Application of transient elastography in nonalcoholic fatty liver disease

Zhang, Xinrong; Wong, Grace Lai Hung; Wong, Vincent W. S.

doi:10.3350/cmh.2019.0001n

Cited by 91 publications

(84 citation statements)

References 99 publications

(127 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is clear that the NLCSP warrants further improvement. 15,16 Inclusion of these patients should be considered for the first candidate group when expanding the NLCSP. In terms of the target group identification process, none of the three suggestions for improving the surveillance target selection process achieved high agreement rates (Table 2).…”

Section: Discussionmentioning

confidence: 99%

A Survey of Liver Cancer Specialists’ Views on the National Liver Cancer Screening Program in Korea

Sohn¹,

Lee²,

Lee

et al. 2020

J Liver Cancer

View full text Add to dashboard Cite

Background/Aims: To reduce the cancer burden, the Korean government initiated the National Cancer Control Plan including the National Liver Cancer Screening Program (NLCSP). Ultrasonography examinations and α-fetoprotein tests at six-month intervals are currently offered for high-risk individuals. High-risk individuals are identified by reviewing the National Health Insurance Service claims data for medical use for the past two years using International Classification of Diseases Codes for specific liver disease. We surveyed the attitudes and opinions towards the NLCSP to understand the issues surrounding the NLCSP in Korea. Methods: Altogether, 90 Korean Liver Cancer Association members participated in online and offline surveys between November and December 2019. Results: Approximately one-quarter (27%) of the survey participants rated the NLCSP as very contributing and about two-thirds (68%) as contributing to some extent toward reducing hepatocellular carcinoma (HCC)-related deaths in Korea. Most (87.8%) responded that the current process of identifying high-risk individuals needs improvement. Many (78.9%) were concerned that the current process identifies individuals who use medical services and paradoxically misses those who do not. When asked for the foremost priority for improvement, solving 'duplication issues between the NLCSP and private clinic HCC screening practices' was the most commonly selected choice (23.3%). Conclusions: The survey participants positively rated the role of the NLCSP in reducing liver cancer deaths. However, many participants rated the NCLSP as needing improvement in all areas. This survey can be a relevant resource for future health policy decisions regarding the NLCSP in Korea.

show abstract

Section: Discussionmentioning

confidence: 99%

A Survey of Liver Cancer Specialists’ Views on the National Liver Cancer Screening Program in Korea

Sohn¹,

Lee²,

Lee

et al. 2020

J Liver Cancer

View full text Add to dashboard Cite

show abstract

“…CAP and LS measurement were performed on the right lobe of the liver through the intercostal spaces with subjects lying in the dorsal decubitus position with the right arm in maximal abduction by one experienced technician who was blind to the subjects' clinical data 9 . An experienced technician (>10 000 examinations) from each institute who was blinded to the patients’ clinical data performed all LS and CAP measurements.…”

Section: Methodsmentioning

confidence: 99%

“…Transient elastography (Fibroscan ® ) is an accurate, noninvasive, simple machine to measure the degree of fibrosis and is easy to repeat 9,10 . Therefore, Fibroscan ® has been used as a useful tool for monitoring fibrosis improvement after antiviral treatment in CHB patients 10‐15 .…”

Section: Introductionmentioning

confidence: 99%

High body mass index hinders fibrosis improvement in patients receiving long‐term tenofovir therapy in hepatitis B virus‐related cirrhosis

