preliminary study on the evaluation of liver fibrosis using endoscopic ultrasound elastography and transabdominal ultrasound transient elastography combined with strain ratio

Background: this study aimed to explore the effectiveness of endoscopic ultrasound elastography (eus-eg) in evaluating liver fibrosis. methods: the present study involved 11 patients with chronic liver disease who met study criteria and underwent eus-eg, transabdominal ultrasound transient elastography (tus-te), and liver biopsy (lb) examinations at the same time. the batts-ludwig scoring system for liver fibrosis was used as the gold standard to analyze the correlation between the eus-eg strain ratio (sr) and tus-te liver stiffness measurement with the pathological stage of liver fibrosis. the optimal cut-off value and area under the receiver operating characteristic curve (auroc) of eus-eg and tus-te for diagnosing liver fibrosis were calculated by drawing an roc curve, and the corresponding sensitivity, specificity, and accuracy were also calculated. results: endoscopic ultrasound elastography was highly positively correlated with the pathological stage of liver fibrosis (s ≥ 2, r = 0.759, p = 0.01), and tus-te was positively correlated with the pathological stage of liver fibrosis (s ≥ 2, r = 0.857, p = 0.003). the optimal diagnostic cut-off value of cirrhosis undergoing eus-eg and tus-te was 0.84 and 14.2 kpa, respectively. when the pathological stage was s0 - s1, the sensitivity, specificity, accuracy, and auroc value of tus-te in the diagnosis of liver fibrosis were higher than those of eus-eg (96.2%, 83.3%, 81.8%, and 0.96 vs. 94.6%, 75%, 72.7%, and 0.8958). when the pathological stage was ≥ s2, the sensitivity, specificity, accuracy, and auroc values of eus-eg were higher than those of tus-te (100%, 87.5%, 88.9%, and 0.97 vs. 100%, 83.3%, 88.9%, and 0.94). conclusions: there is a superior correlation between eus-eg combined with sr and the pathological stage of liver fibrosis, compared to tus-te, and it has the same or even higher diagnostic efficacy as tus-te. larger prospective studies are needed to evaluate the clinical utility of this approach in the assessment of liver fibrosis.