*Noninvasive Assessment of HCV Patients Using Ultrasound Elastography DOI: http://dx.doi.org/10.5772/intechopen.102294*

**81**

*Performance of 2D-SWE for detecting different stages of fibrosis in patients with CHC.*

**Table 4.**

*3These studies used VCTE as reference standard for fibrosis evaluation.*

*4The Baldea study offered result two 2D-SWE techniques: General Electric and SuperSonic Imagine, respectively.*

lacking post-SVR LB [6, 89, 90]. A recent prospective longitudinal study by Knop et al. [91] sought to elucidate the dynamics of liver and spleen stiffness in cirrhotic patients through VCTE and p-SWE, 3 years post-treatment. Even if their analysis showed that LS decreases in a significant proportion of patients with CHC, spleen stiffness, a non-invasive marker for portal hypertension, remained unchanged. Similarly, other research found lower LS values by p-SWE (VTTQ ) in HCV-infected patients who achieved SVR [92, 93].

In addition, the diagnostic accuracy of VCTE for SVR prediction remains controversial, since the improvement of LS post-DAA treatment may be overrated by elastography in contrast with histological staging [94]. In fact, a recent prospective multicenter study comprising of 746 HCV-infected patients with CHC with SVR evaluated 3 years post-DAA therapy, discovered cirrhosis by LB in more than half of cACLD patients, in spite of normal VCTE values or liver function parameters. Due to its poor diagnostic accuracy (AUROC = 0.75), VCTE turned out to be an unreliable method for the accurate identification of the fibrosis stage in HCV-infected patients who acquired SVR [95].

Latest EASL guidelines conclude that neither noninvasive elastographic techniques are appropriate enough to detect fibrosis regression after SVR in CHC patients. Additionally, cut-off values of LS by VCTE used in untreated HCV patients should not be utilized for liver fibrosis staging after SVR. Therefore, the appraisal of liver disease severity and prognosis remains an unmet need in this field, requiring larger cohort sizes and extended follow-up in order to establish the role of noninvasive techniques in treating HCV-infected patients [6].
