%0 Journal Article %T Intra-individual comparison of two-dimensional shear wave elastography techniques using plane wave imaging and the multi-beam technique: are they interchangeable in measuring liver fibrosis? %A Kim JH %A Yoon JH %A Joo I %A Lee JM %J Ultrasonography %V 42 %N 2 %D Apr 2023 %M 36935597 %F 4.725 %R 10.14366/usg.22135 %X OBJECTIVE: This study compared two different two-dimensional shear wave elastography techniques-plane wave imaging (PWI) and multi-beam (MB) imaging-from the same vendor to evaluate liver fibrosis.
METHODS: In this prospective study, 42 patients with chronic liver disease who had recently undergone magnetic resonance elastography (<3 months) were enrolled, and their liver stiffness (LS) values were measured using PWI or MB. The LS values (kPa) were compared using the Wilcoxon rank-sum test. Inter-technique reproducibility and intra-observer repeatability were assessed using Bland-Altman analysis with 95% limits of agreement (LOA) and coefficients of variation (CVs). The cutoff values for predicting severe fibrosis (≥F3) were estimated using receiver operating characteristic curve (ROC) analysis, with magnetic resonance elastography as the reference standard.
RESULTS: PWI exhibited technical failure in four patients. Therefore, 38 patients underwent both examinations. The LS values showed moderate agreement between PWI and MB (CV, 22.5%) and 95% LOA of -3.71 to 7.44 kPa. The MB technique showed good intra-observer agreement (CV, 8.1%), while PWI showed moderate agreement (CV, 11.0%). The cutoff values of PWI and MB for diagnosing ≥F3 were 12.3 kPa and 13.8 kPa, respectively, with areas under the ROC curve of 0.89 and 0.95 (sensitivity, 100% and 100%; specificity, 65.6% and 85.7%).
CONCLUSIONS: The LS values significantly differed between PWI and MB, hindering their interchangeable use in longitudinal follow-up. Considering its low technical failure rate and better repeatability, the MB technique may be preferable for evaluating liver fibrosis in chronic liver disease patients.