Correlation of liver imaging and transient elastography among patients with hepatitis C at a safety net hospital

• Type of Material: Article
• Authors: Hima Veeramachaneni, Emory University; Bobak Moazzami, Emory University; Navila Sharif, Emory University; Emad Qayed, Emory University; Lesley S. Miller, Emory University
• Language: English
• Date: 2025-04-27
• Publisher: Baishideng Publishing Group Inc
• Publication Version: Final Published Version
• Copyright Statement: ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): https://doi.org/10.4254/wjh.v17.i4.105065
• Title of Journal or Parent Work: World Journal of Hepatology
• Volume: 17
• Issue: 4
• Start Page: 105065
• Keywords: Liver stiffness measurement; Hepatic fibrosis; Transient elastography; Liver imaging; Hepatic steatosis; Controlled attenuation parameter; Chronic hepatitis C virus
• Research Categories: Virology

Abstract

BACKGROUND Liver imaging and transient elastography (TE) are both tools used to assess liver fibrosis and steatosis among people with hepatitis C virus (HCV) infection. However, the diagnostic accuracy of conventional imaging in detecting fibrosis and steatosis in this patient population remains unclear. AIM To investigate the correlation between steatosis and fibrosis and abnormal findings on liver imaging in patients with HCV. METHODS We conducted a retrospective cross-sectional analysis of patients with HCV at Grady Liver Clinic who had TE exams between 2018-2019. We analyzed the correlation of controlled attenuation parameter and liver stiffness measurement on TE and abnormal findings on liver imaging. Liver imaging findings (hepatic steatosis, increased echogenicity, cirrhosis, and chronic liver disease) were further evaluated for their diagnostic performance in detecting fibrosis (≥ F2, ≥ F3, ≥ F4) and steatosis (≥ S1, ≥ S2, ≥ S3). RESULTS Of 959 HCV patients who underwent TE, 651 had liver imaging. Higher controlled attenuation parameter scores were observed in patients with abnormal liver findings (P = 0.0050), hepatic steatosis (P < 0.0001), and increased echogenicity (P < 0.0001). Higher liver stiffness measurement values were also noted in those with abnormal liver (P < 0.0001) and increased echogenicity (P = 0.0026). Steatosis severity correlated with hepatic steatosis (r = 0.195, P < 0.001) and increased echogenicity (r = 0.209, P < 0.001). For fibrosis detection, abnormal liver imaging had moderate sensitivity (81.7%) and specificity (70.4%) for cirrhosis (≥ F4), while cirrhosis on imaging had high specificity (99.2%) but low sensitivity (18.3%). Increased echogenicity showed high specificity (92.8%) but low sensitivity (20.9%) for steatosis detection. CONCLUSION Liver imaging detects advanced fibrosis and steatosis but lacks early-stage sensitivity. Integrating TE with imaging may improve evaluation in patients with HCV.