Role of two-dimensional shear wave elastography in chronic liver diseases: A narrative review

Table 1 Diagnostic performance of shear wave elastography for significant fibrosis (F ≥ 2), advanced fibrosis (F ≥ 3) and cirrhosis (F4) in patients with various liver diseases

Ref.	Year	Patients (n)	F ≥ 2 (%)	F ≥ 3 (%)	F = 4 (%)	AUROC	Cutoffs (kPa)	Se (%)	Sp (%)	PPV (%)	NPV (%)
Jeong et al[44]	2014	70	78.6			0.915	8.60	78.2	93.3	97.7	53.8
				50		0.913	10.46	88.6	80.0	81.6	87.6
					31.4	0.878	14.00	77.3	85.4	70.8	89.2
Deffieux et al[45]	2015	120	48.0			0.890	8.90	77.0	79.0	77.0	79.0
				33		0.880	9.10	85.0	72.0	60.0	90.0
					15.0	0.890	10.20	83.0	76.0	38.0	96.0

AUROC: Area under ROC curve; Se: Sensitivity; Sp: Specificity; PPV: Positive predictive value; NPV: Negative predictive value; SWE: Shear wave elastography.

Table 2 Diagnostic performance of shear wave elastography for significant fibrosis (F ≥ 2), advanced fibrosis (F ≥ 3) and cirrhosis (F4) in patients with chronic hepatitis C

Ref.	Year	Patients (n)	F ≥ 2 (%)	F ≥ 3 (%)	F = 4 (%)	AUROC	Cutoffs (kPa)	Se (%)	Sp (%)	PPV (%)	NPV (%)
Bavu et al[46]1	2011	113	55.8			0.950	9.12	81.0	72.0
				34.5		0.960	10.08	75.0	78.0
					13.3	0.970	13.30	80.0	87.0
Ferraioli et al[47]	2012	121	58.7			0.920	7.10	90.0	87.5	91.3	85.7
				31.4		0.980	8.70	97.3	95.1	90.0	98.7
					19.8	0.980	10.40	87.5	96.8	87.5	96.8
Tada et al[48]	2013	55	32.7			0.940	8.80	88.9	91.9	84.2	94.4
Herrmann et al[49]	2018	379	58.3			0.863	7.10	94.7	52.0
				33.5		0.915	9.20	90.3	76.8
					18.2	0.929	13.00	85.8	87.8

¹The reference fibrosis level is derived from the algorithm proposed by Sebastiani et al[79]. AUROC: Area under ROC curve; Se: Sensitivity; Sp: Specificity; PPV: Positive predictive value; NPV: Negative predictive value.

Table 3 Diagnostic performance of shear wave elastography for significant fibrosis (F ≥ 2), advanced fibrosis (F ≥ 3) and cirrhosis (F4) in patients with chronic hepatitis B

Ref.	Year	Patients (n)	F ≥ 2 (%)	F ≥ 3 (%)	F = 4 (%)	AUROC	Cutoffs (kPa)	Se (%)	Sp (%)	PPV (%)	NPV (%)
Leung et al[14]	2013	226	60.2			0.880	7.100	84.70	92.10	85.3	91.7
				35.4		0.930	7.900	89.80	90.30	71.8	97.0
					15.5	0.980	10.100	97.40	93.00	60.1	99.6
Zeng et al[54]1	2014	206 (104)	45.7 (45.1)			0.917 (0.907)	7.200	86.36 (85.19)	86.96 (80.85)	88.8 (83.6)	84.2 (82.6)
				69.0 (70.1)		0.945 (0.934)	9.100	91.94 (89.66)	85.71 (80.56)	74.0 (65.0)	96.0 (95.1)
					81.1 (83.7)	0.945 (0.967)	11.700	91.89 (88.24)	89.70 (88.10)	66.7 (60.0)	98.0 (97.4)
Wu et al[53]	2016	437	47.2			0.903	8.200	78.16	85.28	82.6	81.4
					14.0	0.926	11.256	91.80	84.31	48.7	98.4
Zhuang et al[55]1	2017	304(155)	86.8 (84.6)			0.970 (0.970)	7.600	92.00 (91.6)	90.00 (87.5)	98.4 (96.0)	64.3 (65.0)
				70.4 (67.8)		0.960 (0.970)	9.200	91.60 (88.6)	96.70 (96.0)	98.5 (97.8)	82.9 (80.1)
					54.9 (48.4)	0.980 (0.980)	10.400	94.60 (92.0)	94.90 (95.0)	95.7 (94.5)	93.5 (92.7)
Zeng et al[52]	2017	257	46.3			0.882	7.100	88.89	76.38	76.2	89.0
				24.9		0.917	8.300	89.66	76.84	55.9	95.8
					13.2	0.926	11.300	93.55	87.25	52.7	98.9
Herrmann et al[49]	2018	379	52.0			0.906	7.100	87.60	73.60
				29.8		0.931	8.100	94.90	73.10
					13.0	0.955	11.500	79.90	93.90

