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Hepatitis: HELP
Articles by Rong Qin Zheng
Based on 14 articles published since 2008
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Between 2008 and 2019, Rongqin Zheng wrote the following 14 articles about Hepatitis.
 
+ Citations + Abstracts
1 Review Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis. 2018

Herrmann, Eva / de Lédinghen, Victor / Cassinotto, Christophe / Chu, Winnie C-W / Leung, Vivian Y-F / Ferraioli, Giovanna / Filice, Carlo / Castera, Laurent / Vilgrain, Valérie / Ronot, Maxime / Dumortier, Jérôme / Guibal, Aymeric / Pol, Stanislas / Trebicka, Jonel / Jansen, Christian / Strassburg, Christian / Zheng, Rongqin / Zheng, Jian / Francque, Sven / Vanwolleghem, Thomas / Vonghia, Luisa / Manesis, Emanuel K / Zoumpoulis, Pavlos / Sporea, Ioan / Thiele, Maja / Krag, Aleksander / Cohen-Bacrie, Claude / Criton, Aline / Gay, Joel / Deffieux, Thomas / Friedrich-Rust, Mireen. ·Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University Frankfurt, Frankfurt, Germany. · Hepatology Unit, Centre Hospitalier Universitaire, Bordeaux, France. · INSERM U1053, Bordeaux University, Bordeaux, France. · Department of Diagnostic and Interventional Imaging, Centre Hospitalier Universitaire du Haut-Lévèque, Bordeaux, France. · Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China. · Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. · Infectious Diseases Department, Ultrasound Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy. · Department of Hepatology, Assistance Publique de Hôpitaux de ParisHôpital Universitaire Beaujon, Clichy, France. · Department of Radiology, Assistance Publique de Hôpitaux de Paris, Hôpital Universitaire Beaujon, Clichy, France. · Department of Hepatology, Hospices Civils de Lyon, Hôpital Universitaire Edouard Herriot, Lyon, France. · Department of Radiology, Centre Hospitalier Général de Perpignan, Perpignan, France. · Department of Hepatology, Assistance Publique de Hôpitaux de Paris, Hôpital Cochin, and Université Paris Descartes and INSERM UMS20, Institut Pasteur, Paris, France. · Department of Internal Medicine I, Universitätsklinikum Bonn, Bonn, Germany. · Research Unit for Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark. · European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain. · Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. · Division of Gastroenterology and Hepatology, Antwerp University Hospital, Edegem, Belgium. · Department of Internal Medicine, Athens University School of Medicine, Athens, Greece. · Department of Radiology, Athens University School of Medicine, Athens, Greece. · Department of Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania. · SuperSonic Imagine, Aix-en-Provence, France. · INSERM U979-Institut Langevin-ESPCI ParisTec, Paris, France. · Department of Internal Medicine, Goethe University Hospital Frankfurt, Frankfurt, Germany. ·Hepatology · Pubmed #28370257.

ABSTRACT: Two-dimensional shear wave elastography (2D-SWE) has proven to be efficient for the evaluation of liver fibrosis in small to moderate-sized clinical trials. We aimed at running a larger-scale meta-analysis of individual data. Centers which have worked with Aixplorer ultrasound equipment were contacted to share their data. Retrospective statistical analysis used direct and paired receiver operating characteristic and area under the receiver operating characteristic curve (AUROC) analyses, accounting for random effects. Data on both 2D-SWE and liver biopsy were available for 1,134 patients from 13 sites, as well as on successful transient elastography in 665 patients. Most patients had chronic hepatitis C (n = 379), hepatitis B (n = 400), or nonalcoholic fatty liver disease (n = 156). AUROCs of 2D-SWE in patients with hepatitis C, hepatitis B, and nonalcoholic fatty liver disease were 86.3%, 90.6%, and 85.5% for diagnosing significant fibrosis and 92.9%, 95.5%, and 91.7% for diagnosing cirrhosis, respectively. The AUROC of 2D-SWE was 0.022-0.084 (95% confidence interval) larger than the AUROC of transient elastography for diagnosing significant fibrosis (P = 0.001) and 0.003-0.034 for diagnosing cirrhosis (P = 0.022) in all patients. This difference was strongest in hepatitis B patients. CONCLUSION: 2D-SWE has good to excellent performance for the noninvasive staging of liver fibrosis in patients with hepatitis B; further prospective studies are needed for head-to-head comparison between 2D-SWE and other imaging modalities to establish disease-specific appropriate cutoff points for assessment of fibrosis stage. (Hepatology 2018;67:260-272).

