Assessment of liver fibrosis with liver and spleen stiffness measured by sound touch elastography, serum fibrosis markers in patients with chronic hepatitis B.

OBJECTIVES To compare the performance of liver stiffness (LS) and spleen stiffness (SS) determined with sound touch elastography (STE), splenic index, aspartate transaminase-to-platelet ratio index (APRI), fibrosis-4 index (FIB-4), King's score, and their combined models for diagnosing fibrosis in chronic hepatitis B (CHB). METHODS One hundred patients with CHB underwent STE measurements and serological tests. LS and SS values were measured with STE technique, and splenic index was calculated. Pathologic stages were determined using liver biopsy. Correlations between the 6 individual parameters and fibrosis stage were evaluated with Spearman correlation analysis. The receiver operating characteristic (ROC) curve was used to analyze the performance of all methods for predicting fibrosis. RESULTS Among the 6 individual parameters, LS showed the highest values for diagnosing ≥S2, ≥S3, and S4 stages (AUROC: 0.70, 0.86, and 0.96, respectively; all, P  0.05). CONCLUSIONS Liver STE is reliable for diagnosing fibrosis in CHB with better performance than that of SS, splenic index and three serum markers. Two combined models did not significantly improve the diagnostic performance than LS for staging fibrosis.