Comparative diagnostic efficacy of shear wave and transient elastography in predicting the risk of esophagogastric varices and histological staging in patients with primary biliary cholangitis

Background This study aimed to compare the diagnostic efficacy of shear wave elastography (SWE) with that of transient elastography (TE) in predicting the risk of esophagogastric varices and histological staging in patients with primary biliary cholangitis (PBC). Methods This single-center prospective study enrolled 77 patients with PBC diagnosed by liver biopsy following SWE and TE. Receiver operating characteristic (ROC) curves were constructed for SWE-liver stiffness measurement (LSM) and TE-LSM to assess their diagnostic efficacy for histological staging ≥ stage 2, ≥ stage 3, and = stage 4. The diagnostic efficacy and accuracy of SWE-LSM were compared with those of the Baveno VI criteria for detecting esophagogastric varices. Additionally, the impact of different laboratory parameters on SWE-LSM was analyzed. Results We evaluated 77 patients (median age, 52 years (range: 16 − 75 years), 66 females). ROC curves constructed using TE-LSM and SWE-LSM demonstrated similar diagnostic efficacy for histological staging ≥ stage 2 (area under the curve [AUC]: 0.824 vs 0.823 for TE-LSM and SWE-LSM, respectively, p = 0.9764), ≥ stage 3 (AUC: 0.918 vs 0.907 for TE-LSM and SWE-LSM, respectively, p = 0.6443), and = stage 4 (AUC: 0.907 vs 0.902 for TE-LSM and SWE-LSM, respectively, p = 0.8763). Additionally, while there was no significant difference in the diagnostic efficacy between the two methods for detecting esophagogastric varices (95% confidence interval: -0.0366 − 0.287, p = 0.1296), SWE had a slightly higher diagnostic accuracy than TE (61.8% vs 76.4%). Transaminases and bilirubin levels had little influence on SWE-LSM. Conclusion SWE exhibited comparable performance to TE in predicting the risk of esophagogastric varices and histological staging.