Shear wave velocity values measured by 2D-shear wave elastography are not different between awake and anesthetized cats without clinically significant hepatic fibrosis

Victoria Van, Nathalie Rademacher, Chin-Chi Liu, Sarah Keeton, Andrea N. Johnston

Background: Hepatic fibrosis is a common consequence of chronic liver injury in cats, and it can be diagnosed by liver biopsy. However, biopsy is invasive and has limitations. 2D-shear wave elastography (2D-SWE) is a noninvasive technique that measures liver stiffness, which reflects the degree of fibrosis.

Study: The objectives of this study were to assess the feasibility of 2D-SWE in awake and anesthetized cats, to compare the shear wave velocity (SWV) measurements between the two states, and to correlate the SWV measurements with histologic fibrosis scores.

Methods: Eleven healthy cats underwent 2D-SWE in both awake and anesthetized states, and liver biopsies were obtained during anesthesia. SWV measurements were compared between states, observers, and anesthetic protocols. Histologic fibrosis was quantified using image analysis software. The correlation between SWV and fibrosis was evaluated using statistical analysis.

Results: The mean SWV was 1.47 m/s in both awake and anesthetized cats, with no significant difference between states. There was moderate agreement between observers. Anesthetic drugs did not affect SWV measurements. The IQR of SWV was lower in anesthetized cats than in awake cats. All cats had clinically insignificant fibrosis, and there was no correlation between SWV and fibrosis.

Limitations: The small sample size, the lack of cats with moderate or severe fibrosis, and the difficulty of obtaining a ROI free of capsule and vessels were the main limitations of this study.

Conclusions: This study established a reference SWV of 1.47 m/s for hepatic stiffness in healthy cats using 2D-SWE. SWV measurements were feasible and reliable in both awake and anesthetized cats, and were not affected by anesthetic drugs. 2D-SWE could not detect mild differences in hepatic fibrosis in cats. Further studies with larger populations and higher grades of fibrosis are needed to validate the use of 2D-SWE for the assessment of hepatic fibrosis in cats.

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