DIAGNOSTIC ACCURACY OF SHEAR WAVE ELASTOGRAPHY IN DIAGNOSIS OF LIVER CIRRHOSIS IN PATIENTS OF NON-ALCOHOLIC FATTY LIVER DISEASE TAKING HISTOPATHOLOGY AS GOLD STANDARD

Abstract

Introduction: Non-Alcoholic Fatty Liver Disease (NAFLD) is a leading cause of chronic liver disease worldwide, with a significant risk of progression to cirrhosis. Liver biopsy remains the gold standard for diagnosing fibrosis and cirrhosis, but its invasiveness limits routine use. Shear Wave Elastography (SWE) is a promising non-invasive alternative for assessing liver stiffness and fibrosis. Therefore, we aimed to evaluate the diagnostic accuracy of SWE in detecting liver cirrhosis in NAFLD patients, using histopathology as the reference standard.

Methods: This validation study was conducted at Ayub Teaching Hospital, Abbottabad from August 2024 to July 2025. A total of 101 NAFLD patients, aged 20-60 years, underwent SWE followed by liver biopsy were included in the study by consecutive sampling technique. Informed consent was obtained from the patients at enrolment. Patients who did not undergo liver biopsy after SWE were excluded from the study. Validity parameters were calculated from a 2x2 table. Data were analysed using SPSS version 27.0, with statistical significance set at p < 0.05.

Results: The mean age of participants was 46.65 ± 6.12 years, with 50.5% being male. SWE demonstrated a sensitivity of 94.3%, specificity of 79.2%, PPV of 83.3%, NPV of 92.7%, and an overall accuracy of 87.1%. Strong concordance was observed between SWE and histopathology with a high area under ROC curve (AUC = 0.868, p < 0.001), reinforcing its diagnostic reliability.

Conclusion: SWE is a highly accurate, non-invasive tool for detecting liver fibrosis and cirrhosis in NAFLD patients making it a viable alternative to liver biopsy, particularly for routine monitoring and early disease detection.