Diagnostic accuracy of acoustic radiation force impulse elastography (ARFI) in comparison to other non-invasive modalities in staging of liver fibrosis in chronic HCV patients: single-center experience

Alem, Shereen Abdel; Abdellatif, Zeinab; Mabrouk, Mahasen; Elsharkawy, Aisha; Khairy, Mohamed M.; Musa, Sherief; Anwar, Ismail; Yosry, Ayman

doi:10.1007/s00261-019-02031-1

Cited by 14 publications

(5 citation statements)

References 32 publications

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“…Acoustic radiation force impulse (ARFI), which is based on ultrasound technology, evaluates liver stiffness. Scores such as aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and the fibrosis-4 (FIB-4) score, which is calculated from age, platelet count, AST and alanine aminotransferase (ALT) levels, are also used in clinical practice [138][139][140]. All of these noninvasive methods can accurately exclude and prove advanced liver cirrhosis, but are not reliable for diagnosis of intermediate fibrosis stages [141].…”

Section: Pcsk9 and Hcv-induced Chronic Liver Diseasementioning

confidence: 99%

Emerging Insights on the Diverse Roles of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) in Chronic Liver Diseases: Cholesterol Metabolism and Beyond

Grewal

Buechler

2022

IJMS

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Chronic liver diseases are commonly associated with dysregulated cholesterol metabolism. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a serine protease of the proprotein convertase family that is mainly synthetized and secreted by the liver, and represents one of the key regulators of circulating low-density lipoprotein (LDL) cholesterol levels. Its ability to bind and induce LDL-receptor degradation, in particular in the liver, increases circulating LDL-cholesterol levels in the blood. Hence, inhibition of PCSK9 has become a very potent tool for the treatment of hypercholesterolemia. Besides PCSK9 limiting entry of LDL-derived cholesterol, affecting multiple cholesterol-related functions in cells, more recent studies have associated PCSK9 with various other cellular processes, including inflammation, fatty acid metabolism, cancerogenesis and visceral adiposity. It is increasingly becoming evident that additional roles for PCSK9 beyond cholesterol homeostasis are crucial for liver physiology in health and disease, often contributing to pathophysiology. This review will summarize studies analyzing circulating and hepatic PCSK9 levels in patients with chronic liver diseases. The factors affecting PCSK9 levels in the circulation and in hepatocytes, clinically relevant studies and the pathophysiological role of PCSK9 in chronic liver injury are discussed.

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Section: Pcsk9 and Hcv-induced Chronic Liver Diseasementioning

confidence: 99%

Emerging Insights on the Diverse Roles of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) in Chronic Liver Diseases: Cholesterol Metabolism and Beyond

Grewal

Buechler

2022

IJMS

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“…Another study also reported that the stiffness of malignant lesions was significantly higher than benign lesions (P<.0001) (Dong et al, 2023). However, some studies reported no difference in the stiffness values of both lesions (Alem et al, 2023;Dong et al, 2020).…”

