SHEAR WAVE ELASTOGRAPHY AS A NON-INVASIVE PREDICTOR OF FATTY LIVER SEVERITY: CORRELATION WITH SONOGRAPHIC FINDINGS

Abstract

Objective: To evaluate the effectiveness of shear wave elastography (SWE) as a non-invasive tool for predicting the severity of fatty liver disease.

Material and Method: It was cross-sectional analytical study conducted at Radiology Department, Cancer Care Hospital and Research Center, Lahore Inclusion criteria: Both male and female diagnosed with fatty liver disease based on sonographic findings (graded as 0, 1, 2, or 3), age group of 18-80 years were included in this study. Exclusion criteria: Patients with known chronic liver diseases other than fatty liver, such as hepatitis B/C, cirrhosis, or autoimmune hepatitis, were excluded from the study. Additionally, those who had undergone previous liver surgery or liver transplantation, and pregnant women, due to physiological changes affecting liver parameters, were also excluded.

Results: Significant difference was observed in focal liver lesions (p = 0.020), where patients without focal lesions had higher KPA values (11.67 ± 2.99) compared to those with focal lesions (10.41 ± 4.54). Additionally, KPA values significantly increased with fatty liver severity (p < 0.001), progressing from 5.28 ± 1.27 in Grade 0, 10.02 ± 1.81 in Grade 1, 13.52 ± 1.88 in Grade 2, to 20.63 ± 5.50 in Grade 3. Obese individuals are more likely to have severe fatty liver grades (2 & 3). High lipid profile is associated with higher fatty liver grades. Higher grades (2 & 3) appear more frequent in diabetic individuals. Strong positive correlation (r = 0.80), confirming that higher fatty liver grades are associated with higher KPA values. The Spearman’s correlation analysis revealed a strong positive correlation (r = 0.768, p < 0.001) between sonographic grades of fatty liver disease and fibro scan, indicating that as the severity of fatty liver disease increases, liver stiffness also rises significantly.

Conclusion: The strong correlation between SWE values and sonographic grades supports its role as a non-invasive alternative to liver biopsy for assessing liver stiffness. Our results suggest that liver stiffness is more directly related to histological severity rather than metabolic abnormalities alone.