.The pathological staging results of liver fibrosis based on the Scheuer scoring system were as follows:66 cases in stage 0-1(S0-1),21 cases in stage 2(S2),20 cases in stage 3(S3),and 15 cases in stage 4(S4).The Young’s modulus of 122 patients with CHB were assessed using STE and STQ were all reliable results.2.The Spearman correlation coefficients between STE and STQ values and the stages of liver fibrosis were 0.619 and 0.579,respectively(all,P<0.001),which were higher than those of the 4 serum fibrosis indexes(all,P<0.05),were 0.274,0.417,0.295 and 0.384 for APRI,FIB-4,the King score,and the forns index,respectively.3.The cutoff values of STE for liver fibrosis stages S2 to S4 were 8.85,9.97,and 10.29 kPa,respectively,and the AUCs were 0.703,0.821,and 0.900,respectively.The cutoff values of STQ for liver fibrosis stages S2 to S4 were 11.31,13.81,and 20.60 kPa,respectively,and the AUCs were 0.674,0.807,and 0.893,respectively.4.The AUCs for the ability of APRI,FIB-4,the King score,and the forns index to diagnose S2 fibrosis were 0.502,0.624,0.542,and 0.616,respectively,and the AUCs for the ability to diagnose S4 fibrosis were 0.856,0.861,0.883,and 0.823,respectively.The AUCs of STE and STQ in diagnosing fibrosis stage were significantly higher than those of liver serum biomarkers(all,P<0.05).ConclusionBoth STE and STQ are noninvasive methods for the assessment of liver fibrosis in CHB patients,with better diagnostic performances than those of 4 serum fibrosis indexes.