Adherence to quality criteria improves concordance between transient elastography and ElastPQ for liver stiffness assessment

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®) and
(ii) impacts on the performance of ElastPQ® 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® (Echosens, France) and ElastPQ® with EPIQ® or Affiniti® systems (Philips, The Netherlands). The agreement between TE and ElastPQ® LSMs was assessed with Lin's concordance correlation coefficient (CCC). Diagnostic performance of ElastPQ® 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® were obtained with IQR/M ≤ 30% (p < 0.001). The diagnostic performance of ElastPQ® for fibrosis staging also increased if LSM values were obtained with IQR/M ≤ 30%.
Conclusion: Quality criteria should be followed when using ElastPQ® for LSM, since the concordance with TE fibrosis staging was better at an ElastPQ® IQR/M ≤ 30.