Examination of Shear Wave Elastography and Attenuation Imaging by Subcutaneous Thickness

We evaluated the data acquisition rate by subcutaneous thickness of Shear Wave Elastography (SWE) and Attenuation Imaging (ATI) and the consistency with the pathological tissue by comparison with Transient Elastography (TE) and Controlled Attenuation Parameter (CAP). 100 patients underwent TE/CAP, SWE/ATI evaluation and liver biopsy on the same day at our hospital. Median age 58 years (16-82), male/female was 47/53 cases, HBV/NASH/AIH/PBC/Other was 6/57/18/3/16 cases. Median subcutaneous thickness 17.8 mm (8.0-42.3), <20/≥20 was 67/33 cases. For fibrosis stage, F ≤1/2/3/4 was 68/21/9/2 cases, and for steatosis grade, S0 (≤5%)/S1 (5-33%)/S2 (33-66%)/S3 (>66%) was 50/36/10/4 cases. The acquisition rate of highly reliable data and the consistency between the acquired data and the pathological tissue were evaluated. The overall acquisition rates were 84/90% and 85/96% for TE/CAP and SWE/ATI, respectively. When the subcutaneous thickness ≥ 20mm; 90.9/84.8%, 87.9/93.9%. At <20mm; TE/SWE AUROC diagnosed as ≥F2, ≥F3, F4 is 0.839/0.769, 0.871/0.910, 0.954/0.944, respectively, and the CAP/ATI diagnosed as ≥S1, ≥S2, S3 AUROCs were 0.927/0.774, 0.963/0.952, 0.929/1.000, respectively. At ≥20mm, the TE/SWE AUROCs diagnosed as ≥F2 and ≥F3 are 0.806/0.739 and 0.946/0.917, respectively, and the CAP/ATI AUROCs diagnosed as ≥S1 and ≥S2 are 0.833/0.965 and 0.757/0.890, respectively. SWE/ATI was able to obtain data even in cases with deep subcutaneous thickness, and the correlation with histopathology showed the same results as fibroscan.