The Evaluation of Liver Fibrosis in the Real-Time Shear Wave Elastography Technique in Chronic Hepatitis B and C Patients: How Many Measurements Are Necessary to Assign Patients to METAVIR Score Properly?

Background: Hepatic fibrosis is part of chronic liver disorders such as chronic hepatitis, cirrhosis, or metabolic disorders. Two-dimensional shear wave elastography (2D SWE) is one of the newest elastography techniques, which enables the assessment of the liver fibrosis in a non-invasive way. Objectives: The aim of the study was to determine how many measurements are necessary to assess liver fibrosis in a healthy population and patients with hepatitis B and C. Methods: We analyzed the retrospective data of 642 patients who underwent the complex ultrasonic abdomen examination and liver 2D SWE examination. We analyzed the statistical differences and the interclass correlation coefficient between the value of the first measurement, the median value of the first three measurements, and the median value of all five measurements. Results: There was no statistical difference between the 2D SWE value of the first measurement and the median value of the first three and the first five measurements in healthy controls. In the group of patients with hepatitis B, the median value of the first five 2D SWE measurements was significantly higher than the value of the first 2D SWE measurement. Our study presented no statistical difference between the median of the first three measurements and the median value of all five measurements in the group of HCV positive patients. The analysis of the assignment to the METAVIR groups with respect to the median value of the first three 2D SWE measurements revealed no statistical difference in comparison with the assignment of patients with respect to the all five 2D SWE measurements of the liver. Conclusions: Depending on the patients’ condition, different numbers of 2D SWE measurements can affect the median values of liver stiffness although they do not affect the assignment to the METAVIR scale.