Diagnostic performance on multiple parameters of real-time ultrasound shear wave elastography for evaluating nonalcoholic fatty liver disease: A rabbit model

Article type: Research Article

Authors: Lei, Pinggui^{a; 1; *} | Zhang, Piaochen^{a; c; 1} | Xu, Hengtian^{a; 1} | Liu, Qianijao^a | Wang, Yan^a | Wang, Pingxian^b | Duan, Qinghong^a | Liu, Jing^a | Zhou, Shi^a | Qian, Wei^d | Jiao, Jun^a

Affiliations: [a] Department of Radiology, the Affiliated Hospital of Guizhou Medical University, Guiyang, China | [b] Department of Medical Insurance, the Affiliated Hospital of Guizhou Medical University, Guiyang, China | [c] Department of Radiology, Affiliated Tungwah Hospital, Sun Yat-sen University, Dongguan, China | [d] Department of Electrical and Computer Engineering, College of Engineering, University of Texas, El Paso, TX, USA

Correspondence: [*] Corresponding author: Pinggui Lei, Department of Radiology, the Affiliated Hospital of Guizhou Medical University. No.28, Guiyi Street, Yunyan District, Guiyang, Guizhou 550004, China. E-mail: [email protected].

Note: [1] Equal contributors.

Abstract: OBJECTIVE:To study the diagnostic value of real-time ultrasound shear wave elastography (US-SWE) in evaluating the histological stages of nonalcoholic fatty liver disease (NAFLD) in a rabbit model. MATERIALS AND METHODS:Twenty-one 8-week-old rabbits were fed a high-fat, high-cholesterol diet (experimental groups), and seven rabbits were fed a standard diet (control group). All rabbits underwent real-time US-SWE at various time points to document the histological stages of NAFLD. We categorized the histological stages as normal, NAFL, borderline nonalcoholic steatohepatitis (NASH), and NASH. We measured the elastic modulus of the liver parenchyma and analyzed the diagnostic efficacy of real-time US-SWE using the area under receiver operating characteristic curve (AUC) for the four histological stages. RESULTS:The mean, minimum, and maximum elastic modulus increase for NAFL, borderline NASH, and NASH. For the mean, minimum, and maximum elastic modulus, AUCs are 0.891 (95% confidence interval [CI]: 0.716–0.977), 0.867 (95% CI: 0.686–0.965), and 0.789 (95% CI:0.594–0.919) for differentiating normal liver from liver with NAFLD, respectively; AUCs are 0.846 (95% CI: 0.660–0.954), 0.818 (95% CI: 0.627–0.937), and 0.797 (95% CI:0.627–0.913) for differentiating normal liver or liver with NAFL from liver with borderline NASH or NASH, respectively; AUCs are 0.889 (95% CI: 0.713–0.976), 0.787 (95% CI: 0.591–0.918), and 0.895 (95% CI:0.720–0.978) for differentiating liver with NASH from liver with lower severity NAFLD or normal liver, respectively. CONCLUSIONS:Real-time US-SWE is an accurate, noninvasive technique for evaluating the histological stages of NAFLD by measuring liver stiffness. We recommend using the mean elastic modulus to differentiate the histological stages, with the minimum and maximum elastic modulus as valuable complements.

DOI: 10.3233/XST-200676

Journal: Journal of X-Ray Science and Technology, vol. 28, no. 6, pp. 1187-1197, 2020