2 Clinical Trial Machine-learning-based classification of real-time tissue elastography for hepatic fibrosis in patients with chronic hepatitis B. 2017

Chen, Yang / Luo, Yan / Huang, Wei / Hu, Die / Zheng, Rong-Qin / Cong, Shu-Zhen / Meng, Fan-Kun / Yang, Hong / Lin, Hong-Jun / Sun, Yan / Wang, Xiu-Yan / Wu, Tao / Ren, Jie / Pei, Shu-Fang / Zheng, Ying / He, Yun / Hu, Yu / Yang, Na / Yan, Hongmei. ·Center for Information in Biomedicine, University of Electronic Science and Technology of China, Chengdu 610000, China; Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610000, China. Electronic address: sophie-0627@163.com. · Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610000, China. Electronic address: luoyan15957@126.com. · Center for Information in Biomedicine, University of Electronic Science and Technology of China, Chengdu 610000, China. Electronic address: lembert1990@163.com. · Center for Information in Biomedicine, University of Electronic Science and Technology of China, Chengdu 610000, China. Electronic address: 15182510600@163.com. · Department of Ultrasound, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, China. Electronic address: zssyzrq@163.com. · Department of Ultrasound, Guangdong General Hospital, Guangzhou 510000, China. Electronic address: shzhcong@163.com. · Department of Ultrasound, Beijing Youan Hospital, Capital Medical University, Beijing 100000, China. Electronic address: mengfankun818@126.com. · Department of Ultrasound, First Affiliated Hospital, Guangxi Medical University, Nanning 530000, China. Electronic address: yanghonggx@163.com. · Department of Ultrasound, Jiangsu Province Hospital, Nanjing 210000, China. Electronic address: linhongjun0909@163.com. · Department of Ultrasound, Second Affiliated Hospital, Kunming Medical University, Kunming 650000, China. Electronic address: 1131191506@qq.com. · Department of Ultrasound, Tongji Hospital, Tongji University, Shanghai 200000, China. Electronic address: tjwangxiuyan@163.com. · Department of Ultrasound, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, China. Electronic address: wutao83@126.com. · Department of Ultrasound, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, China. Electronic address: renjieguangzhou@126.com. · Department of Ultrasound, Guangdong General Hospital, Guangzhou 510000, China. Electronic address: peishufang2008@163.com. · Department of Ultrasound, Beijing Youan Hospital, Capital Medical University, Beijing 100000, China. Electronic address: xl2264@126.com. · Department of Ultrasound, First Affiliated Hospital, Guangxi Medical University, Nanning 530000, China. Electronic address: heyungx@gmail.com. · Department of Ultrasound, Jiangsu Province Hospital, Nanjing 210000, China. Electronic address: helenhuyu@163.com. · Department of Ultrasound, Second Affiliated Hospital, Kunming Medical University, Kunming 650000, China. Electronic address: yangna627@126.com. · Center for Information in Biomedicine, University of Electronic Science and Technology of China, Chengdu 610000, China. Electronic address: hmyan@uestc.edu.cn. ·Comput Biol Med · Pubmed #28779596.

ABSTRACT: Hepatic fibrosis is a common middle stage of the pathological processes of chronic liver diseases. Clinical intervention during the early stages of hepatic fibrosis can slow the development of liver cirrhosis and reduce the risk of developing liver cancer. Performing a liver biopsy, the gold standard for viral liver disease management, has drawbacks such as invasiveness and a relatively high sampling error rate. Real-time tissue elastography (RTE), one of the most recently developed technologies, might be promising imaging technology because it is both noninvasive and provides accurate assessments of hepatic fibrosis. However, determining the stage of liver fibrosis from RTE images in a clinic is a challenging task. In this study, in contrast to the previous liver fibrosis index (LFI) method, which predicts the stage of diagnosis using RTE images and multiple regression analysis, we employed four classical classifiers (i.e., Support Vector Machine, Naïve Bayes, Random Forest and K-Nearest Neighbor) to build a decision-support system to improve the hepatitis B stage diagnosis performance. Eleven RTE image features were obtained from 513 subjects who underwent liver biopsies in this multicenter collaborative research. The experimental results showed that the adopted classifiers significantly outperformed the LFI method and that the Random Forest(RF) classifier provided the highest average accuracy among the four machine algorithms. This result suggests that sophisticated machine-learning methods can be powerful tools for evaluating the stage of hepatic fibrosis and show promise for clinical applications.

3 Article Shear wave elastography for liver fibrosis in chronic hepatitis B: Adapting the cut-offs to alanine aminotransferase levels improves accuracy. 2019

Zeng, Jie / Zheng, Jian / Jin, Jie-Yang / Mao, Yong-Jiang / Guo, Huan-Yi / Lu, Ming-De / Zheng, Hai-Rong / Zheng, Rong-Qin. ·Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangdong Key Laboratory of Liver Disease Research, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China. · Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangdong Key Laboratory of Liver Disease Research, Sun Yat-Sen University, Guangzhou, China. · Department of Medical Ultrasonics, Third Hospital of Longgang, Shenzhen, China. · Department of Hepatobiliary Surgery and Medical Ultrasonics, First Affiliated Hospital of Sun Yat-Sen University, Sun Yat-Sen University, Guangzhou, China. · Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, SZ University Town, Shenzhen, 518055, China. hr.zheng@siat.ac.cn. · Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangdong Key Laboratory of Liver Disease Research, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China. zhengrq@mail.sysu.edu.cn. ·Eur Radiol · Pubmed #30039224.

ABSTRACT: OBJECTIVES: To determine and validate alanine aminotransferase (ALT)-adapted dual cut-offs of liver stiffness measurements (LSMs) for assessing liver fibrosis with two-dimensional shear wave elastography (2D-SWE) in patients with chronic hepatitis B (CHB) infection. METHODS: Patients with CHB infection who underwent liver biopsy to assess liver fibrosis were consecutively included. 2D-SWE confirmation thresholds with a positive likelihood ratio ≥10 and 2D-SWE exclusion thresholds with a negative likelihood ratio ≤0.1 were identified to rule in or rule out significant fibrosis and cirrhosis, respectively. RESULTS: The first 515 patients (index cohort) and the next 421 patients (validation cohort) were included in the final analysis. The low and high cut-offs to rule out and rule in patients with significant fibrosis (≥ F2) were 5.4 kPa and 9.0 kPa, respectively, in patients with ALT levels ≤ 2 × the upper limit of normal (ULN) and 7.1 kPa and 11.2 kPa in patients with ALT levels > 2 × ULN. For cirrhosis (F4), the corresponding values were 8.1 kPa and 12.3 kPa in patients with ALT levels ≤ 2 × ULN and 11.9 kPa and 24.7 kPa in patients with ALT levels > 2 × ULN. The dual cut-off values showed an overall accuracy of more than 90% for diagnosis of the presence or absence of significant fibrosis and cirrhosis in the index and validation cohorts. There were no significant differences in the accuracy values between the cohorts (all p>0.05). CONCLUSION: The ALT-adapted dual cut-offs of LSMs showed high accuracy for diagnosis of the presence or absence of significant fibrosis and cirrhosis in patients with CHB infection. KEY POINTS: • The ALT-adapted dual cut-off values of LSMs showed high accuracy for diagnosis of the presence or absence of significant fibrosis and cirrhosis. • ALT levels did not influence the overall diagnostic accuracy for predicting significant fibrosis and cirrhosis. • The ALT-adapted dual cut-offs in patients with ALT levels > 2 × ULN were markedly higher than those in patients with ALT levels ≤ 2 × ULN.

4 Article Deep learning Radiomics of shear wave elastography significantly improved diagnostic performance for assessing liver fibrosis in chronic hepatitis B: a prospective multicentre study. 2019

Wang, Kun / Lu, Xue / Zhou, Hui / Gao, Yongyan / Zheng, Jian / Tong, Minghui / Wu, Changjun / Liu, Changzhu / Huang, Liping / Jiang, Tian'an / Meng, Fankun / Lu, Yongping / Ai, Hong / Xie, Xiao-Yan / Yin, Li-Ping / Liang, Ping / Tian, Jie / Zheng, Rongqin. ·Guangdong Key Laboratory of Liver Disease Research, Department of Medical Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. · CAS Key Laboratory of Molecular Imaging, Institute of Automation, Chinese Academy of Sciences, Beijing, China. · Department of the Artificial Intelligence Technology, University of Chinese Academy of Sciences, Beijing, China. · Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China. · Department of Medical Ultrasonics, Third Hospital of Longgang, Shenzhen, China. · Functional Examination Department of Children's Hospital, Lanzhou University Second Hospital, Lanzhou, China. · Ultrasound Department, The First Affiliated Hospital of Harbin Medical University, Harbin, China. · Ultrasound Department, Guangzhou Eighth People's Hospital, Guangzhou, China. · Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China. · Department of Ultrasonography, The First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China. · Function Diagnosis Center, Beijing Youan Hospital, Affiliated to Capital Medical University, Beijing, China. · Ultrasound Department, The Second People's Hospital of Yunnan Province, Kunming, China. · Ultrasound Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. · Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. · Department of Ultrasound, Jiangsu Province Hospital of TCM, Affiliated Hospital of Nanjing University of TCM, Nanjing, China. ·Gut · Pubmed #29730602.

