Table 3.
Intrastrategy and interstrategy comparisons of DLRE and 2D-SWE for their relationship of diagnostic accuracy versus the number of image/measurement acquisitions in assessing liver fibrosis stages in training and validation cohorts
| n (P) | AUC | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | LR+ | LR− | ||
| Cirrhosis (F4) | |||||||||
| DLRE | |||||||||
| 1 image | T | 266 (24.8%) | 0.94** (0.91 to 0.97) |
95.5 (94.2 to 96.8) |
84.5 (79.6 to 89.4) |
67.0 (60.4 to 73.8) |
98.3 (96.1 to 99.6) |
6.2 (5.8 to 6.4) |
0.1 (0.0 to 0.1) |
| V | 132 (24.2%) | 0.84*** (0.81 to 0.87) |
75.0 (72.6 to 77.4) |
82.0 (77.3 to 86.7) |
57.1 (50.4 to 63.4) |
91.1 (85.4 to 97.2) |
4.2 (3.9 to 4.3) |
0.3 (0.3 to 0.4) |
|
| 3 images | T | 266 (24.8%) | 1.00 (0.98 to 1.00) |
100.0 (98.0 to 100.0) |
100.0 (98.0 to 100.0) |
100.0 (99.0 to 100.0) |
100.0 (99.0 to 100.0) |
– | 0.0 (0.0 to 0.0) |
| V | 132 (24.2%) | 0.96 (0.93 to 0.98) |
84.4 (76.9 to 91.9) |
95.0 (91.2 to 98.7) |
84.4 (78.5 to 90.1) |
95.0 (90.1 to 98.9) |
16.9 (14.9 to 18.6) |
0.2 (0.1 to 0.2) |
|
| 5 images | T | 266 (24.8%) | 1.00 (0.99 to 1.00) |
100.0 (98.0 to 100.0) |
100.0 (98.0 to 100.0) |
100.0 (99.0 to 100.0) |
100.0 (99.0 to 100.0) |
– | 0.0 (0.0 to 0.0) |
| V | 132 (24.2%) | 0.97 (0.94 to 0.99) |
96.9 (94.7 to 99.1) |
88.0 (82.8 to 92.2) |
72.1 (65.8 to 79.1) |
98.9 (94.8 to 99.7) |
8.1 (7.9 to 8.3) |
0.0 (0.0 to 0.1) |
|
| 2D-SWE | |||||||||
| 1 measurement | T | 266 (24.8%) | 0.87****** (0.83 to 0.91) |
84.9 (73.9 to 92.5) |
75.5 (68.9 to 81.3) |
53.3 (43.3 to 63.1) |
93.8 (88.9 to 97.0) |
3.5 (3.0 to 3.9) |
0.2 (0.1 to 0.4) |
| V | 132 (24.2%) | 0.86 (0.78 to 0.91) |
93.8 (79.2 to 99.2) |
74.0 (64.3 to 82.3) |
53.6 (39.7 to 67.0) |
97.4 (90.8 to 99.7) |
3.6 (3.1 to 4.2) |
0.1 (0.0 to 0.3) |
|
| 3 measurements | T | 266 (24.8%) | 0.88****** (0.83 to 0.92) |
86.4 (75.7 to 93.6) |
74.5 (67.9 to 80.4) |
52.8 (42.9 to 62.5) |
94.3 (89.5 to 97.4) |
3.4 (3.0 to 3.8) |
0.2 (0.1 to 0.4) |
| V | 132 (24.2%) | 0.85***** (0.78 to 0.91) |
87.5 (71.0 to 96.5) |
76.0 (66.4 to 84.0) |
53.8 (39.5 to 67.8) |
95.0 (87.7 to 98.6) |
3.7 (3.1 to 4.3) |
0.2 (0.1 to 0.4) |
|
| 5 measurements | T | 266 (24.8%) | 0.87****** (0.83 to 0.91) |
80.3 (68.7 to 89.1) |
79.0 (72.7 to 84.4) |
55.8 (45.2 to 66.0) |
92.4 (87.4 to 95.9) |
3.8 (3.3 to 4.4) |
0.3 (0.1 to 0.4) |
| V | 132 (24.2%) | 0.86***** (0.79 to 0.92) |
87.5 (71.0 to 96.5) |
76.0 (66.4 to 84.0) |
53.8 (39.5 to 67.8) |
95.0 (87.7 to 98.6) |
3.7 (3.1 to 4.3) |
0.2 (0.1 to 0.4) |
|
| Advanced fibrosis (≥F3) | |||||||||
| DLRE | |||||||||
| 1 image | T | 266 (83.8%) | 0.91* (0.86 to 0.95) |
