Gut Liver. 2017 Jun 27. doi: 10.5009/gnl16521. [Epub ahead of print]
Role of Shear Wave Elastography in Evaluating the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B.Jeong JY1, Sohn JH1, Sohn W2, Park CH1, Kim TY1, Jun DW3, Kim Y4, Jeong WK5. Author information 1Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.2Hepatology Center, Bundang Jesaeng General Hospital, Seongnam, Korea.3Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea.4Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.5Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
AbstractBackground/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.