ABSTRACT: OBJECTIVE: We aimed to evaluate the performance of the newly developed deep learning Radiomics of elastography (DLRE) for assessing liver fibrosis stages. DLRE adopts the radiomic strategy for quantitative analysis of the heterogeneity in two-dimensional shear wave elastography (2D-SWE) images. DESIGN: A prospective multicentre study was conducted to assess its accuracy in patients with chronic hepatitis B, in comparison with 2D-SWE, aspartate transaminase-to-platelet ratio index and fibrosis index based on four factors, by using liver biopsy as the reference standard. Its accuracy and robustness were also investigated by applying different number of acquisitions and different training cohorts, respectively. Data of 654 potentially eligible patients were prospectively enrolled from 12 hospitals, and finally 398 patients with 1990 images were included. Analysis of receiver operating characteristic (ROC) curves was performed to calculate the optimal area under the ROC curve (AUC) for cirrhosis (F4), advanced fibrosis (≥F3) and significance fibrosis (≥F2). RESULTS: AUCs of DLRE were 0.97 for F4 (95% CI 0.94 to 0.99), 0.98 for ≥F3 (95% CI 0.96 to 1.00) and 0.85 (95% CI 0.81 to 0.89) for ≥F2, which were significantly better than other methods except 2D-SWE in ≥F2. Its diagnostic accuracy improved as more images (especially ≥3 images) were acquired from each individual. No significant variation of the performance was found if different training cohorts were applied. CONCLUSION: DLRE shows the best overall performance in predicting liver fibrosis stages compared with 2D-SWE and biomarkers. It is valuable and practical for the non-invasive accurate diagnosis of liver fibrosis stages in HBV-infected patients. TRIAL REGISTRATION NUMBER: NCT02313649; Post-results.

5 Article 2D shear wave elastography combined with MELD improved prognostic accuracy in patients with acute-on-chronic hepatitis B liver failure. 2018

Jin, Jie-Yang / Zheng, Yu-Bao / Zheng, Jian / Liu, Jing / Mao, Yong-Jiang / Chen, Shi-Gao / Gao, Zhi-Liang / Zheng, Rong-Qin. ·Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China. · GuangDong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, China. · Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, China. · Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA. · GuangDong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, China. gaozl@21cn.com. · Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, China. gaozl@21cn.com. · Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China. zhengrq@mail.sysu.edu.cn. · GuangDong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, China. zhengrq@mail.sysu.edu.cn. ·Eur Radiol · Pubmed #29696433.

ABSTRACT: OBJECTIVES: To evaluate accuracy of two-dimensional shear wave elastography (2D SWE) and develop and validate a new prognostic score in predicting prognosis of acute-on-chronic liver failure (ACLF) patients. METHODS: From 1 October 2013 to 30 September 2015, we consecutively enrolled 290 patients, sequentially collected data (including 2D SWE, ultrasound parameters, laboratory data and prognostic scores) and recorded patients' outcome (recovering/steady or worsening) during a 90-day follow-up period. We evaluated ability of 2D SWE to predict outcomes of acute-on-chronic hepatitis B liver failure (ACLF-HBV) patients. We developed a new score (MELD-SWE, combining MELD and SWE values) for predicting mortality risk of ACLF-HBV in 179 patients in a derivation group, and validated in 111 patients. RESULTS: 2D SWE values were higher in worsening patients than recovering/steady ones (p < 0.001). Accuracy of 2D SWE in predicting outcomes of ACLF-HBV was comparable to that of the MELD score (p = 0.441). MELD-SWE showed a significantly higher prognostic value than MELD in both derivation (AUROC, 0.80 vs. 0.76, p = 0.040) and validation (AUROC, 0.87 vs. 0.82, p = 0.018) group. CONCLUSIONS: The MELD-SWE score, combining MELD and SWE values, was superior to MELD alone for outcoming prediction in patients with ACLF-HBV. KEY POINTS: • 2D SWE is a simple prognostic evaluation tool in patients with ACLF-HBV. • MELD-SWE was created in this study: 1.3×MELD + 0.3×2D SWE (kPa). • MELD-SWE score was superior to MELD alone for outcoming prediction in ACLF-HBV. • In this study, 46.8 was the optimal cut-off value of MELD-SWE score.

6 Article Comparison of 2-D Shear Wave Elastography and Transient Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B. 2017

Zeng, Jie / Zheng, Jian / Huang, Zeping / Chen, Shigao / Liu, Jing / Wu, Tao / Zheng, Rongqin / Lu, Mingde. ·Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China. · Department of Medical Ultrasonics, Sun Yat-Sen University Tungwah Hospital, Dongguan, China. · Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. · Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. · Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China. Electronic address: zhengrq@mail.sysu.edu.cn. · Departments of Hepatobiliary Surgery and Medical Ultrasonics, First Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, Guangzhou, China. ·Ultrasound Med Biol · Pubmed #28483579.

ABSTRACT: This study compared 2-D shear wave elastography (SWE) and transient elastography (TE) for liver fibrosis staging in patients with chronic hepatitis B (CHB) infection using liver biopsy as the reference standard. Patients with CHB infection who underwent liver biopsy were consecutively included. After exclusions, 257 patients were analyzed. Two-dimensional SWE resulted in a significantly higher rate of reliable measurements (98.1%, 252/257) than TE (93.0%, 239/257) (p = 0.011). Liver stiffness measurements of the two examinations exhibited a strong correlation (r = 0.835, p < 0.001). In patients given a confirmed histologic diagnosis, Spearman's rank coefficients were 0.520 in stage F0 (p < 0.001), 0.684 in stage F1 (p < 0.001), 0.777 in stage F2 (p < 0.001), 0.672 in stage F3 (p < 0.001) and 0.755 in stage F4 (p < 0.001). There were no significant differences between the areas under the receiver operating characteristic (ROC) curves of 2-D SWE and TE for liver fibrosis staging (all p values > 0.05). Two-dimensional SWE had diagnostic accuracy comparable to that of TE for liver fibrosis staging. The measurements that the two techniques provide are not interchangeable.

