Assessment of 10‐year changes in liver stiffness using vibration‐controlled transient elastography in non‐alcoholic fatty liver disease

Abstract

Aim Although liver biopsy is the gold standard for the diagnosis and staging of non‐alcoholic fatty liver disease (NAFLD), repeated assessment of patients’ liver tissue conditions are impractical. We assessed the 10‐year changes in liver stiffness measurements (LSM) utilizing vibration‐controlled transient elastography in NAFLD patients. Methods From January 2006 to September 2007, LSM was carried out for 97 biopsy‐proven NAFLD patients. Of these, 34 patients underwent 10‐year LSM reassessments (14 of them with paired biopsies). Results We evaluated the changes in the fibrosis stage as estimated using LSM (FS‐LSM). Over a 10‐year period, 32.4% had FS‐LSM progression, 50% had static disease, and 17.6% had FS‐LSM improvement. From among the initially diagnosed non‐alcoholic steatohepatitis patients, 18% had progressed to considerable stage 4 (cirrhosis) 10 years later. In this cohort, none of the patients who had been initially diagnosed as FS‐LSM stage 0 had progressed to cirrhosis 10 years later. The changes in LSM were correlated with the change in the histological fibrosis stage, the NAFLD activity score, and the change in the sum of the steatosis, activity, and fibrosis score. Improving more than 1 body mass index (kg/m2) and having a higher initial aspartate aminotransferase, alanine aminotransferase (ALT), or ALT responder (>30% improvement or reduction to less than 40 IU/L) were factors contributing to LSM improvements (≥2 kPa). Conclusions Vibration‐controlled transient elastography is likely to become a more clinically important tool for the long‐term monitoring of NAFLD patients.

Higher Responsiveness for Women, High Transaminase Levels, and Fat Percentage to Pemafibrate Treatment for NAFLD

“…A response to pharmacological intervention was defined as a decrease in ALT of >30% compared with baseline after 6 months of PEM treatment according to several NAFLD clinical trials [ 21 , 22 ]. We compared the baseline clinical features of PEM responders (n = 40) and non-responders (n = 48) in HTG-NAFLD patients, including those who underwent body composition analysis.…”

Elastography Techniques for the Assessment of Liver Fibrosis in Non-Alcoholic Fatty Liver Disease

“…Although VCTE is a blind technique, it is the most commonly used technique for screening, treatment monitoring, and longitudinal follow-up in various chronic liver diseases, and is the best-validated elastography modality worldwide. In patients with NAFLD, repeated measurements of liver stiffness made using VCTE are useful for long-term monitoring and the prediction of liver-related complications and cardiovascular events [18,19]. In addition, repeated measurements of liver stiffness can reduce false-positive diagnosis of advanced fibrosis in patients with NAFLD [20,21].…”

A prospective 5-year study on the use of transient elastography to monitor the improvement of non-alcoholic fatty liver disease following bariatric surgery

“…To the best of our knowledge, our study was the first study to evaluate the long-term treatment responses of NAFLD to bariatric surgery using TE as a monitoring tool. In the literature, TE had been tested on the roles of monitoring disease progression and response to treatment of NAFLD [21][22][23][24][25] . Suzuki et al reported the changes of LSM over 4 years in 36 patients without paired liver biopsies for monitoring disease progression of NAFLD 21 .…”

“…However, histopathological correlation with paired liver biopsies was not available. Nogami et al evaluated the disease progression of NAFLD in terms of fibrosis stage using LSM in 34 patients over 10 years 22 . Based on LSM, 32.4% of patients had progression in fibrosis stage and 17.6% had improvement.…”