86.8 (81.2 to 92.4) |
81.7 (76.4 to 87.1) |
86.2 (80.6 to 91.5) |
82.5 (77.1 to 87.5) |
4.8 (4.2 to 5.3) |
0.2 (0.1 to 0.2) |
| V | 132 (83.3%) | 0.82** (0.75 to 0.89) |
75.3 (70.3 to 80.3) |
79.7 (71.4 to 87.7) |
82.1 (77.0 to 87.6) |
72.3 (67.1 to 77.9) |
3.7 (3.5 to 3.9) |
0.3 (0.3 to 0.3) |
|
| 3 images | T | 266 (83.8%) | 0.96 (0.92 to 0.99) |
90.1 (86.8 to 93.4) |
88.7 (82.3 to 95.1) |
91.3 (83.8 to 97.3) |
81.2 (74.8 to 87.6) |
8.0 (7.7 to 8.2) |
0.1 (0.1 to 0.1) |
| V | 132 (83.3%) | 0.95 (0.91 to 0.98) |
94.5 (90.8 to 98.2) |
86.4 (81.2 to 91.6) |
89.6 (82.5 to 95.6) |
92.7 (87.5 to 96.8) |
7.0 (6.5 to 7.4) |
0.1 (0.1 to 0.1) |
|
| 5 images | T | 266 (83.8%) | 0.99 (0.97 to 1.00) |
97.4 (93.2 to 99.1) |
95.7 (91.4 to 98.6) |
95.6 (90.2 to 97.8) |
71.9 (63.8 to 78.5) |
22.4 (21.5 to 23.3) |
0.0 (0.0 to 0.0) |
| V | 132 (83.3%) | 0.98 (0.96 to 1.00) |
90.4 (84.2 to 94.6) |
98.3 (95.3 to 99.3) |
98.5 (95.8 to 99.8) |
89.2 (83.5 to 94.5) |
53.3 (51.0 to 55.3) |
0.1 (0.1 to 0.1) |
|
| 2D-SWE | |||||||||
| 1 measurement | T | 266 (83.8%) | 0.81****** (0.75 to 0.82) |
72.2 (64.3 to 79.2) |
75.7 (66.8 to 83.2) |
79.6 (71.8 to 86.0) |
67.4 (58.6 to 75.5) |
3.0 (2.6 to 3.4) |
0.4 (0.2 to 0.6) |
| V | 132 (83.3%) | 0.83 (0.75 to 0.89) |
68.5 (56.6 to 78.9) |
89.8 (79.2 to 96.2) |
89.3 (78.0 to 96.0) |
69.7 (58.1 to 79.8) |
6.7 (5.6 to 8.0) |
0.4 (0.2 to 0.8) |
|
| 3 measurements | T | 266 (83.8%) | 0.81****** (0.75 to 0.85) |
80.79 (73.6 to 86.7) |
68.7 (59.4 to 77.0) |
77.2 (69.9 to 83.5) |
73.1 (63.7 to 81.3) |
2.6 (2.2 to 3.0) |
0.3 (0.2 to 0.4) |
| V | 132 (83.3%) | 0.84***** (0.77 to 0.90) |
78.1 (66.9 to 86.9) |
79.7 (67.2 to 89.0) |
82.6 (71.5 to 90.7) |
74.6 (61.9 to 84.8) |
3.8 (3.2 to 4.6) |
0.3 (0.1 to 0.5) |
|
| 5 measurements | T | 266 (56.8%) | 0.81****** (0.75 to 0.85) |
81.5 (74.3 to 87.3) |
70.4 (61.2 to 78.6) |
78.3 (71.1 to 84.5) |
74.3 (65.0 to 82.2) |
2.8 (2.4 to 3.2) |
0.3 (0.2 to 0.4) |
| V | 132 (55.3%) | 0.85****** (0.78 to 0.90) |
79.5 (68.4 to 88.0) |
78.0 (65.3 to 87.7) |
81.7 (70.6 to 89.9) |
75.4 (62.7 to 85.5) |
3.6 (3.0 to 4.3) |
0.3 (0.1 to 0.5) |
|
| Significance fibrosis (≥F2) | |||||||||
| DLRE | |||||||||
| 1 image | T | 266 (83.8%) | 0.95 (0.93 to 0.97) |
89.7 (83.5 to 95.9) |
93.0 (87.5 to 98.5) |
98.5 (95.7 to 99.7) |
63.5 (58.4 to 68.1) |
12.9 (11.6 to 13.5) |
0.1 (0.1 to 0.1) |
| V | 132 (83.3%) | 0.74 (0.68 to 0.79) |
76.4 (71.3 to 81.5) |
72.7 (68.1 to 77.3) |
93.3 (96.7 to 98.1) |
38.1 (35.5 to 40.5) |
2.8 (2.7 to 2.9) |
0.3 (0.3 to 0.4) |
|
| 3 images | T | 266 (83.8%) | 0.97 (0.94 to 0.99) |
97.8 (92.4 to 99.9) |
95.3 (92.5 to 98.1) |
99.1 (97.2 to 99.9) |
