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

Abstract

SUMMARY BackgroundInterquartile range ⁄ median value (IQR ⁄ M) of liver stiffness measurement (LSM) is a factor in chronic hepatitis C (CHC) leading to over estimation of fibrosis by Fibroscan.

Discordance in fibrosis staging between liver biopsy and transient elastography using the FibroScan XL probe

“…Finally, the length of biopsy specimens and the number of portal tracts were recorded as measures of biopsy quality. Biopsies <1.5 cm or with <6 portal tracts were considered uninterpretable [4,22,23].…”

“…Prior to the widespread use of the XL probe, however, it is important to understand factors associated with its accuracy. Although specific data for the XL probe is not available, recent studies have examined discordances between fibrosis determined histologically and estimated by TE using the conventional M probe [14,15,[21][22][23]. In several reports, highly variable LSMs, as defined by the ratio of the interquartile range of measurements to the median value (IQR/M), were reported to increase the risk of discordance [14,15].…”

Clinical Application of Liver Stiffness Measurement Using Transient Elastography: A Surgical Perspective

“…Thus, accurate determination of the presence and degree of liver fibrosis is of paramount importance in choosing treatment strategies, evaluating responses to treatment, assessing the risk of developing liver-related complications, and predicting prognosis in CLD patients. As a surrogate for liver biopsy (LB), which is an invasive procedure and is often subject to not only sampling error but also intra- and inter-observer variability in histological interpretation [3,4,5,6,7], liver stiffness (LS) measurement using transient elastography (TE) was introduced as a promising non-invasive method for assessing liver fibrosis [8,9,10,11,12,13]. In many studies, TE proved reliable and accurate in terms of predicting significant fibrosis or cirrhosis [14,15,16,17,18,19].…”

728 Discordance Between Liver Biopsy and Fibrotest in Assessing Liver Fibrosis in Chronic Hepatitis B

“…In contrast to the FT, for transient elastography, a fibrosis stage of F0-2 is the only factor that predicts significant discordance with reference to LB in Asian patients with CHB, and necroinflammation (i.e., serum ALT level more than twice the upper normal limit) has been identified as a significant confounder, which nonspecifically increases liver stiffness values and thus leads to overestimation of the fibrosis stage [15][16][17][18]20]. Therefore, with active necroinflammation or ALT flares, measuring liver stiffness using transient elastography should be delayed after stabilization of necroinflammation and normalization of serum ALT to exclude such undesirable overestimating effects [21].…”

“…The chi-squared or Fisher's exact tests were used for categorical variables. Based on previous studies [15][16][17], discordance was defined as a discordance of at least two stages between fibrosis stages determined by the FT and LB. Subsequent multivariate analysis using binary logistic regression analyses was performed to identify independent factors related to discordance between fibrosis stage of the FT and LB.…”