Chon

Jung

et al. 2020

Journal of Viral Hepatitis

View full text Add to dashboard Cite

Long-term suppression of hepatitis B virus with tenofovir (TDF) induces fibrosis regression, and repeated liver stiffness (LS) measurement can indicate the improvement of fibrosis. We aimed to investigate predictors for LS improvement assessed by changes in patients receiving long-term TDF therapy in chronic hepatitis B (CHB) with liver cirrhosis. CHB patients with histologically proven liver cirrhosis who received TDF as the first-line therapy from 2012 to 2015 were recruited. LS and controlled attenuation parameter (CAP) measurements were repeated at baseline and 3 years after therapy. Liver stiffness improvement was defined as a drop of LS value ≥30% from the baseline. A total of 131 patients were enrolled (mean age 51.4% and male 64.9%). After 3 years of TDF therapy, the mean LS value significantly improved (from 14.7 to 8.6 kPa, P < .001), and 96 (73.3%) patients have achieved LS improvement. Predictors associated with improvement of LS were low body mass index (BMI), HBeAg positivity, and low CAP value at baseline. In multivariate analysis, low BMI was a single factor independently associated with LS improvement (odds ratio 0.680, 95% CI 0.560-0.825, P < .001). Patients with BMI < 23.5, had a 1.96 times more chance of achieving LS improvement compared to those with BMI ≥ 23.5 (90.1% vs. 46.0%, P = .001). High BMI was a single significant factor hindering the fibrosis improvement in patients receiving long-term TDF therapy in CHB with liver cirrhosis. Life style modification and BMI reduction should be encouraged to enhance fibrosis improvement. K E Y W O R D S body mass index, chronic hepatitis B, fibrosis improvement, liver stiffness, tenofovir How to cite this article: Chon YE, Jung KS, Ha Y, et al. High body mass index hinders fibrosis improvement in patients receiving long-term tenofovir therapy in hepatitis B virusrelated cirrhosis.

show abstract

“…Therefore, it has been thought that the cut-off values for the XL probe should be lower, around 1.5–2 kPa, than the ones used for the standard M probe [ 35 , 40 , 68 , 96 , 97 ]. However, in a novel prospective study [ 65 ], Wong et al found that the same LS cut-off values can be used for both M and XL probe in clinical practice, when used in patients with BMI <30 kg/m 2 and ≥30 kg/m 2 , respectively, as the high BMI independently increases liver stiffness values [ 98 ].…”

Section: Liver Parenchyma Characterization In Nafld Patients With mentioning

confidence: 99%

Hepatocellular Carcinoma and Non-Alcoholic Fatty Liver Disease: A Step Forward for Better Evaluation Using Ultrasound Elastography

Lupșor-Platon

Şerban

Silion

et al. 2020

Cancers

View full text Add to dashboard Cite

The increasing prevalence of non-alcoholic fatty liver disease (NAFLD) in the general population prompts for a quick response from physicians. As NAFLD can progress to liver fibrosis, cirrhosis, and even hepatocellular carcinoma (HCC), new non-invasive, rapid, cost-effective diagnostic methods are needed. In this review, we explore the diagnostic performance of ultrasound elastography for non-invasive assessment of NAFLD and NAFLD-related HCC. Elastography provides a new dimension to the conventional ultrasound examination, by adding the liver stiffness quantification in the diagnostic algorithm. Whilst the most efficient elastographic techniques in staging liver fibrosis in NAFLD are vibration controlled transient elastography (VCTE) and 2D-Shear wave elastography (2D-SWE), VCTE presents the upside of assessing steatosis through the controlled attenuation parameter (CAP). Hereby, we have also critically reviewed the most important elastographic techniques for the quantitative characterization of focal liver lesions (FLLs), focusing on HCC: Point shear wave elastography (pSWE) and 2D-SWE. As our paper shows, elastography should not be considered as a substitute for FLL biopsy because of the stiffness values overlap. Furthermore, by using non-invasive, disease-specific surveillance tools, such as US elastography, a subset of the non-cirrhotic NAFLD patients at risk for developing HCC can be detected early, leading to a better outcome. A recent ultrasomics study exemplified the wide potential of 2D-SWE to differentiate benign FLLs from malignant ones, guiding the clinician towards the next steps of diagnosis and contributing to better long-term disease surveillance.

show abstract

Application of transient elastography in nonalcoholic fatty liver disease

Cited by 91 publications

References 99 publications

A Survey of Liver Cancer Specialists’ Views on the National Liver Cancer Screening Program in Korea

A Survey of Liver Cancer Specialists’ Views on the National Liver Cancer Screening Program in Korea

High body mass index hinders fibrosis improvement in patients receiving long‐term tenofovir therapy in hepatitis B virus‐related cirrhosis

Hepatocellular Carcinoma and Non-Alcoholic Fatty Liver Disease: A Step Forward for Better Evaluation Using Ultrasound Elastography

Contact Info

Product

Resources

About