89.1 (83.4 to 94.5) |
21.0 (19.8 to 22.2) |
0.0 (0.0 to 0.0) |
| V | 132 (83.3%) | 0.82 (0.78 to 0.86) |
67.3 (62.6 to 72.1) |
95.5 (91.8 to 99.1) |
98.7 (95.8 to 99.7) |
36.8 (34.8 to 38.4) |
14.8 (13.4 to 16.0) |
0.3 (0.3 to 0.4) |
|
| 5 images | T | 266 (83.8%) | 0.99 (0.97 to 1.00) |
100.0 (99.0 to 100.0) |
97.7 (92.5 to 99.3) |
99.5 (97.8 to 99.9) |
51.2 (48.5 to 53.9) |
43.0 (41.8 to 44.5) |
0.0 (0.0 to 0.0) |
| V | 132 (83.3%) | 0.85 (0.81 to 0.89) |
69.1 (64.3 to 73.5) |
90.9 (83.6 to 96.7) |
97.4 (96.8 to 99.7) |
37.0 (35.8 to 38.1) |
7.6 (6.9 to 8.4) |
0.3 (0.3 to 0.4) |
|
| 2D-SWE | |||||||||
| 1 measurement | T | 266 (83.8%) | 0.72****** (0.66 to 0.77) |
59.2 (52.4 to 65.7) |
79.1 (64.0 to 90.0) |
93.6 (88.2 to 97.0) |
27.2 (19.6 to 35.9) |
2.8 (2.3 to 3.4) |
0.5 (0.3 to 0.9) |
| V | 132 (83.3%) | 0.76 (0.67 to 0.83) |
60.0 (50.2 to 69.2) |
86.4 (65.1 to 97.1) |
95.7 (87.7 to 99.1) |
30.2 (19.2 to 43.0) |
4.4 (3.5 to 5.5) |
0.5 (0.2 to 1.4) |
|
| 3 measurements | T | 266 (83.8%) | 0.74****** (0.68 to 0.79) |
54.3 (47.5 to 60.9) |
83.7 (69.3 to 93.2) |
94.5 (89.0 to 97.8) |
26.1 (19.0 to 34.2) |
3.3 (2.8 to 4.0) |
0.6 (0.3 to 1.1) |
| V | 132 (83.3%) | 0.77 (0.69 to 0.84) |
51.8 (42.1 to 61.4) |
95.5 (77.2 to 99.9) |
98.3 (90.7 to 100.0) |
28.4 (18.5 to 40.1) |
11.4 (9.3 to 14.0) |
0.5 (0.1 to 3.5) |
|
| 5 measurements | T | 266 (83.8%) | 0.74****** (0.68 to 0.79) |
50.7 (43.9 to 57.4) |
88.4 (74.9 to 96.1) |
95.8 (90.4 to 98.6) |
25.7 (18.8 to 33.5) |
4.4 (3.7 to 5.2) |
0.6 (0.2 to 1.3) |
| V | 132 (83.3%) | 0.77 (0.69 to 0.84) |
49.1 (39.4 to 58.8) |
95.5 (77.2 to 99.9) |
98.2 (90.2 to 100.0) |
27.3 (17.7 to 38.7) |
10.8 (8.7 to 13.3) |
0.5 (0.1 to 3.7) |
|
Statistical quantifications were demonstrated with 95% CI, when applicable.
Intrastrategy comparison: for either DLRE or 2D-SWE, AUCs obtained by analysing three images/measurements were compared with these obtained by analysing one and five images/measurements, respectively (*P<0.05; **P<0.01; ***P<0.001).
Interstrategy comparison: for using the same number of images/measurements, AUCs obtained by DLRE were compared with these obtained by 2D-SWE in each liver fibrosis classification, respectively (****P<0.05; *****P<0.01; ******P<0.001).
2D-SWE, two-dimensional shear wave elastography; AUC, area under the receiver operating characteristic curve; DLRE, deep learning Radiomics of elastography; LR+, positive diagnostic likelihood ratio; LR−, negative diagnostic likelihood ratio; n, number of patients; NPV, negative predictive value; P, prevalence; PPV, positive predictive value; T, training cohort; V, validation cohort.