7 Article Comparison of Two-Dimensional Shear Wave Elastography and Real-Time Tissue Elastography for Assessing Liver Fibrosis in Chronic Hepatitis B. 2016

Wu, Tao / Wang, Ping / Zhang, Ting / Zheng, Jian / Li, Shuoyang / Zeng, Jie / Kudo, Masatoshi / Zheng, Rongqin. · ·Dig Dis · Pubmed #27750231.

ABSTRACT: BACKGROUND: Noninvasive assessment of liver fibrosis has important clinical significance. Different techniques including two-dimensional shear-wave elastography (2D SWE) and real-time tissue elastography (RTE) are reported to be useful for the noninvasive diagnosis of hepatic fibrosis. All these techniques are affected by many factors. How to choose a reasonable method needs further studies. PURPOSE: This study was conducted to comparatively assess the diagnostic performance of 2D SWE and RTE in patients with Chronic Hepatitis B (CHB) and influence of inflammation on the stiffness values obtained by both techniques, so as to objectively assess the reasonable choice between these 2 elastography techniques for noninvasive assessment of hepatic fibrosis in clinical practice. MATERIALS AND METHODS: Four-hundred and thirty-seven patients with CHB meeting the inclusion criteria were enrolled in the study. All patients underwent liver stiffness measurements by using 2D SWE and RTE on the same day. Histologic fibrosis was staged and inflammation activity was graded based on the METAVIR scoring system on liver biopsy specimens. RESULTS: The liver stiffness values by using 2D SWE and RTE both increased in parallel with the degree of liver fibrosis and the grade of inflammation. However, the diagnostic efficacy of significant fibrosis and cirrhosis using 2D SWE was significantly higher than that of RTE. The 2D SWE measurement values were statistically different in different alanine aminotransferase (ALT) levels and METAVIR activity grades; however, no statistically significant differences were observed by using RTE. The diagnostic efficacy of 2D SWE significantly varied with elevated ALT levels compared with RTE. CONCLUSION: 2D SWE was more accurate than RTE in the assessment of significant fibrosis and cirrhosis in patients with CHB. Compared with RTE, the measurement values and diagnostic performance obtained by 2D SWE were prone to be more easily affected by the inflammation fluctuations.

8 Article [Comparative study of transient elastography versus real-time tissue elastography for assessment of liver fibrosis in patients with chronic liver disease]. 2014

Zheng, Jian / Yang, Lixin / Wu, Tao / Zeng, Jie / Huang, Zeping / Zheng, Bowen / Zhang, Hongjun / Zheng, Rongqin. ·Department of Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China. ·Zhonghua Gan Zang Bing Za Zhi · Pubmed #25496860.

ABSTRACT: OBJECTIVE: To compare the abilities of transient elastography (TE) versus real-time tissue elastography (RTE) for assessing liver fibrosis in patients with chronic liver disease. METHODS: Ninetytwo patients with chronic liver disease were enrolled in the study, and included 77 cases of chronic hepatitis B, 4 cases of chronic hepatitis C, 4 cases of autoimmune liver disease, 2 cases of primary biliary cirrhosis, I case of abnormal bile duct development, and 4 cases of unknown etiology.All patients were assessed by both TE and RTE in a single day.The correlation coefficient of liver fibrosis level and the receiver operating characteristic (ROC) curve of S more than 2 and =4 of TE and RTE were determined.The values were compared using findings fiom pathological analysis as reference. RESULTS: The correlation coefficient of liver fibrosis level was significantly higher for TE (r =0.755, 95% CI:0.651-0.831, P =0.000) than for RTE (r=0.481, 95% CI:0.306-0.624, P =0.000) (Z=3.07, P =0.002).The areas under the ROC curves for S more than 2 and =4 were 0.903 and 0.740 for TE and 0.915 and 0.786 for RTE, respectively, indicating that the performance of TE was superior to that of RTE. CONCLUSION: TE was superior to RTE for assessment of liver fibrosis.

9 Article Accuracy of real-time tissue elastography for the evaluation of hepatic fibrosis in patients with chronic hepatitis B: a prospective multicenter study. 2014

Wu, Tao / Ren, Jie / Cong, Shu-Zhen / Meng, Fan-Kun / Yang, Hong / Luo, Yan / Lin, Hong-Jun / Sun, Yan / Wang, Xiu-Yan / Pei, Shu-Fang / Zheng, Ying / He, Yun / Chen, Yang / Hu, Yu / Yang, Na / Li, Ping / Kudo, Masatoshi / Zheng, Rong-Qin. ·Department of Ultrasound, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. ·Dig Dis · Pubmed #25376298.

