Ultrasound-based Dual Elastography for Evaluating the Severity of Drug-induced Liver Injury: One Step Closer to Pathology

Liyun Xue, PhD; Hui Feng, MD; Fankun Meng, MD; Ying Zheng, MD; Guangwen Cheng, PhD; Yao Zhang, MD; Zhiyong Yin, MD; Jing Wu, MD; Jiabao Zhu, MD; Xueqi Li, MD; Jie Yu, PhD; Ping Liang, PhD; Hong Ding, PhD

doi:10.37015/AUDT.2024.240017

ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY >

2024 , Vol. 8 >Issue 3: 106 - 115

DOI: https://doi.org/10.37015/AUDT.2024.240017

Original Research

Ultrasound-based Dual Elastography for Evaluating the Severity of Drug-induced Liver Injury: One Step Closer to Pathology

Liyun Xue, PhD ,
Hui Feng, MD ,
Fankun Meng, MD ,
Ying Zheng, MD ,
Guangwen Cheng, PhD ,
Yao Zhang, MD ,
Zhiyong Yin, MD ,
Jing Wu, MD ,
Jiabao Zhu, MD ,
Xueqi Li, MD ,
Jie Yu, PhD ,
Ping Liang, PhD ,
Hong Ding, PhD

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^aDepartment of Ultrasound, Huashan Hospital, Fudan University, Shanghai
^bDepartment of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing
^cDepartment of Ultrasound, Beijing Youan Hospital Capital Medical University, Beijing Institute of Hepatology, Beijing
^dDepartment of Ultrasound, Beijing Ditan Hospital Capital Medical University, Beijing
^eDepartment of Ultrasound, Nantong Third Hospital Affiliated to Nantong University, Jiangsu

First author contact:

¹ Liyun Xue and Hui Feng contributed equally to this study.

Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai 200040, China (HD) e-mail: ding_hong@fudan.edu.cn (HD);
Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, China (PL) e-mail: liangping301@hotmail.com(PL);
Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, China (JY) e-mail: jiemi301@163.com (JY)

Received date: 2024-03-25

Revised date: 2024-06-27

Accepted date: 2024-09-09

Online published: 2024-10-16

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Abstract

Objective: Drug-induced liver injury (DILI) is one of the most challenging forms of liver disorder. We aimed to use ultrasound dual elastography, by combining strain and shear wave imaging, to noninvasively assess liver inflammation and injury severity of DILI.

Methods: 291 DILI patients were included in the prospective multicenter study and divided into training and validation cohorts. All patients received liver biopsy and dual elastography examination. Liver inflammation grading (G0-4) and fibrosis staging (F0-4) were considered as the gold standard of liver injury and G+F ≥ 5 was defined as severe liver injury. Indexes of dual elastography and serological indicators (DESI) were selected and analyzed with multivariable logistic regression to build DESI models for evaluating liver inflammation, and the C score model was built with the same method for diagnosing severe liver injury.

Results: Areas under the receiver operating characteristic curve (AUCs) of the DESI model to assess liver inflammation ≥ G2 were 0.887 and 0.868 in training and validation cohorts, respectively. AUCs of the DESI model in diagnosing ≥ G3 were 0.893 and 0.896 in the two cohorts, respectively. The C score accurately assessed severe liver injury with AUCs of 0.909 and 0.885 in two cohorts. Of the 87 patients with mild clinical severity, 10 (11.49%) had severe pathological injury, which could be identified by C score.

Conclusion: Dual elastography demonstrated high performance in diagnosing liver inflammation and identifying severe pathological liver injury of DILI, making up for the deficiency of serological indicators alone for evaluating DILI severity.

Key words： Drug-induced liver injury; Liver inflammation activity; Dual elastography; Strain elastography; Shear wave elastography

Cite this article

Liyun Xue, PhD , Hui Feng, MD , Fankun Meng, MD , Ying Zheng, MD , Guangwen Cheng, PhD , Yao Zhang, MD , Zhiyong Yin, MD , Jing Wu, MD , Jiabao Zhu, MD , Xueqi Li, MD , Jie Yu, PhD , Ping Liang, PhD , Hong Ding, PhD . Ultrasound-based Dual Elastography for Evaluating the Severity of Drug-induced Liver Injury: One Step Closer to Pathology[J]. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY, 2024 , 8(3) : 106 -115 . DOI: 10.37015/AUDT.2024.240017

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