Assessment of Liver Fibrosis by Real Time SonoElastography (Hitachi) as Compared to Liver Biopsy and Transient Elastography

  • Alina Popescu, Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara, Romania, Romania
  • Ioan Sporea, Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara, Romania, Romania
  • Mircea Focsa, Department of Biophysics and Medical Informatics, University of Medicine and Pharmacy Timisoara, Romania, Romania
  • Viviana Sandra, Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara, Romania, Romania
  • Veronica Ruta, Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara, Romania, Romania
  • Alexandra Deleanu, Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara, Romania, Romania
  • Mirela Danila, Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara, Romania, Romania
  • Roxana Sirli, Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy Timisoara, Romania, Romania

    • Aim: to compare real time sonoelastographic (RT-SE) evaluation of liver fibrosis with two well established methods, liver biopsy (LB) and transient elastography (TE).
    Material and method: Our study included 44 patients: 9 healthy volunteers; 30 patients with chronic hepatitis who underwent LB; and 6 with cirrhosis.
    All the patients were evaluated by:
    - TE (FibroScan®, EchoSens): a median value of liver stiffness was obtained after 10 measurements (kPa).
    - RT-SE (Hitachi HiVision 900 System), using a convex probe (2.5-5MHz) and a linear probe (6.5-13MHz). Five images were obtained with each probe and were processed by means of ImageJ application. We separated the RGB color channels and we calculated the ratio between the blue colored areas (stiff tissue encoded in blue) and the total elastographic area (blue ratio).
    We assessed the correlation between the data from RTSE and those obtained by LB and TE.
    Results: A strong direct correlation was observed between TE and liver fibrosis (Spearman's rho=0.871).
    The mean values for the blue ratio were: 11.1±6.3 for the convex probe and 18.0±8.9 for the linear probe (p=0.458).
    For the convex probe, only a weak direct correlation was found between RT-SE and LB (rho=0.306) or TE (rho=0.216). No correlation was found between RT-SE evaluations made with the linear probe and LB, nor with TE.
    Conclusion: As compared with LB or TE, our processing technique of RT-SE images did not result in expected information regarding the liver fibrosis.