{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T20:11:43Z","timestamp":1787602303377,"version":"build-2736575974"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the diagnostic accuracy of a novel approach that combines noninvasive indicators with two-dimensional shear wave elastography (2D SWE) to assess liver fibrosis stages in patients with chronic hepatitis B (CHB), using the Scheuer score as the reference standard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and materials<\/jats:title>\n                    <jats:p>2D SWE and serum indicators are commonly used for the noninvasive assessment of liver fibrosis. A total of 102 patients with CHB underwent 2D SWE measurements and serum tests for liver fibrosis markers. Standardized protocols were followed for all diagnostic procedures to ensure reproducibility and consistency. Binary logistic regression was used to generate a combined predictive probability value. Receiver operating characteristic (ROC) curves were used to evaluate the efficacy of the noninvasive diagnosis of liver fibrosis stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Combining multiple serum indicators increased the AUC for diagnosing substantial liver fibrosis from 0.735 (0.650\u20130.810) to 0.825 (0.746\u20130.888) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.016), for severe liver fibrosis from 0.815 (0.730\u20130.881) to 0.881 (0.810\u20130.932) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.024), and for cirrhosis from 0.904 (0.823\u20130.923) to 0.954 (0.900\u20130.984) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.013). The AUC for diagnosing substantial liver fibrosis increased from 0.805 (0.725\u20130.858) to 0.889 (0.820\u20130.939) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.040) with the combined serum indicators and 2D SWE, indicating a clinically meaningful improvement in diagnostic accuracy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combination of multiple noninvasive indicators can improve the accuracy of assessing liver fibrosis stages in patients with CHB. This approach offers a potential noninvasive alternative to liver biopsy for assessing liver fibrosis, particularly in advanced stages that require clinical intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1709007","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:18:07Z","timestamp":1768205887000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Non-invasive assessment of liver fibrosis staging in chronic hepatitis B patients: combining two-dimensional shear wave elastography with serum indicators"],"prefix":"10.3389","volume":"12","author":[{"given":"Yaoren","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinyun","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Gan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxue","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e278","DOI":"10.1016\/S2214-109X(21)00517-9","article-title":"Cost-effectiveness of universal screening for chronic hepatitis B virus infection in China: an economic evaluation","volume":"10","author":"Su","year":"2022","journal-title":"Lancet Glob Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"230","DOI":"10.2471\/BLT.18.219469","article-title":"Countdown to 2030: eliminating hepatitis B disease, China","volume":"97","author":"Liu","year":"2019","journal-title":"Bull World Health Organ"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.jhep.2017.03.021","article-title":"EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection","volume":"67","year":"2017","journal-title":"J Hepatol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1002\/cld.728","article-title":"Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance","volume":"12","author":"Terrault","year":"2018","journal-title":"Clin Liver Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1056\/NEJM200102153440706","article-title":"Liver biopsy","volume":"344","author":"Bravo","year":"2001","journal-title":"N Engl J Med"},{"key":"ref6","first-page":"1621","article-title":"Complications and risk factors of a large series of percutaneous liver biopsies in patients with liver transplantation or liver disease","volume":"19","author":"Filingeri","year":"2015","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1002\/hep.20535","article-title":"Sources of variability in histological scoring of chronic viral hepatitis","volume":"41","author":"Rousselet","year":"2005","journal-title":"Hepatology"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"S57","DOI":"10.1053\/jhep.2002.36800","article-title":"Noninvasive monitoring of patients with chronic hepatitis C","volume":"36","author":"Fontana","year":"2002","journal-title":"Hepatology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1344","DOI":"10.1373\/clinchem.2004.032227","article-title":"Prospective analysis of discordant results between biochemical markers and biopsy in patients with chronic hepatitis C","volume":"50","author":"Poynard","year":"2004","journal-title":"Clin Chem"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1056\/NEJMra1610570","article-title":"Use of liver imaging and biopsy in clinical practice","volume":"377","author":"Tapper","year":"2017","journal-title":"N Engl J Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2037","DOI":"10.1007\/s00261-017-1211-7","article-title":"Evaluation of hepatic fibrosis: a review from the society of abdominal radiology disease focus panel","volume":"42","author":"Horowitz","year":"2017","journal-title":"Abdom Radiol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1053\/jhep.2003.50346","article-title":"A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C","volume":"38","author":"Wai","year":"2003","journal-title":"Hepatology"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1002\/hep.21669","article-title":"FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. 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