Liver stiffness in nonalcoholic fatty liver disease: A comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy
Top Cited Papers
- 22 January 2016
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Hepatology
- Vol. 63 (6), 1817-1827
- https://doi.org/10.1002/hep.28394
Abstract
Non-alcoholic fatty liver disease (NAFLD) has become a major public health issue. The aim was to assess the clinical utility of liver stiffness measurement (LSM) evaluated by Supersonic Shear Imaging (SSI), FibroScan, and ARFI in a cohort of NAFLD patients who underwent liver biopsy. A total of 291 NAFLD patients were prospectively enrolled from November 2011 to February 2015 at 2 French university hospitals. LSM was assessed by SSI, FibroScan (M probe), and ARFI within two weeks prior to liver biopsy. Calculations of the area under the receiver operating curve (AUROC) were performed and compared for the staging of liver fibrosis. AUROC for SSI, FibroScan, and ARFI were 0.86, 0.82, and 0.77 for diagnoses of ≥F2; 0.89, 0.86, and 0.84 for ≥F3; and 0.88, 0.87, and 0.84 for F4, respectively. SSI had a higher accuracy than ARFI for diagnoses of significant fibrosis (≥F2) (p=0.004). Clinical factors related to obesity such as body mass index ≥30kg/m2, waist circumference ≥102cm or increased parietal wall thickness were associated with LSM failures when using SSI or FibroScan and with unreliable results when using ARFI. In univariate analysis, FibroScan values were slightly correlated with NAFLD activity score and steatosis (R=0.28 and 0.22, respectively), whereas SSI and ARFI were not; however, these components of NAFLD didn't affect LSM results in multivariate analysis. The cut-off values for SSI and FibroScan for staging fibrosis with a sensitivity ≥90% were very close: 6.3/6.2 kPa for ≥F2, 8.3/8.2 kPa for ≥F3, and 10.5/9.5 kPa for F4. Conclusion: Although obesity is associated with an increase in LSM failure, the studied techniques and especially SSI provide high value for the diagnosis of liver fibrosis in NAFLD patients.This publication has 28 references indexed in Scilit:
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