ABSTRACT: BACKGROUND: The prognosis and management of hepatic fibrosis are closely related to the stage of the disease. The limitations of liver biopsy, which is the gold standard for treatment, include its invasiveness and sampling error. Ultrasound elasticity might be the most promising imaging technology for the noninvasive and accurate assessment of hepatic fibrosis. Real-time tissue elastography (RTE) measures the relative stiffness of the tissue in the region of interest caused by the heartbeat. Many studies have verified that RTE is useful for the diagnosis of hepatic fibrosis in patients with chronic hepatitis C (CHC). PURPOSE: To determine the formula of the liver fibrosis index for chronic hepatitis B (BLFI) and to validate the diagnostic accuracy of the BLFI for hepatic fibrosis compared with the liver fibrosis index (LFI). MATERIALS AND METHODS: RTE was performed in 747 prospectively enrolled patients with chronic hepatitis B (CHB) or cirrhosis from 8 centers in China; 375 patients were analyzed as the training set, and 372 patients were evaluated as the validation set. The fibrosis stage was diagnosed from pathological specimens obtained by ultrasound-guided liver biopsy. Nine image features were measured from strain images, and the new formula for the BLFI was obtained by combining the nine imaging features of the RTE images using multiple regression analysis of the training set. The BLFI and LFI were compared with the pathological fibrosis stage at diagnosis, and the diagnostic performances of the indexes were compared. RESULTS: The Spearman correlation coefficient between the BLFI and hepatic fibrosis stages was significantly positive (r = 0.711, p < 0.001), and significant differences were present between all disease stages. The areas under the receiver-operating characteristic (AUROC) curves of the BLFI and LFI for predicting significant fibrosis (S0-S1 vs. S2-S4) were 0.858 and 0.858, respectively. For cirrhosis (S0-S3 vs. S4), the AUROC curves of the BLFI and LFI were 0.868 and 0.862, respectively. CONCLUSION: The results of this large, multicenter study confirmed that RTE is valuable for the diagnosis of hepatic fibrosis in patients with CHB. However, the diagnostic efficiencies of the new BLFI and the original LFI, which were based on CHC, for the assessment of CHB hepatic fibrosis were similar; thus, the LFI has the potential to be used to directly evaluate the extent of hepatic fibrosis in patients with CHB.

10 Article Study of detection times for liver stiffness evaluation by shear wave elastography. 2014

Huang, Ze-Ping / Zhang, Xin-Ling / Zeng, Jie / Zheng, Jian / Wang, Ping / Zheng, Rong-Qin. ·Ze-Ping Huang, Xin-Ling Zhang, Jie Zeng, Jian Zheng, Ping Wang, Rong-Qin Zheng, Department of Medical Ultrasonics, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China. ·World J Gastroenterol · Pubmed #25071355.

ABSTRACT: AIM: To investigate enough valid measurements (VMs) to assess liver fibrosis in chronic hepatitis B patients (CHB). METHODS: One hundred and twelve CHB patients (25 women, 87 men) with a mean age of 38.43 years received liver stiffness evaluations using real-time shear wave elastography for 10 VMs. All patients underwent liver biopsy. Based on the biopsy pathology, the liver stiffness data obtained from different VMs (1, 2, 3, 5 and 10 times) were compared for the evaluation of liver fibrosis. The correlation between the elastic modulus means of the liver obtained from different VMs of detection at each pathological stage was analysed. The receiver operating characteristic (ROC) curve was employed to determine the diagnostic performance of different VMs of detection, and the areas under the ROC curve of different groups were compared. RESULTS: The liver stiffness values obtained from 1 VM, 2 VMs, 3 VMs, 5 VMs and all 10 VMs for stage F0 were 6.95 ± 2.01 kPa, 6.87 ± 1.83 kPa, 6.90 ± 1.88 kPa, 6.95 ± 1.93 kPa and 7.15 ± 1.89 kPa, respectively (F = 0.043, P = 0.996). For stage F1, these values were 7.12 ± 1.72 kPa, 7.24 ± 1.72 kPa, 7.21 ± 1.74 kPa, 7.10 ± 1.78 kPa and 7.04 ± 1.70 kPa, respectively (F = 0.075, P = 0.990). For stage F2, they were 9.37 ± 3.87 kPa, 9.18 ± 3.68 kPa, 9.19 ± 3.81 kPa, 9.18 ± 3.81 kPa and 9.19 ± 3.53 kPa, respectively (F = 0.012, P = 1.000). For stage F3, these were 11.91 ± 3.88 kPa, 11.78 ± 4.04 kPa, 11.83 ± 4.07 kPa, 11.94 ± 4.17 kPa and 12.00 ± 4.02 kPa, respectively (F = 0.010, P = 1.000). For stage F4, the readings were 19.30 ± 7.63 kPa, 19.40 ± 7.36 kPa, 19.54 ± 7.43 kPa, 19.73 ± 7.21 kPa and 20.25 ± 7.22 kPa, respectively (F = 0.054, P = 0.995). There were no significant differences between these groups. Intraclass correlation coefficients among different pathological stages (F0-F4) with different detection VMs were 0.995, 0.993, 0.996, 0.994 and 0.996, respectively. The mean elasticity values from 1 VM, 2 VMs, 3 VMs, 5 VMs and 10 VMs can accurately distinguish fibrosis stages (F0 vs F1234, F01 vs F234, F012 vs F34 and F0123 vs F4) with no significant differences in the five groups (P > 0.05 for all). CONCLUSION: One VM may be sufficient to assess liver fibrosis by using SWE without any significant loss of accuracy in patients with CHB. However, future studies of larger patient samples are necessary for the validation of this method.

