Reliability of acoustic radiation force impulse shear wave elastography in the evaluation of liver stiffness in morbidly obese patients

Anil Chauhan, Sara Pourhassan Shamchi, Kristoffel R. Dumon, Noel N. Williams, Chandra M. Sehgal

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate technical and patient-related factors that can affect the reliability of acoustic radiation force impulse shear wave elastography (ARFI-SWE) in morbidly obese patients. Methods: A prospective single-center study was performed on 41 patients (32 females, 78%) presenting for preoperative evaluation for bariatric surgery. ARFI-SWE was performed using a 6 to 1.5 MHz curved (6C1) transducer. Hepatic steatosis was mild, moderate, severe, and absent in 24.4%, 12.2%, 43.9%, and 19.5% of patients, respectively. Interquartile range/median (IQR/M) ranged from 0.05 to 2.07 (0.78 ± 0.56 m/s). Twenty patients (48.7%) had reliable measurements (IQR/M < 0.3). Shear wave velocity (SWV) values were >1.34 m/s (clinically significant fibrosis) in 25 of 41 patients (61%) and >2.2 m/s (advanced fibrosis) in 19 patients (46%). Results: Median SWV was correlated with body mass index (BMI; correlation coefficient [CC] =.37; 95% CI, 0.07-0.61; P-value =.03) and skin-to-liver capsule distance (SLD) (CC =.38; 95% CI, 0.09-0.62; P-value =.01). IQR/M was higher in patients with BMI > 40 (0.24 ± 0.11 vs 0.39 ± 0.25, P-value =.031) and SLD > 3 cm (0.46 ± 0.27 vs 0.23 ± 0.08, P-value =.001), and there was higher number of unreliable examinations among patient with SLD > 3 cm (16/23 vs 5/18, P-value =.01). Conclusion: ARFI-SWE is technically more challenging among patients with higher BMI and SLD, resulting in a higher number of unreliable studies, which highlights the need for further advancement of ARFI technology.

Original languageEnglish (US)
Pages (from-to)369-376
Number of pages8
JournalJournal of Clinical Ultrasound
Volume48
Issue number7
DOIs
StatePublished - Sep 1 2020

Keywords

  • ARFI-SWE
  • fibrosis
  • liver
  • obesity
  • shear wave elastography
  • ultrasound elastography

PubMed: MeSH publication types

  • Journal Article

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