Shear Wave Velocity of 1.03 m/s: Clinical Interpretation
A shear wave velocity (SWV) of 1.03 m/s indicates minimal to no liver fibrosis and effectively rules out compensated advanced chronic liver disease (cACLD) in patients with suspected liver disease. 1
Understanding the Value
- SWV of 1.03 m/s falls well below established thresholds for significant fibrosis, which typically begin at 1.22-1.37 m/s depending on the underlying etiology 1
- This value is within the normal range (0.5-4.4 m/s measurement range for point SWE), indicating minimal liver stiffness 1
- The Korean Association for the Study of the Liver (KASL) 2024 guidelines emphasize that SWE provides quantitative assessment of liver fibrosis while allowing visualization of liver anatomy 1
Fibrosis Stage Interpretation
Based on established cutoff values from multiple guidelines:
- For significant fibrosis (≥F2): Cutoffs range from 1.22-1.37 m/s 1
- For cirrhosis (F4): Cutoffs range from 1.73-2.11 m/s 1
- Your value of 1.03 m/s is substantially below these thresholds, making significant fibrosis or cirrhosis highly unlikely 1
Clinical Implications by Disease Etiology
Chronic Hepatitis C
- Meta-analyses show sensitivity of 69% and specificity of 80% for significant fibrosis at cutoffs of 1.34-1.35 m/s 1
- A value of 1.03 m/s has high negative predictive value for excluding significant disease 1
Chronic Hepatitis B
- 2D-SWE studies demonstrate cutoffs of 7.1 kPa (approximately 1.54 m/s) for significant fibrosis 1
- Your value suggests minimal fibrosis risk 1
NAFLD
- Studies show cutoffs ranging from 1.24 m/s for significant fibrosis 1
- SWV of 1.03 m/s indicates low probability of advanced steatohepatitis with fibrosis 1
Quality Control Considerations
Ensure measurement reliability by verifying:
- IQR/M (interquartile range/median) should be <15% when reported in m/s to ensure valid staging 1
- Measurements should be taken at 1.5-2 cm depth below liver capsule to avoid reverberation artifacts 1
- Patient should have fasted at least 4 hours before testing, as postprandial blood flow can falsely elevate values 1
- Repeat measurements 5-10 times and use the median value for reliability 1
Factors That Could Falsely Elevate SWE Values
Be aware that SWE results may be overestimated in:
- Intrahepatic inflammation (acute hepatitis flares) 1
- Cholestasis (biliary obstruction) 1
- Right heart failure leading to hepatic congestion 1
- Amyloidosis 1
- Recent food intake (within 4 hours) 1
Since your value is low (1.03 m/s), these confounding factors are not relevant in this case, but they become critical when interpreting elevated values 1
Recommended Clinical Action
For a patient with SWV of 1.03 m/s:
- No immediate need for liver biopsy based on elastography findings alone 1
- Continue monitoring underlying liver disease with appropriate disease-specific management 1
- Repeat elastography annually or as clinically indicated to monitor for progression 1
- Investigate and treat the underlying cause of liver disease (viral hepatitis, metabolic syndrome, alcohol use) rather than focusing on fibrosis staging 1
Comparison to Other Non-Invasive Tests
The EASL 2021 guidelines note that:
- Point SWE and 2D-SWE have AUROCs >0.90 for diagnosing cACLD (typically defined as LSM >10-15 kPa or approximately 1.8-2.2 m/s) 1
- Your value of 1.03 m/s provides strong evidence against cACLD 1
- Transient elastography cutoffs of <10 kPa (approximately 1.8 m/s) combined with platelet count >150 G/L effectively rule out high-risk varices (Baveno VI criteria) 1
Important Caveats
Remember that:
- Optimal cutoff values vary by disease etiology and have not been universally standardized 1
- The range of SWE measurements for each fibrosis stage is relatively wide, and differences between successive stages can be small 1
- Inter-system variability exists between different elastography devices, so values and cutoffs are not directly comparable across platforms 1
- Clinical context, laboratory values, and imaging findings should always be integrated with elastography results 1