ORIGINAL RESEARCH n ULTRASONOGRAPHY 910 radiology.rsna.org n Radiology: Volume 269: Number 3—December 2013 Quantitative Elastography of Liver Fibrosis and Spleen Stiffness in Chronic Hepatitis B Carriers: Comparison of Shear-Wave Elastography and Transient Elastography with Liver Biopsy Correlation 1 Vivian Yee-fong Leung, PhD Jiayun Shen, MSc Vincent Wai-sun Wong, MD Jill Abrigo, FRCR Grace Lai-hung Wong, MD Angel Mei-ling Chim, MSc Shirley Ho-ting Chu, MSc Anthony Wing-hung Chan, MD Paul Cheung-lung Choi, MD Anil T. Ahuja, MD Henry Lik-yuen Chan, MD Winnie Chiu-wing Chu, MD Purpose: To document utility of shear-wave (SW) elastography for assessing liver fibrosis in chronic hepatitis B and to com- pare its performance with that of transient elastography. Materials and Methods: Ethics committee approved the study, and informed con- sent was obtained. Patients with liver biopsy correlation (n = 226) and healthy patients (n = 171) were analyzed. Results of SW elastography of liver, SW elastography of spleen, and transient elastography of liver were compared and correlated according to METAVIR scores. Areas un- der the receiver operating characteristic curve (AUCs), binary logistic regression, and Delong test were used. Results: AUC for SW elastography of liver, transient elastography of liver, and SW elastography of spleen was, respectively, 0.86, 0.80, and 0.81 for fibrosis (F1 stage); 0.88, 0.78, and 0.82 for moderate fibrosis (F2 stage); 0.93, 0.83, and 0.83 for severe fibrosis (F3 stage); and 0.98, 0.92, and 0.84 for cirrhosis (F4 stage). SW elastography of liver showed significantly higher accuracy than transient elastog- raphy of liver and SW elastography of spleen in all fibrosis stages (P = .01–.04). SW elastography of spleen showed similar accuracy with transient elastography of liver (P = .21–.99). Combination SW elastography of liver and SW elastography of spleen to predict fibrosis staging showed diagnostic accuracy not further improved compared with SW elastography of liver alone (similar AUC; F1, P = .87; F2, P = .81; F3, P = .84; F4, P = .88). SW elas- tography of liver had higher successful rate than transient elastography of liver (98.9% vs 89.6%). Prevalence of dis- cordance in at least two stages with liver histologic staging was 10.2% (23 of 226) for SW elastography of liver and 28.2% (58 of 206) for SW elastography of spleen. Conclusion: SW elastography provides more accurate correlation of liver elasticity with liver fibrosis stage compared with transient elastography, especially in identification of stage F2 or greater. q RSNA, 2013 1 From the Institute of Digestive Disease (J.S., V.W.W., G.L.W., A.M.C., S.H.C., H.L.C., W.C.C.), Department of Imaging and Interventional Radiology (V.Y.L., J.A., A.T.A., W.C.C.), Department of Medicine and Therapeutics (J.S., V.W.W., G.L.W., A.M.C., S.H.C., H.L.C.), and Department of Anatomical and Cellular Pathology (A.W.C., P.C.C.), Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, Hong Kong, SAR, China 852. Received January 16, 2013; revision requested February 22; revision received March 20; accepted May 13; final version accepted May 23. Address correspondence to W.C.C. (e-mail: winnie@med.cuhk.edu.hk). q RSNA, 2013 Note: This copy is for your personal non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, contact us at www.rsna.org/rsnarights.