11 Article Diagnostic accuracy of two-dimensional shear wave elastography for the non-invasive staging of hepatic fibrosis in chronic hepatitis B: a cohort study with internal validation. 2014

Zeng, Jie / Liu, Guang-Jian / Huang, Ze-Ping / Zheng, Jian / Wu, Tao / Zheng, Rong-Qin / Lu, Ming-De. ·Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Institute of Diagnostic and Interventional Ultrasound, Sun Yat-Sen University, 600 Tianhe Road, Guangzhou, 510630, China, zenenv@gmail.com. ·Eur Radiol · Pubmed #25027837.

ABSTRACT: OBJECTIVES: To determine the accuracy of two-dimensional shear wave elastography (2D-SWE) for noninvasive staging of hepatic fibrosis in chronic hepatitis B (CHB). METHODS: Patients with CHB infection who underwent liver biopsy were consecutively included. Receiver-operating characteristic (ROC) curves were constructed to assess the overall accuracy and identify optimal cutoff values. RESULTS: Three hundred three patients were analysed. The diagnostic performance characteristics were determined for the first 202 patients (the index cohort) and were validated on the next 101 patients (validation cohort). The areas under the ROC curves for significant fibrosis, severe fibrosis and cirrhosis were all greater than 0.90 and did not differ significantly between the index and validation cohorts. Using the cutoff values generated from the index cohort, the validation cohort 2D-SWE had negative predictive values of 82.6 % (95 % confidence interval [CI]: 68.4 % - 92.3 %) for significant fibrosis, 95.1 % (95 % CI: 86.3 % - 99.0 %) for severe fibrosis and 97.4 % (95 % CI: 90.8 % - 99.7 %) for cirrhosis. The positive predictive values were 83.6 % (95 % CI: 71.2 % - 92.2 %), 65.0 % (95 % CI: 48.1 - 79.5 %) and 60.0 % (95 % CI: 38.7 % - 78.9 %), respectively. CONCLUSION: The 2D-SWE showed good diagnostic accuracy in staging liver fibrosis in patients with CHB infection and assisted in excluding liver fibrosis and cirrhosis. KEY POINTS: • Two-dimensional shear wave elastography showed good diagnostic accuracy in assessing liver fibrosis. • Diagnostic performance did not differ significantly between the index and validation cohorts. • Two-dimensional shear wave elastography assisted in excluding liver fibrosis and cirrhosis.

12 Article Three-dimensional contrast-enhanced ultrasonic cholangiography: a new technique for delineation of the biliary tract in a liver donor. 2009

Xu, Er-Jiao / Mao, Ren / Zheng, Rong-Qin / Lu, Min-Qiang / Liao, Mei / Ren, Jie / Li, Kai. ·Department of Medical Ultrasonics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China. ·Liver Transpl · Pubmed #19718646.

ABSTRACT: -- No abstract --

13 Article Diagnostic accuracy of imaging for liver cirrhosis compared to histologically proven liver cirrhosis. A multicenter collaborative study. 2008

Kudo, Masatoshi / Zheng, Rong Qin / Kim, Soo Ryang / Okabe, Yoshihiro / Osaki, Yukio / Iijima, Hiroko / Itani, Toshinao / Kasugai, Hiroshi / Kanematsu, Masayuki / Ito, Katsuyoshi / Usuki, Norio / Shimamatsu, Kazuhide / Kage, Masayoshi / Kojiro, Masamichi. ·Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Japan. m-kudo@med.kindai.ac.jp ·Intervirology · Pubmed #18544944.