¹These studies are divided into index cohort and validation cohort and parentheses are index cohort. AUROC: Area under ROC curve; Se: Sensitivity; Sp: Specificity; PPV: Positive predictive value; NPV: Negative predictive value.

Table 4 Diagnostic performance of shear wave elastography for significant fibrosis (F ≥ 2), advanced fibrosis (F ≥ 3) and cirrhosis (F4) in patients with non-viral liver diseases

Ref.	Year	Etiology	Patients (n)	F ≥ 2 (%)	F ≥ 3 (%)	F = 4 (%)	AUROC	Cutoffs (kPa)	Se (%)	Sp (%)	PPV (%)	NPV (%)
Cassinotto et al[20]	2016	NAFLD	291	70.8			0.860	8.90	68.0	94.0
					43.3		0.890	9.30	84.0	83.0
						16.8	0.880	10.00	95.0	69.0
Takeuchi et al[58]	2018	NAFLD	71	64.8			0.750	11.57	52.0	44.0
					45.1		0.820	13.07	63.0	57.0
						7.0	0.900	15.73	100.0	82.0
Herrmann et al[49]	2018	NAFLD	156	58.3			0.855	7.10	93.8	52.0
					32.1		0.928	9.20	93.1	80.9
						12.2	0.917	13.00	75.3	87.8
Thiele et al[19]	2016	Alcohol	199	42.0			0.940	10.20	82.0	93.0	90.0	88.0
						18.0	0.950	16.40	94.0	91.0	71.0	99.0
Zeng et al[59]	2017	Autoimmune	114	71.9			0.850	9.70	81.7	81.3	91.8	63.4
					41.3		0.850	13.20	83.0	74.6	69.6	86.2
						20.2	0.860	16.30	87.0	80.2	52.6	96.1
Li et al[60]	2018	Autoimmune	51	35.2			0.781	9.15	83.3	72.7

AUROC: Area under ROC curve; Se: Sensitivity; Sp: Specificity; PPV: Positive predictive value; NPV: Negative predictive value; NAFLD: Non-alcoholic fatty liver disease

Table 5 Diagnostic performance of shear wave elastography for detecting clinically significant portal hypertension (HVPG ≥ 10 mmHg)

Ref.	Year	Patients (n)	Study design	Prevalence (%)	Site	Success rate (%)	Cutoffs (kPa)	AUROC	Se (%)	Sp (%)	PPV (%)	NPV (%)
Procopet et al[64]	2015	88	Restospective	55.0	LS	99.0	17.0	0.859	80.8	82.1
							15.41	0.948	91.3	90.9
					SS	66.0		0.725
Elkrief et al[65]	2015	79	Prospective	90.9	LS	97.0	24.5	0.870	81.0	88.0	98.0	35.0
					SS	97.0	34.7	0.640	40.0	100.0	100.0	18.0
Kim et al[66]	2015	92	Prospective	83.7	LS	98.3	15.2	0.819	85.7	80.0	95.7	52.2
							21.62	0.867	83.3	80.8	91.7	65.6
Jansen et al[67]	2017	109	Prospective multicenter	67.9	LS	100.0	24.6	0.860	68.3	80.4	87.7	55.4
					SS	81.2	26.3	0.840	79.7	84.2	90.8	68.0

¹Highly reliable and reliable measurements (n = 45): SD/median > 0.10 or depth ≥ 5.6 cm;

²Severe portal hypertension (HVPG ≥ 12 mmHg). AUROC: Area under ROC curve; Se: Sensitivity; Sp: Specificity; PPV: Positive predictive value; NPV: Negative predictive value; LS: Liver stiffness; SS: Spleen stiffness.