Is liver stiffness measurement different in patients with NASH or with viral hepatitis?

Gaia, Silvia; Carenzi, S.; Brunello, F.; Barilli, Amelia; Lagget, Marco; Bugianesi, E.; Smedile, Antonina; Rizzetto, M.

doi:10.1016/j.dld.2008.07.156

Cited by 6 publications

(4 citation statements)

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“…This suggests that LSM can be performed with high precision if subjects are strictly selected and that normal subjects can be reliably separated from those with potential liver abnormalities. Secondly, the younger subjects with the lower BMI in our study compared with European studies might cause differences in hepatic steatosis and could explain our findings (32), although to date research has not been conclusive whether or not steatosis itself increases LS value (33–35). This lower BMI could explain the lower failure rate of LSM in our study (2.7%).…”

Section: Discussionmentioning

confidence: 70%

What are âtrue normalâ liver stiffness values using FibroScan^Â®?: a prospective study in healthy living liver and kidney donors in South Korea

Kim

Choi

Han

et al. 2010

Liver International

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Section: Discussionmentioning

confidence: 70%

What are âtrue normalâ liver stiffness values using FibroScan^Â®?: a prospective study in healthy living liver and kidney donors in South Korea

Kim

Choi

Han

et al. 2010

Liver International

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“…To date, the effects of steatosis on LSM have still been inconclusive. [35][36][37][38][39][40] Although metabolic syndrome and its components did not seem to influence LS values in our study (all P > 0.05, data not shown), the influence of metabolic syndome should be validated further with large number of patients with chronic liver disease, because the portion of patients with metabolic syndrome in our study was extremely small (n = 3, 3.3%) and the influence of metabolic syndrome was confirmed initially in healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

The usefulness of liver stiffness measurement using FibroScan in chronic hepatitis C in South Korea: A multicenter, prospective study

Kim

Jang

Cheong

et al. 2010

J of Gastro and Hepatol

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Aim: We investigated the accuracy of liver stiffness measurement (LSM) in chronic hepatitis C (CHC) in a multicenter, prospective study in South Korea. Methods: Between June 2005 and July 2009, 91 CHC patients without a previous history of antiviral treatment, clinical evidences of cirrhosis, coinfection with other viruses, and heavy alcohol consumption and with alanine aminotransferase (ALT) Յ 5x upper limit of normal, total bilirubin Յ 1.5 mg/dL, sufficient liver biopsy quality (Ն 15 mm and more than six portal tracts), interquartile range to median liver stiffness (LS) value ratio Յ 0.21, and more than 10 valid measurements, were recruited. The Batts and Ludwig scoring system was used for histologic assessment. Age-platelet index (API), aspartate aminotransferase (AST)-to-platelet ratio index (APRI), and age-spleen-platelet ratio index (ASPRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used to evaluate the performance of LSM and other noninvasive models. Results: The mean age was 47.9 years, and the mean LS value was 7.7 kPa (44 men and 47 women). LS value was highly correlated to the fibrosis stages (r = 0.835, P < 0.001). The AUROCs of LSM were 0.909 for Ն F2, 0.993 for Ն F3, and 0.970 for F = 4 and were superior to those of API (0.72, 0.858, and 0.948, respectively), APRI (0.780, 0.887, and 0.904, respectively), and ASPRI (0.713, 0.862, and 0.957, respectively). The optimal cutoff LS values were 6.2 kPa for Ն F2, 7.7 kPa for Ն F3, and 11.0 kPa for F = 4. Conclusions: Our data suggest that LSM can accurately assess liver fibrosis in patients with CHC and be applied in South Korea.

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“…In addition, there was a close relationship between the augmentation of liver stiffness and the degree of steatosis. However studies in chronic hepatitis B have shown that patients with the same stage of fibrosis had lower [20] or equal stiffness [21] in the case of accompanying steatosis. It seems unlikely that steatosis might influence liver stiffness in discordant ways depending on the type of hepatitis and therefore further studies are needed to clarify this issue.…”

Section: Do Steatosis and Transaminase Levels Affect The Readings?mentioning

confidence: 99%

Is transient elastography a useful tool for screening liver disease?

