Background Noninvasive measurements including transient elastography (TE) and the two-dimensional shear wave elastography (SWE) have been clinical used instead of liver biopsy for the regular assessment of liver fibrosis in patients during following-up. We aimed to investigate independent factors of SWE compared with TE and find the optimal cutoff values of these two non-invasive evaluation assessments based on our cohort of treatment-naive CHB patients.
Methods Fifty-four treatment-naive CHB patients were enrolled and studied. All of them were performed SWE, TE, serum tests and liver biopsy. Potential factors of SWE and TE values were analysed by linear regression and orthogonal partial least squares (OPLS) discriminant analysis. The agreement, the association, the comparison of the two different methods were implemented based on the results of liver biopsy by using Bland–Altman analysis, spearman’s correlation and areas under the receive operating characteristic curves (AUROCs).
Results There were 27 cases (50%) of mild fibrosis (F0-F2) and 27 (50%) cases of significant fibrosis (F3-F6), fibrosis was assessed with the Ishak scoring system. Multivariate linear regression analyses revealed that fibrosis stage was the only factor affecting the values of SWE (P<0.001), whereas total bilirubin levels (P=0.013) and fibrosis stage (P=0.037) were independent factors affecting TE values. OPLS showed the numbers independent factors (VIP>1) were more in TE than SWE. Bland-Altman analysis showed satisfied agreement between LSMs of SWE and TE. Both of SWE and TE could significantly evaluate significant fibrosis (P<0.001). Spearman’s correlation analysis revealed a correlation between liver fibrosis and LSMs of SWE and TE (r=0.65 and 0.50, P<0.001). Areas under receiver operating characteristics curves (AUROCs) of SWE and TE for significant fibrosis (F>2) were 0.786 and 0.714, respectively. The optimal cutoff values of LSMs of SWE and TE were 9.05kPa and 8.15kPa, respectively.
Conclusions According to the AUROCs in comparative data, SWE may be more sensitive and more precise than TE in predicting significant fibrosis (>F2) in CHB patients. Compare to TE, the value of SWE is less affected by factors and will be more promising application prospects.