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Point Shear?Wave Elastography Using Acoustic Radiation Force Impulse Imaging for the Prediction of Liver?Related Events in Patients With Chronic Viral Hepatitis

ABSTRACT: Chronic viral hepatitis is associated with substantial morbidity and mortality worldwide. Our study shows good comparability of point shear wave elastography (pSWE) and transient elastography. pSWE is a promising tool for the prediction of liver?related events in patients with viral hepatitis, particularly in patients with cHCV. Chronic viral hepatitis is associated with substantial morbidity and mortality worldwide. The aim of our study was to assess the ability of point shear?wave elastography (pSWE) using acoustic radiation force impulse imaging for the prediction of the following liver?related events (LREs): new diagnosis of HCC, liver transplantation, or liver?related death (hepatic decompensation was not included as an LRE). pSWE was performed at study inclusion and compared with liver histology, transient elastography (TE), and serologic biomarkers (aspartate aminotransferase to platelet ratio index, Fibrosis?4, FibroTest). The performance of pSWE and TE to predict LREs was assessed by calculating the area under the receiver operating characteristic curve and a Cox proportional?hazards regression model. A total of 254 patients with a median follow?up of 78 months were included in the study. LRE occurred in 28 patients (11%) during follow?up. In both patients with hepatitis B virus and hepatitis C virus (HCV), pSWE showed significant correlations with noninvasive tests and TE, and median pSWE and TE values were significantly different between patients with LREs and patients without LREs (both P < 0.0001). In patients with HCV, the area under the receiver operating characteristic curve for pSWE and TE to predict LREs were comparable: 0.859 (95% confidence interval [CI], 0.747?0.969) and 0.852 (95% CI, 0.737?0.967) (P = 0.93). In Cox regression analysis, pSWE independently predicted LREs in all patients with HCV (hazard ratio, 17.9; 95% CI, 5.21?61?17; P < 0.0001) and those who later received direct?acting antiviral therapy (hazard ratio, 17.11; 95% CI, 3.88?75.55; P = 0.0002). Conclusion: Our study shows good comparability between pSWE and TE. pSWE is a promising tool for the prediction of LREs in patients with viral hepatitis, particularly those with chronic HCV. Further studies are needed to confirm our data and assess their prognostic value in other liver diseases.

SUBMITTER: Hernandez Sampere L

PROVIDER: S-EPMC7789843 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Project description:Thromboembolism in a cerebral blood vessel is associated with high morbidity and mortality. Mechanical thrombectomy (MT) is one of the emergenc proceduresperformed to remove emboli. However, the interventional approaches such as aspiration catheters or stent retriever are empirically selected. An inappropriate selection of surgical devices can influence the success rate during embolectomy, which can lead to an increase in brain damage. There has been growing interest in the study of clot composition and using a priori knowledge of clot composition to provide guidance for an appropriate treatment strategy for interventional physicians. Developing imaging tools which can allow interventionalists to understand clot composition could affect management and device strategy. In this study, we investigated how clots of different compositions can be characterized by using acoustic radiation force optical coherence elastography (ARF-OCE) and compared with ultrasound shear wave elastography (SWE). Five different clots compositions using human blood were fabricated into cylindrical forms from fibrin-rich (21% red blood cells, RBCs) to RBC-rich (95% RBCs). Using the ARF-OCE and SWE, we characterized the wave velocities measured in the time-domain. In addition, the semi-analytical finite element model was used to explore the relationship between the phase velocities with various frequency ranges and diameters of the clots. The study demonstrated that the wave group velocities generally decrease as RBC content increases in ARF-OCE and SWE. The correlation of the group velocities from the OCE and SWE methods represented a good agreement as RBC composition is larger than 39%. Using the phase velocity dispersion analysis applied to ARF-OCE data, we estimated the shear wave velocities decoupling the effects of the geometry and material properties of the clots. The study demonstrated that the composition of the clots can be characterized by elastographic methods using ARF-OCE and SWE, and OCE demonstrated better ability to discriminate between clots of different RBC compositions, compared to the ultrasound-based approach, especially in clots with low RBC compositions.

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Point Shear?Wave Elastography Using Acoustic Radiation Force Impulse Imaging for the Prediction of Liver?Related Events in Patients With Chronic Viral Hepatitis

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