Poggio¹,

Colombo²

2009

WJG

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Transient elastography (TE) is a new non invasive tool for measuring liver stiffness, which is correlated to the histologic stage of liver fibrosis. Several studies in chronic liver disease (CLD) have determined a good accuracy of TE in predicting significant fibrosis and an optimal accuracy in predicting cirrhosis. Normal liver stiffness ranges between 3.3-7.8 KPa and using a cut off of 7.1 KPa, significant fibrosis and cirrhosis can be excluded with a very high negative predictive value (NPV). Positive predictive value (PPV) for the diagnosis of cirrhosis is lower using just a single scan but increases to 90% if high stiffness values are confirmed by a second independent scan. However the presence of fatty liver and metabolic syndrome slightly increases the readings and may reduce the accuracy of the test. It is uncertain if this increase is related to the presence of steatofibrosis or if it is caused by steatosis itself. TE can be used in screening patients attending the liver clinics to identify those with significant fibrosis or cirrhosis and may be particularly useful in discriminating HBV inactive carriers from chronic hepatitis B patients. TE, however, is not reliable in predicting the presence of esophageal varices in cirrhotics. Another potential indication for TE is the systematic screening of populations at high risk for CLD, such as intravenous drug users and alcoholics, but further studies are needed to determine its diagnostic accuracy in these settings. INTRODUCTIONTransient elastography (TE) is a new non invasive tool for measuring liver stiffness, which is correlated to the histologic stage of liver fibrosis [1] . The device (Fibroscan) generates an elastic wave by means of a vibrator applied to the thoracic wall at the level of the right liver lobe. The vibrator produces a shot and a low amplitude shear wave propagating through the liver parenchyma. The velocity of propagation is directly proportional to liver stiffness and is automatically calculated by the instrument. The range of measurements, expressed in kilopascals, varies from 2.5 to 74 KPa.Many studies have been published on the use of TE in patients with already diagnosed chronic liver disease (CLD) but few have addressed the issue of its possible use as a first line examination in the liver clinic or in facilities where patients at risk of liver disease are attending. HOW TO TAKE AND INTERPRET THE MEASUREMENTSIn order to obtain valid and reproducible measurements the probe should be placed at the center of the right liver lobe, two intercostal spaces below the upper liver margin and at the level of the anterior or middle axillary line. If measurements are taken below this point and too close to the lower liver edge both the percentage of valid shots and the median stiffness tend to decrease [2] . Ultrasound assistance to locate the upper liver margin is usually unnecessary if the patient is reasonably thin because the liver can be recognized by percussion alone. The device incorporates an M-mode window enabling the ope...

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Is liver stiffness measurement different in patients with NASH or with viral hepatitis?

Cited by 6 publications

References 0 publications

What are âtrue normalâ liver stiffness values using FibroScan^Â®?: a prospective study in healthy living liver and kidney donors in South Korea

What are âtrue normalâ liver stiffness values using FibroScan^Â®?: a prospective study in healthy living liver and kidney donors in South Korea

The usefulness of liver stiffness measurement using FibroScan in chronic hepatitis C in South Korea: A multicenter, prospective study

Is transient elastography a useful tool for screening liver disease?

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Is liver stiffness measurement different in patients with NASH or with viral hepatitis?

Cited by 6 publications

References 0 publications

What are âtrue normalâ liver stiffness values using FibroScanÂ®?: a prospective study in healthy living liver and kidney donors in South Korea

What are âtrue normalâ liver stiffness values using FibroScanÂ®?: a prospective study in healthy living liver and kidney donors in South Korea

The usefulness of liver stiffness measurement using FibroScan in chronic hepatitis C in South Korea: A multicenter, prospective study

Is transient elastography a useful tool for screening liver disease?

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What are âtrue normalâ liver stiffness values using FibroScan^Â®?: a prospective study in healthy living liver and kidney donors in South Korea

What are âtrue normalâ liver stiffness values using FibroScan^Â®?: a prospective study in healthy living liver and kidney donors in South Korea