Seung Woo Cha MD, Presenter: Nothing to Disclose

Yong-Soo Kim MD, PhD, Abstract Co-Author: Nothing to Disclose

Woo Kyoung Jeong MD, Abstract Co-Author: Nothing to Disclose

Min Yeong Kim MD, Abstract Co-Author: Nothing to Disclose

Tae Yeob Kim, Abstract Co-Author: Nothing to Disclose

Joo Hyun Sohn, Abstract Co-Author: Nothing to Disclose

To investigate the performance change of B-mode ultrasonographic (US) images for grading chronic liver disease (CLD) after getting the information from liver stiffness measurement (LSM) with Supersonic shear wave elastography (SWE).

This retrospective study was designed for 46 patients (M:F=27:19) who had undergone liver biopsy for CLD. And 37 normal subjects (M:F=9:28) who underwent LSM to evaluate the hepatotoxic effect of long-term use of methotrexate were included and satisfied both of the following criteria, APRI <0.50 and FORNS <4.21. Two abdominal radiologists reviewed B-mode US image sets randomized by a study coordinator, and classified them into normal, non-cirrhotic CLD, and liver cirrhosis (LC) based on the US features such as echogenicity, echotexture, surface nodularity, and edge blunting of the liver without any knowledge of clinical information and LSM. After 4 weeks, the radiologists re-reviewed the image sets with data of LSM and repeated to classify into three degrees of CLD. Spearman’s correlation was used for assessment US grading and weighted κ statistics was used for interobserver agreement. Z-test was used to compare the correlation coefficients. Diagnostic performance for LC was evaluated by area under the curve (AUC) with ROC curves.

Standard diagnosis was classified as follows: normal (n=40), control group and F0 stage (n=3) on METAVIR system; non-cirrhotic CLD (n=26), F1-F3; LC (n=17), F4. When reviewing without LSM, correlation coefficients (rho) of each observer were 0.401 and 0.316, respectively. However, using the information of LSM made the correlation with standard diagnosis increased (rho= 0.728 and 0.748, respectively). The change between two reviewing was statistically significant (all P<.05). The κ-value of reviewing without LSM was 0.282, but it was also dramatically increased when reviewing with LSM (κ=0.732; P<.05). The AUCs for the LC of each observer were 0.884 and 0.783 without LSM and 0.904 and 0.904 with LSM, respectively.

When LSM is added into B-mode US evaluation of CLD, the efficacy of US would be improved and the interobserver variability of B-mode US would be decreased.

Using liver stiffness measurement during ultrasonographic examination for chronic liver disease is advantageous to overcome the limitations of B-mode ultrasonography

Cha, S, Kim, Y, Jeong, W, Kim, M, Kim, T, Sohn, J, Accuracy of B-mode Ultrasonography with or without Liver Stiffness Measurement for Chronic Liver Disease: Comparison of Diagnostic Performance and Interobserver Variability.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043627.html