Comparison between vibration-controlled transient elastography and point shear wave elastography for assessment of hepatic fibrosis based on magnetic resonance elastography.

PURPOSE: This study prospectively compared the diagnostic accuracy of vibration-controlled transient elastography (VCTE) and point shear wave elastography (pSWE) in the assessment of liver fibrosis, versus a reference standard of magnetic resonance elastography (MRE).

METHODS

This study prospectively enrolled patients with chronic liver disease, who underwent pSWE, VCTE, and MRE. Fibrosis was staged based on liver stiffness (LS) values measured using MRE: F0 (<2.61 kPa), F1 (≥2.61 to <2.97 kPa), F2 (≥2.97 to <3.62 kPa), F3 (≥3.62 to <4.69 kPa), and F4 (≥4.69 kPa). Each modality was performed independently, and the results were blinded to minimize bias. Diagnostic performance was assessed using the Pearson correlation coefficient (CC), Lin concordance correlation coefficient (CCC), area under the receiver operating characteristic curve (AUROC), Obuchowski index, integrated discrimination improvement (IDI), and net reclassification improvement (NRI).

RESULTS

In total, 251 patients (median age, 64 years; 97 women) were evaluated. Both pSWE (CC, 0.838; CCC, 0.825) and VCTE (CC, 0.803; CCC, 0.784) demonstrated strong correlations with MRE, with no statistically significant differences. AUROC values for diagnosing fibrosis stage were comparable between pSWE and VCTE. Based on the Obuchowski index, pSWE provided closer agreement with MRE in detecting ≥F1, ≥F2, and ≥F4. Analyses of IDI and NRI also displayed significantly better agreement between pSWE and MRE in detecting ≥F1, ≥F2, and ≥F4 (NRI: P<0.001; IDI: F1 and F2, P<0.001; F4, P=0.002).

CONCLUSION

pSWE demonstrated closer alignment than VCTE with LS values measured by MRE, suggesting the potential of pSWE for noninvasively assessing liver fibrosis.