SYSTEMIC sclerosis assessment using transabdominal shear wave elastography demonstrated good discriminatory ability for detecting lower oesophageal involvement, suggesting the technique could complement conventional diagnostic approaches by identifying tissue stiffness associated with early fibrotic change.
Gastrointestinal involvement is common in patients with systemic sclerosis, and fibrosis affecting the distal oesophagus may develop before clear clinical symptoms become apparent. Conventional investigations such as manometry and endoscopy primarily evaluate function or mucosal abnormalities rather than tissue stiffness. Researchers therefore evaluated whether transabdominal shear wave elastography could distinguish lower oesophageal involvement in patients with systemic sclerosis and examined associations with clinical characteristics.
The retrospective case-control study included 37 adults with clinically documented lower oesophageal involvement and 37 matched healthy controls. Participants underwent standardised transabdominal ultrasound and shear wave elastography after fasting. Investigators measured distal oesophageal double wall thickness alongside tissue stiffness values and assessed discriminatory performance using receiver operating characteristic analysis.
Elastography measurements were significantly higher in patients with systemic sclerosis than in healthy controls (1.41±0.31 kPa vs 0.76±0.28 kPa; p<0.001). Diagnostic performance was reported as good, with an area under the curve of 0.796; p<0.001. Using a cut off value of 1.25 kPa, transabdominal shear wave elastography achieved a sensitivity of 78.4% and a specificity of 81.1%.
In contrast, distal oesophageal wall thickness did not differ significantly between the two groups. Researchers also found that higher stiffness values were associated with more advanced capillaroscopic patterns. No significant associations were identified between stiffness measurements and demographic or serological characteristics.
The findings suggested that transabdominal shear wave elastography may detect fibrotic remodelling by quantifying tissue stiffness rather than relying solely on structural measurements. This may allow lower oesophageal involvement to be recognised before more obvious structural or functional abnormalities develop.
The researchers concluded that transabdominal shear wave elastography is a non-invasive and reproducible technique with meaningful discriminatory ability in systemic sclerosis. They suggested it could complement established diagnostic investigations while supporting earlier risk stratification and longitudinal monitoring of lower oesophageal involvement in clinical practice.
Reference
Parlatan C et al. Transabdominal shear-wave elastography for the assessment of esophageal stiffness in systemic sclerosis: a retrospective case-control study. Clin Rheumatol. 2026;DOI:10.1007/s10067-026-08297-3.
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