Assessing significant fibrosis using imaging-based elastography in chronic hepatitis B patients: Pilot study

Table 1 The baseline characteristics of the enrolled treatment-naïve chronic hepatitis B patients with normal or minimally raised alanine aminotransferase levels

Characteristics (n = 63)
Sex, male/female	37/26
Age, mean (± SD) yr	50.8 (± 8.9)
Body mass index, mean (± SD) kg/m2	23.4 (± 3.4)
AST, mean (± SD), IU/L (normal 4-40 IU/L)	43.5 (± 22.6)
ALT, mean (± SD), IU/L (normal 4-40 IU/L)	44.0 (± 20.8)
Platelet counts, mean (± SD), × 103/mm3	163.5 (± 39.4)
Prothrombin time, mean (± SD), INR	1.05 (± 0.08)
Total bilirubin, mean (± SD), mg/dL	0.75 (± 0.47)
Albumin, mean (± SD), g/dL	3.97 (± 0.24)
γ-glutamyl transferase, mean (± SD), U/L	47.5 (± 31.0)
HBeAg status, positive/negative	35/28
HBV-DNA, mean (± SD), log10 IU/mL	5.78 (± 1.64)
Grade of inflammatory activity (0/1/ 2/3)	9/26/15/13
Fibrosis stage (0/1/2/3 /4)	3/16/14/ 14/16

ALT: Alanine transaminase; AST: Aspartate transaminase; INR: International normalized ratio; SD: Standard deviation.

Table 2 Statistics of liver stiffness value measured by magnetic resonance elastography and two-dimensional shear wave elastography, fibrosis index based on four factors score, and aspartate transaminase-to-platelet ratio index score with the Spearman’s coefficients according to fibrosis stages

	F0/F1 (n = 19)	F2 (n = 14)	F3 (n = 14)	F4 (n = 16)	r	P value
MRE	1.96 ± 0.43	2.46 ± 0.54	2.91 ± 0.45	3.91 ± 0.50	0.869	< 0.001
2D-SWE	6.09 ± 1.58	8.05 ± 2.23	8.16 ± 2.08	11.39 ± 3.01	0.649	< 0.001
FIB-4	1.75 ± 0.61	1.76 ± 0.60	2.48 ± 0.91	3.21 ± 1.45	0.517	< 0.001
APRI	0.58 ± 0.20	0.71 ± 0.46	0.95 ± 0.44	1.04 ± 0.58	0.431	< 0.001

MRE: Magnetic resonance elastography; 2D-SWE: Two-dimensional shear wave elastography; FIB-4: Fibrosis index based on four factors; APRI: Aspartate transaminase-to-platelet ratio index.

Table 3 Factors associated with the values of liver stiffness measured by magnetic resonance elastography and two-dimensional shear wave elastography in univariate and multivariate linear regression analyses

Parameters	Factors associated with liver stiffness values by MRE				Factors associated with liver stiffness values by 2D-SWE
	Univariate	P value	Multivariate	P value	Univariate	P value	Multivariate	P value
Sex, male/female	-0.054 (-0.508, 0.401)	0.815			0.685 (-0.840, 2.210)	0.372
Age, yr	0.019 (-0.006, 0.044)	0.132			0.067 (-0.017, 0.151)	0.117
BMI, kg/m2	-0.048 (-0.114, 0.018)	0.149			-0.251 (-0.469, -0.034)	0.024	-0.186 (-0.366, -0.007)	0.042
AST, U/L	0.007 (-0.003, 0.017)	0.157			0.032 (-0.001, 0.065)	0.054
ALT, U/L	0.002 (-0.009, 0.013)	0.674			0.000 (-0.037, 0.037)	0.995
PLT counts, × 103/mm3	-0.007 (-0.012, -0.001)	0.014	0.001 (-0.002, 0.005)	0.530	-0.027 (-0.045, -0.009)	0.004	-0.012 (-0.029, 0.004)	0.136
PT, INR	1.312 (-1.595, 4.220)	0.370			8.658 (-0.971, 18.288)	0.077
Total bilirubin, mg/dL	0.331 (-0.140, 0.802)	0.165			0.098 (-1.517, 1.713)	0.904
Albumin, g/dL	-0.540 (-1.510, 0.429)	0.270			-3.152 (-6.359, 0.055)	0.054
γ-GT, U/L	0.004 (-0.003, 0.011)	0.302			0.012 (-0.012, 0.036)	0.327
HBeAg status, +/-	0.166 (-0.282, 0.615)	0.461			1.052 (-0.445, 2.549)	0.165
HBV-DNA, log10 IU/mL	-0.051 (-0.189, 0.086)	0.456			-0.076 (-0.541, 0.389)	0.745
Inflammatory grade	0.363 (0.153, 0.573)	0.001	0.105 (-0.031, 0.241)	0.129	0.903 (0.163, 1.644)	0.018	0.220 (-0.411, 0.852)	0.487
Fibrosis stage	0.626 (0.520, 0.732)	< 0.001	0.609 (0.487, 0.731)	< 0.001	1.616 (1.116, 2.116)	< 0.001	1.276 (0.690, 1.863)	< 0.001

MRE: Magnetic resonance elastography; 2D-SWE: Two-dimensional shear wave elastography; ALT: Alanine transaminase; AST: Aspartate transaminase; BMI: Body mass index; INR: International normalized ratio; PLT: Platelet; PT: Prothrombin time; γ-GT: Gamma-GT.

Table 4 Diagnostic performance of magnetic resonance elastography and two-dimensional shear wave elastography, fibrosis index based on four factors score, and aspartate transaminase-to-platelet ratio index for evaluation of significant fibrosis (≥ F2) and cirrhosis (F4)

		AUC (95%CI)	P value	Cutoff	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)
MRE	≥ F2	0.906 (0.806, 0.965)	< 0.001	> 2.47 (kPa)	81.8	94.7	97.3	69.2
	F4	0.894 (0.791, 0.958)	< 0.001	> 3.46 (kPa)	88.9	97.8	94.1	95.6
2D-SWE	≥ F2	0.843 (0.730, 0.923)	< 0.001	> 6.73 (kPa)	84.1	68.4	86.0	65.0
	F4	0.816 (0.698, 0.902)	< 0.001	> 9.50 (kPa)	77.8	80.0	60.9	90.0
FIB-4	≥ F2	0.697 (0.568, 0.806)	0.003	> 1.80	70.5	63.2	81.6	48.0
	F4	0.786 (0.665, 0.880)	< 0.001	> 3.22	50.0	97.8	90.0	83.0
APRI	≥ F2	0.717 (0.590, 0.823)	0.001	> 0.49	84.1	52.6	80.4	58.8
	F4	0.701 (0.572, 0.810)	0.006	> 0.96	50.0	84.4	562	80.9

MRE: Magnetic resonance elastography; 2D-SWE: Two-dimensional shear wave elastography; FIB-4: Fibrosis index based on four factors; APRI: Aspartate transaminase-to-platelet ratio index; AUC: Area under the curve; PPV: Positive predictive value; NPV: Negative predictive value.