Section: Discussionmentioning

confidence: 93%

Accuracy of Shear Wave Elastography in the Diagnosis of Hepatic Focal Lesions

SHAHZAD,

MUSHTAQ,

MASOOD

et al. 2023

Biol Clin Sci Res J

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This study aimed to evaluate the accuracy of Shear Wave Elastography (SWE) in diagnosing hepatic focal lesions using triphasic CT as the gold standard. The study was conducted prospectively at the Department of Radiology, Nishtar Medical Hospital, from January 2022 to January 2023. Patients with at least one hepatic focal lesion ranging from 1 to 5 cm in diameter were included in the study. All patients underwent SWE scanning and ultrasound examination. The segment of focal lesions was evaluated, and 5-8 measurements were taken for quantitative analysis of stiffness. In patients with multiple focal lesions, the pathology of all lesions was confirmed by MRI and CT, and the most accessible lesion was analyzed. The mean of all measurements was compared with the findings of triphasic CT and tumor markers to estimate SWE's accuracy, specificity, and sensitivity. The study was conducted on 100 patients, of which 85 were males and 17 were females. The mean stiffness in benign lesions was 10.4 ± 6.32 kPa, and in malignant lesions was 16.3 ± 9.24 kPa. This difference was statistically significant (P<.002). A cutoff value 13.25 was used to differentiate between malignant and benign lesions. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SWE were 78.05%, 71.43%, 88.9%, 52.3%, and 64.3%, respectively. The mean tissue stiffness in focal fatty infiltration was 12.7 ± 8.9 kPa, and in hemangioma lesions was 9.6 ± 4.3 kPa. The mean stiffness in HCC was 15.5 ± 7.1 kPa, in cholangiocarcinoma was 32.6 ± 8.26 kPa, and in metastatic lesions was 22.2 ± 0.5 kPa. In conclusion, SWE has a high sensitivity, specificity, and accuracy for differentiating malignant and benign hepatic focal lesions. The study shows that the stiffness of benign and malignant lesions differs significantly.

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“…Acoustic Radiation Force Impulse (ARFI) elastography is a method for non-invasive staging of advanced liver fibrosis [ 33 , 34 ]. ARFI values were obtained before therapy start.…”

Section: Resultsmentioning

confidence: 99%

Serum Ceramide Species Are Associated with Liver Cirrhosis and Viral Genotype in Patients with Hepatitis C Infection

Höring

Peschel

Grimm

et al. 2022

IJMS

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Hepatitis C virus (HCV) infection affects ceramide metabolism, and, here, we have evaluated associations of eight serum ceramide species with viral load, viral genotype, and disease markers in 178 patients with chronic HCV. In this cohort, ceramide d18:1;O2/16:0 was higher in the serum of the 20 diabetic patients compared to the patients without this complication. Moreover, ceramide d18:1;O2/24:0 was negatively correlated with age. Of note, all but ceramide d18:1;O2/16:0 and 26:0 were diminished in the serum of patients with liver cirrhosis and, with the exception of ceramide d18:1;O2/16:0, were negatively correlated with the model for end-stage liver disease (MELD) score. Most of the serum ceramides are carried in low-density lipoprotein (LDL), which rises following effective direct-acting antiviral (DAA) therapy. Ceramide d18:1;O2/24:0 recovered in parallel with LDL, whereas ceramide d18:1;O2/18:0 declined. Genotype-3-infected patients had the lowest ceramide levels, which were comparable to other genotypes after DAA treatment. Notably, ceramide d18:1;O2/23:0 and 24:0 were negatively correlated with the MELD score in patients with liver cirrhosis at the end of DAA therapy. Long-chain (LC) ceramides show adverse effects, whereas very-long-chain (VL) species have protective functions in the liver. The ratio of VL/LC ceramides was higher in non-cirrhosis patients than cirrhosis patients and further increased at the end of therapy in this subgroup. In summary, our study shows that serum ceramide levels are related to liver cirrhosis and viral genotype. Whether the more favorable serum ceramide profile in non-cirrhosis patients, before and after DAA therapy, is of pathophysiological importance needs further investigation.

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Diagnostic accuracy of acoustic radiation force impulse elastography (ARFI) in comparison to other non-invasive modalities in staging of liver fibrosis in chronic HCV patients: single-center experience

Cited by 14 publications

References 32 publications

Emerging Insights on the Diverse Roles of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) in Chronic Liver Diseases: Cholesterol Metabolism and Beyond

Emerging Insights on the Diverse Roles of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) in Chronic Liver Diseases: Cholesterol Metabolism and Beyond

Accuracy of Shear Wave Elastography in the Diagnosis of Hepatic Focal Lesions

Serum Ceramide Species Are Associated with Liver Cirrhosis and Viral Genotype in Patients with Hepatitis C Infection

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