Factors of accuracy of transient elastography (fibroscan) for the diagnosis of liver fibrosis in chronic hepatitis C

Abstract

The purpose of this study was to assess the influence of success rate and interquartile range on the accuracy of transient elastography for the diagnostic of fibrosis in hepatitis C virus infection. Two-hundred fifty-four consecutive patients had liver stiffness measurements and liver biopsy of at least 15 mm. Discordances of at least two stages between transient elastography and histological assessment were observed in 28 cases (11%).

Non-invasive assessment of liver fibrosis in chronic hepatitis C

“…This challenges previous claims [67,98] that LSM requires no learning curve and that a novice can consistently obtain reliable results after a short training period. Operator experience influenced not only the success rate, as previously reported [67,98], but also the IQR/LSM ratio, which was recently shown to be critical for LSM accuracy [99]. These findings emphasize the need for rigorous scientific evaluation of all novel procedures, such as TE before their widespread uptake.…”

Factors that affect the diagnostic accuracy of liver fibrosis measurement by Fibroscan in patients with chronic hepatitis B

“…3,4 However, the prevalence of significant discordance in our study was higher than that in the study of Lucidarme et al (19.1-23.6% vs. 11.0-15.8%). 11 In addition to the higher prevalence of discordance, uneven distribution of fibrosis stage (only two patients had F0 and 80% of the study population had significant fibrosis [ ‡F2]) can be another limitation of our study due to spectrum bias. 25 Body mass index was selected as a predictor for significant discordance with Marcellin et al's cutoff values.…”

“…Significant discordance between LSM and LB was defined as a discordance of at least two stages of fibrosis in the Batts and Ludwig scoring system. 11 Univariate and subsequent multivariate binary logistic regression analyses were performed to identify the independent factors related to significant discordance by comparing patients with significant discordance and those without. Hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) are also indicated.…”

“…11 However, because IQR ⁄ M was investigated only in European patients with CHC, it cannot be applied directly to Asian patients with CHB because different BMI, the prevalence of metabolic syndrome and viral characteristics between CHC and CHB can influence LSM. [22][23][24] Therefore, investigation of factors that affect the diagnostic accuracy of LSM including IQR ⁄ M are needed in Asian patients with CHB.…”

“…The median length of LB samples was 17 mm (range, 15-25 mm) and the median number of portal tracts was 10 (range, [6][7][8][9][10][11][12][13][14][15]. The distribution of the liver histology according to the Batts and Ludwig scoring system is indicated in Table 1.…”