Evaluating the Diagnostic Performance of Sound Touch Elastography, Visco-elastography, and Sound Attenuation in Chronic Liver Diseases Detection

doi:10.26599/AUDT.2026.250108

Abstract

Abstract:

Objectives This study aims to explore the diagnostic effectiveness of sound touch elastography (STE), visco-elastography, and ultrasound attenuation analysis (USAT) in some chronic liver diseases (CLDs).
Materials and Methods From February 1st to September 30th, 2023, participants underwent multiple examinations on the same day, including sound touch elastography (STE), visco-elastography, ultrasound attenuation analysis (USAT), FibroScan-VCTE, and FibroScan-CAP. Statistical analysis utilized t-tests and rank sum tests to compare differences between the hepatic fibrosis and non-hepatic fibrosis groups, the hepatocellular injury state and non-hepatocellular injury state groups, and the fatty liver and non-fatty liver groups. The ROC curve of sound touch elastography, visco-elastography, and ultrasound attenuation analysis was calculated to obtain cut-off values, area under the curve, and corresponding sensitivity and specificity values.
Results This study comprised 310 patients, with age, height, alanine aminotransferase, ultrasound attenuation analysis, and FibroScan-CAP identified as significant variables for liver fibrosis, hepatocellular injury state, and non-alcoholic fatty liver disease. The determined cut-off values for sound touch elastography, visco-elastography, and ultrasound attenuation analysis were 8.09 (7.30-9.17), 1.62 (1.49-1.74), and 0.68 (0.59-0.68), respectively. Based on these cut-off values, preliminary diagnoses can be made for seven different types of chronic liver diseases.
Conclusion The combination of sound touch elastography, visco-elastography, and ultrasound attenuation analysis demonstrates strong reliability for early screening and diagnosis of chronic liver diseases, encompassing liver fibrosis, non-alcoholic fatty liver, and hepatocellular injury state.

Key words: Ultrasonography; Liver diseases; Chronic hepatocellular injury state; Viscoelasticity

Mo Sijie, Ding Zhimin, Huang Zhibin, Wang Mengyun, Xu Jinfeng, Zhang Hongan, Dong Fajin. Evaluating the Diagnostic Performance of Sound Touch Elastography, Visco-elastography, and Sound Attenuation in Chronic Liver Diseases Detection. Advanced Ultrasound in Diagnosis and Therapy, 2026, 10(2): 112-122.

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Variables	Total (n = 310)	Non Fibrosis (n = 225)	Fibrosis (n = 85)	P value
Except where indicated, data are medians, with IQRs in parentheses. HBV, hepatitis B virus; HCV, hepatitis C virus; ALT, alanine aminotransferase; STE, sound touch elastography; USAT, ultrasound attenuation analysis; CAP, controlled attenuation parameter; VCTE, vibration-controlled transient elastography; ^a Disordered classification variables are shown by percentage; ^b Normally distributed numerical variables are shown by mean ± standard deviation; ^c Non-normally distributed numerical variables are shown by median (first quartile, third quantile).
Age ^c	42.5 (34.25, 52)	44 (36, 53)	38 (32, 49)	< 0.01
Sex ^a				0.02
F	103 (33)	84 (37)	19 (22)
M	207 (67)	141 (63)	66 (78)
Height ^c (cm)	168 (160, 172.75)	166 (160, 171)	171 (165, 175)	< 0.01
Weight ^c (Kg)	65.5 (58.62, 75)	64 (58, 72.5)	72 (62.5, 80)	< 0.01
HCV patient ^a	30 (10)	21 (9)	9 (11)	0.91
HBV patient ^a	143 (46)	109 (48)	34 (40)	0.23
ALT ^c (U/L)	27 (19, 43.75)	22 (17, 28)	69 (52, 117)	< 0.01
STE ^c (kPa)	7.47 (6.52, 9)	7.23 (6.38, 8.47)	8.63 (7.12, 11.05)	< 0.01
Visco-elastography ^c (Pa·s)	1.6 (1.42, 1.84)	1.53 (1.31, 1.72)	1.85 (1.68, 2.13)	< 0.01
USAT ^c (dB/cm/MHz)	0.62 (0.52, 0.73)	0.6 (0.52, 0.71)	0.68 (0.54, 0.86)	< 0.01
FibroScan-CAP ^b (dB/m)	241.59 ± 58.43	235.96 ± 53.68	256.49 ± 67.55	< 0.01
FibroScan-VCTE ^c (kPa)	5.4 (4.3, 7.38)	5.1 (4.2, 6.85)	6.5 (5, 9.7)	< 0.01

	Cut-off (95%Cl)	AUC (95%Cl)	Specificity (%)	Sensitivity (%)	Accuracy (%)
CI: confidence interval; STE, sound touch elastography; USAT, ultrasound attenuation analysis.
STE mean	8.09 (7.30-9.17)	0.82 (0.76-0.87)	76.42	74.07	75.81
Visco-E mean	1.62 (1.48-1.74)	0.81 (0.76-0.86)	63.56	83.53	69.03
USAT mean	0.68 (0.58-0.68)	0.82 (0.77-0.87)	90.14	58.93	73.23