Adherence to quality criteria improves concordance between transient elastography and ElastPQ for liver stiffness assessment-A multicenter retrospective study

Background: Assessment of liver stiffness provides important diagnostic and prognostic information in patients with chronic liver disease. Aims: To investigate whether the use of quality criteria (i) improves the concordance between transient elastography (TE) and a novel point shear wave elastography technique (ElastPQ (R)) and (ii) impacts on the performance of ElastPQ (R) for liver fibrosis staging using TE as the reference standard. Methods: In this multicenter retrospective study, data of patients undergoing liver stiffness measurements (LSM) in five European centers were collected. TE was performed with FibroScan (R) (Echosens, France) and ElastPQ (R) with EPIQ (R) or Affiniti (R) systems (Philips, The Netherlands). The agreement between TE and ElastPQ (R) LSMs was assessed with Lin's concordance correlation coefficient (CCC). Diagnostic performance of ElastPQ (R) was assessed by the area under receiver operating characteristic (AUROC) curves. Results: Overall, 664 patients were included: mean age: 54.8(13.5) years, main etiologies: viral hepatitis (83.1%) and NAFLD (7.5%). CCC increased significantly when LSMs with ElastPQ (R) were obtained with IQR/M <= 30% (p < 0.001). The diagnostic performance of ElastPQ (R) for fibrosis staging also increased if LSM values were obtained with IQR/M = 30%. Conclusion: Quality criteria should be followed when using ElastPQ (R) for LSM, since the concordance with TE fibrosis staging was better at an ElastPQ (R) IQR/M <= 30. (c) 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.