Palm-Sized Wireless Transient Elastography System with Real-Time B-Mode Ultrasound Imaging Guidance: Toward Point-of-Care Liver Fibrosis Assessment

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Very good and interesting paper! The issues:
1. The term NAFLD was replaced by MASLD in 2023 (Rinella); use this term.
2. The conclusions are rather lenghty; two or three sentences should suffice. 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Zi-Hao Huang with coauthors wrote an article to introduce Liverscan® and compare its results to other well-known liver elastography assessing devices.

The importance of this study is high as the Authors point out some disadvantages of classical transient elastography (TE) and present a device that fills the missing gap in TE.

From a technical point of view, this manuscript is written clearly, and the paragraphs are consistent with their titles. I noticed the size of the full text while viewing it for the first time. The text is very vast. When I had read it all, I understood that the Authors wished to explain every step of their work, from preparations to tests on patients.

Every issue I was wondering about while reading was explained in the text, thus I have nothing to point out to correct or add.

The topic was also interesting for me because I am currently in a group of physicians that compares similar device as the Authors. It is not laptop/tablet size, it is wired, but also combines elastography with B-mode ultrasound allowing it to find a place in the liver free of blood vessels or large bile ducts. Therefore, I am aware of how the B-mode ultrasound can improve the examination. After collecting a little over 100 examinations with Fibroscan® and the tested device, we have analyzed the results achieved by these two devices and – I am writing it with a little dose of astonishment – we got very similar results with a bit higher elasticity in tested device against the Fibroscan® which was also around of 0.8 kPa. I do not know what the beam width is in the tested device thus I cannot tell you that this is the reason for this observation. Nevertheless, both the Authors and our study team got the same differences between Fibroscan® and the tested device.

Good luck, I will look forward to the next studies, especially in setting the elasticity thresholds for different stages of fibrosis in the METAVIR scale.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf