Gut Liver.  2017 Nov;11(6):852-859. 10.5009/gnl16521.

Role of Shear Wave Elastography in Evaluating the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B

• Jeong JY
• Sohn JH
• Sohn W
• Park CH
• Kim TY
• Jun DW
• Kim Y
• Jeong WK

• KMID: 2395391
• DOI: http://doi.org/10.5009/gnl16521

Abstract

BACKGROUND/AIMS
To investigate the use of measurements of liver stiffness (LS) by two-dimensional real-time shear wave elastography (SWE) for predicting the development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB).
METHODS
We retrospectively collected data on 291 enrolled patients with CHB whose LS had been measured using SWE.
RESULTS
The mean age of the patients was 46.8 years; males predominated (67%), and 40 of the patients (14%) had clinical cirrhosis. Among the patients, 165 (56.7%) received antiviral treatment. The median LS value was 7.4 kPa, and the median follow-up period was 35.8 months (range, 3.0 to 52.8 months). During follow-up, HCC developed in 13 patients (4.5%), and the cumulative incidence rates of HCC at 1, 2, and 4 years were 1.1%, 3.6%, and 8.4%, respectively. Based on a multivariate analysis, older age (≥50 years) and higher LS value (≥10 kPa) were independently associated with the risk of developing HCC (hazard ratio [HR], 4.53, p=0.023; and HR, 4.08, p=0.022). The cumulative incidence rate of HCC was significantly higher in patients with higher LS values (≥10 kPa) than in those with lower LS values ( < 10 kPa) (p=0.001).
CONCLUSIONS
Increased LS measured by SWE at any time point regardless of antiviral treatment is associated with an increased risk of HCC in patients with CHB.

Keyword

Elastography; shear wave; Liver stiffness; Hepatitis B; chronic; Carcinoma; hepatocellular

MeSH Terms

Carcinoma, Hepatocellular*
Elasticity Imaging Techniques*
Fibrosis
Follow-Up Studies
Hepatitis B
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
Incidence
Liver
Male
Multivariate Analysis
Retrospective Studies