397 INDIVIDUAL PATIENT DATA META-ANALYSIS OF TRANSIENT ELASTOGRAPHY DIAGNOSTIC ACCURACY IN LIVER FIBROSIS ASSESSMENT OF CHRONIC HEPATITIS C PATIENTS (TE IPD STUDY)
Élodie PambrunVincent BouteloupVictor de LédinghenJulien AsselineauMirella FraquelliMaurizia Rossana BrunettoXavier FornsHidetsugu SaitoPierre NahonMario PirisiRaphaële ThiébautPatricio Pérez
2
Citation
0
Reference
10
Related Paper
Citation Trend
Keywords:
Transient elastography
Transient elastography
Cite
Citations (0)
Transient elastography
Cite
Citations (0)
Transient elastography (FibroScan, [TE]) and serum fibrosis markers such as the FibroTest (FT) are established methods for the noninvasive staging of liver fibrosis. A study using real-time elastography (HI-RTE), which is integrated in a conventional ultrasound system, was recently published with comparable results to transient elastography. The aim of the present study was to validate real-time elastography using the formulas calculated in previous studies and to compare the results to transient elastography and FibroTest for the noninvasive assessment of liver fibrosis.One hundred and thirty-four patients with chronic liver disease and either histological assessment of liver fibrosis (n = 112) or proven liver cirrhosis (n = 22) were included in the study. All patients received TE, HI-RTE, and biochemical evaluation on the same day as presentation. The calculation of the elasticity score of real-time elastography was performed in accordance with the two previously published studies.The Spearman correlation coefficient between transient elastography, real-time elastography and FibroTest with the histological Chevallier score was statistically significant with 0.78, 0.34, and 0.67, respectively (p < 0.01). The diagnostic accuracy expressed as areas under ROC curves was 0.84, 0.69 and 0.85 for the diagnosis of significant fibrosis (F > or = 2), and 0.97, 0.65, and 0.83 for the diagnosis of cirrhosis, respectively.Real-time elastography in its present form cannot replace transient elastography for noninvasive assessment of liver fibrosis.
Transient elastography
Hepatic fibrosis
Chronic liver disease
Cite
Citations (73)
Transient elastography
Cite
Citations (4)
Transient elastography
Transient (computer programming)
Cite
Citations (1)
Background Transient elastography and acoustic radiation force impulse (ARFI) imaging are noninvasive tools for liver stiffness measurement (LSM), which may be influenced by cholestasis. Aim The aim of the study was to evaluate the performance of transient elastography and ARFI in extrahepatic cholestasis and correlate changes in LSM with biochemical activity. Materials and methods A total of 38 patients with extrahepatic cholestasis prospectively underwent transient elastography and ARFI. Changes in LSM by transient elastography/ARFI were evaluated after 1 week of ERCP and correlated with biochemical parameters. The optimal ARFI cutoffs according to stages of clinical interest were analyzed. Results Biliary obstruction was calcular in 21 (55.3%) and noncalcular in 17 (44.7%) (benign n = 15, malignant n = 2). After 1 week, adequate biliary drainage reduced total bilirubin from 7.7 to 2.2 mg/dL ( P < 0.001) which significantly correlated with reduction of LSM by transient elastography from 12.38 ± 6.68 kPa to 8.08 ± 3.21 kPa ( P < 0.001), and by ARFI from 1.73 ± 0.51 m/s to 1.56 ± 0.70 m/s ( P = 0.014). The LSM percentage change showed a decrease (nonsignificant, P = 0.843) by 25.83% using transient elastography and a significant decrease ( P < 0.001) by 18.42% using ARFI in the improved patients. At initial visit, transient elastography positively correlated with ARFI, bilirubin and platelets, also, transient elastography had a positive correlation with ARFI, bilirubin, alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT) in follow-up visit. LSM by ARFI (visit 1) negatively correlated with ALT, while in (visit 2), ARFI positively correlated with bilirubin, ALP, GGT and negatively correlated with albumin. Conclusion The increased LSM in patients with extrahepatic cholestasis is reduced after adequate biliary drainage, implying that increased values are not solely due to liver fibrosis, but due to biliary congestion leading temporarily to increased elasticity.
Transient elastography
Acoustic Radiation Force
Cite
Citations (5)
Accurate assessment of the degree of liver fibrosis is important for estimating prognosis and deciding on an appropriate course of treatment for cases of chronic liver disease (CLD) with various etiologies. Because of the inherent limitations of liver biopsy, there is a great need for non-invasive and reliable tests that accurately estimate the degree of liver fibrosis. Ultrasound (US) elastography is considered a non-invasive, convenient, and precise technique to grade the degree of liver fibrosis by measuring liver stiffness. There are several commercial types of US elastography currently in use, namely, transient elastography, acoustic radiation force impulse imaging, supersonic shear-wave imaging, and real-time tissue elastography. Although the low reproducibility of measurements derived from operator-dependent performance remains a significant limitation of US elastography, this technique is nevertheless useful for diagnosing hepatic fibrosis in patients with CLD. Likewise, US elastography may also be used as a convenient surveillance method that can be performed by physicians at the patients' bedside to enable the estimation of the prognosis of patients with fatal complications related to CLD in a non-invasive manner.
Transient elastography
Chronic liver disease
Hepatic fibrosis
Ultrasound Elastography
Liver disease
Cite
Citations (117)
This chapter contains sections titled: Introduction Transient elastography: principle and interpretation Diagnostic performance of transient elastography for the extent of fibrosis Diagnostic performance of transient elastography for portal hypertension Limitations of transient elastography Conclusions and perspectives References
Transient elastography
Transient (computer programming)
Cite
Citations (4)
Transient elastography
Antiviral Treatment
Cite
Citations (0)
Transient elastography
Hepatic fibrosis
Hepatitis B
Cite
Citations (0)