ABSTRACT: OBJECTIVE: To evaluate the diagnostic accuracy of liver cirrhosis by imaging modalities, including CT, MRI and US, compared to results obtained from histopathological diagnoses of resected specimens. MATERIALS AND METHODS: CT, MRI and US examinations of 142 patients with chronic liver disease who underwent surgery for complicated hepatocellular carcinoma (<3 cm in diameter) in 10 institutions were blindly reviewed in a multicenter study by three radiologists experienced in CT, MRI and US. The images were evaluated for five imaging parameters (irregular or nodular liver surface, blunt liver edge, liver parenchymal abnormalities, liver morphological changes and manifestations of portal hypertension) using a severity scale. The diagnostic imaging impression score was also calculated. Patients were histologically classified into chronic hepatitis (CH; n = 54), liver cirrhosis (LC; n = 71) and pre-cirrhosis (P-LC; n = 17) by three pathologists, independently, who reviewed the resected liver specimens. The results of the three imaging methods were compared to those from histological diagnoses, and a multivariate analysis (stepwise forward logistic regression analysis) was performed to identify independent predictive signs of cirrhosis. The diagnostic efficacies for LC and early cirrhosis were also compared among CT, MRI and US using a receiver-operating characteristic (ROC) curve analysis. RESULTS: The differences in the five imaging parameters evaluated by CT, MRI and US between LC and CH were statistically significant (p < 0.001) except for the manifestations of portal hypertension on US. Irregular or nodular surface, blunt edge or morphological changes in the liver were selected as the best predictive signs for cirrhosis on US whereas liver parenchymal abnormalities, manifestations of portal hypertension and morphological changes in the liver were the best predictive signs on MRI and CT by multivariate analysis. The predictive diagnostic accuracy, sensitivity and specificity in discriminating LC from CH based on the best predictive signs were 71.9, 77.1 and 67.6% by CT; 67.9, 67.5 and 68.3% by MRI, and 66.0, 38.4 (lower than CT and MRI, p =0.001) and 88.8% (higher than CT and MRI, p =0.001)by US. According to the imaging impression scoring system, diagnostic accuracy, sensitivity and specificity were 67.0, 84.3 and 52.9% by CT; 70.3, 86.7 and 53.9% by MRI, and 64.0, 52.4 (lower than CT and MRI, p =0.0001) and 73.5% (higher than CT and MRI, p < 0.003) by US. ROC analysis showed that MRI and CT were slightly superior to US in the diagnosis of LC but no statistically significant difference was found between them. For the pathological diagnosis of P-LC, cirrhosis was diagnosed in 59.5, 46.7 and 41.7% of the P-LC cases by US, CT and MRI, respectively, with no significant difference among these methods. CONCLUSION: US, CT and MRI had different independent predictive signs for the diagnosis of LC. MRI and CT were slightly superior to US in predicting cirrhosis, especially regarding sensitivity. Noninvasive imaging techniques play an important role in the diagnosis of cirrhosis, especially in the evaluation of P-LC.

14 Article Portalsystemic hemodynamic changes in chronic severe hepatitis B: An ultrasonographic study. 2008

Su, Zhong-Zhen / Shan, Hong / Ke, Wei-Min / He, Bing-Jun / Zheng, Rong-Qin. ·Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China. sp9313@126.com ·World J Gastroenterol · Pubmed #18205274.

ABSTRACT: AIM: To evaluate portalsystemic hemodynamic changes in chronic severe hepatitis B. METHODS: Hemodynamic parameters included portal vein diameter (PVD), portal vein peak velocity (PVPV), portal vein volume (PVV), spleen length (SPL), spleen vein diameter (SPVD), spleen vein volume (SPVV) and umbilical vein recanalization. They were measured by Color Doppler ultrasonography in 36 patients with chronic severe hepatitis B, compared with 51 normal controls, 61 patients with chronic hepatitis B, 46 patients with compensable cirrhosis, and 36 patients with decompensable cirrhosis. RESULTS: In the group of chronic severe hepatitis B, PVD (12.38 +/- 1.23 mm) was significantly different from the normal control, compensable cirrhosis and decompensable cirrhosis groups (P = 0.000-0.026), but not significantly different from the chronic hepatitis group. PVPV (16.15 +/- 3.82 cm/s) dropped more significantly in the chronic severe hepatitis B group than the normal control, chronic hepatitis B and compensable cirrhosis groups (P = 0.000-0.011). PVV (667.53 +/- 192.83 mL/min) dropped significantly as compared with the four comparison groups (P = 0.000-0.004). SPL (120.42 +/- 18.36 mm) and SPVD (7.52 +/- 1.52 mm) were longer in the normal control and chronic hepatitis B groups (P = 0.000-0.009), yet they were significantly shorter than those in the decompensable cirrhosis group (P = 0.000). SPVV (242.51 +/- 137.70 mL/min) was also lower than the decompensable cirrhosis group (P = 0.000). The umbilical vein recanalization rate (75%) was higher than the chronic hepatitis B and compensable cirrhosis groups. In the course of progression from chronic hepatitis to decompensable cirrhosis, PVD, SPL and SPVD gradually increased and showed significant differences between every two groups (P = 0.000-0.002). CONCLUSION: Patients with chronic severe hepatitis B have a tendency to develop acute portal hypertension, resulting in significantly reduced portal vein perfusion. Observation of the portalsystemic hemodynamic changes may be contributed to the disease progression of chronic liver disease.