**6. Appraisal of liver fibrosis by 2D shear wave elastography in HCV-infected patients**

2D shear wave elastography, a novel US-based technique, allows the estimation of tissue dynamics using focused ultrasonic beams in a certain ROI. This technique has the advantage of displaying a real-time color-coded map overlayed on a B-mode image. Furthermore, 2D-SWE estimates LS expressed in kPa or m/s [28, 77]. It should be executed in a well-visualized area of the right hepatic lobe, clear of large vessels, ligaments, gallbladder, and the liver capsule, with the patient situated in a supine position with breathing suspension [15].

As exemplified in **Table 4**, several studies reported the diagnostic accuracy of 2D-SWE for fibrosis assessment among HCV-infected patients [76, 78–86, 88]. In 2017, Herrmann et al. [81] performed a meta-analysis including 13 studies, gathering 379 patients with CHC, that evaluated the diagnostic performance of 2D-SWE for the noninvasive staging of liver fibrosis. They found AUROC values of 0.863, 0.915, and 0.929 for diagnosing significant fibrosis, severe fibrosis, and cirrhosis, respectively. In our analysis, the AUROC values range from 0.82 to 0.888 for ≥ F1, 0.783 to 0.97 for ≥ F2, 0.877 to 0.97 for ≥ F3 and 0.893 to 0.98 for ≥ F4, respectively (**Table 4**).
