Non-Invasive Assessment of Liver Fibrosis by Vibration-Controlled Transient Elastography (Fibroscan®)

Sandrin, Laurent; Oudry, Jennifer; Bastard, Claire; Fournier, C.; Miette, Véronique; Mueller, Sebastian

doi:10.5772/20729

Cited by 11 publications

(9 citation statements)

References 56 publications

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“…Physically, these attributes are conditioned by tissue homogeneity, where structures such as portal or hepatic vein branches or biliary ducts can deflect and alter the mechanical wave trajectory and therefore the parallelism in the elastogram; and extension, in the sense that measurements executed deeper and more central in the right lobe are more likely to provide longer shear displacement and allow for more accurate velocity assessment before attenuation. Such attributes have been previously explored in early developmental research in liver elastography techniques using phantom elements as models and therefore provide the closest resemblance to ideal physical conditions for Young's modulus calculation …”

Section: Discussionmentioning

confidence: 99%

“…Such attributes have been previously explored in early developmental research in liver elastography techniques using phantom elements as models and therefore provide the closest resemblance to ideal physical conditions for Young's modulus calculation. [18][19][20][21][22] Vibration-controlled transient elastography diagnostic performance in CHC has been consistently stronger for advanced fibrosis than that for significant fibrosis. In a meta-analysis of thirty-five studies, mean AUROC for significant fibrosis was 0.85 (95% CI: 0.80-0.89) and for advanced fibrosis was 0.89 (95% CI: 0.88-0.91).…”

Section: Discussionmentioning

confidence: 99%

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Elastogram quality assessment score in vibration‐controlled transient elastography: Diagnostic performance compared to digital morphometric analysis of liver biopsy in chronic hepatitis C

Mendes

Ferreira

Miotto

et al. 2017

Journal of Viral Hepatitis

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Vibration-controlled transient elastography (VCTE) is widely used for noninvasive fibrosis staging in chronic hepatitis C. However, internal validation is based solely on variability and success rate and lacks reproducible quality indicators. We analysed the graphic representation of shear wave propagation in comparison with morphometric results of liver biopsy, eliminating observer variability bias. Individual elastograms were classified according to two morphologic criteria: extension of wave propagation (length of the graphic representation) and shear wave dispersal (level of parallelism displayed in the elastogram). Then, a score based on these criteria stratified the elastogram in classes I through III (highest to lowest technical quality). Liver stiffness results of each measurement were compared with collagen contents in liver biopsy by morphometric analysis. A total of 3243 elastograms were studied (316 patients). Digital morphometry in liver biopsy showed significant fibrosis in 66% of samples and advanced fibrosis in 31%. Elastogram quality analysis resulted in 1438 class I measurements (44%), 1070 class II (34%) and 735 class III. Area under the receiver operating curve (AUROC) for severe fibrosis according to class (I, II and III) was 0.941, 0.887 and 0.766, respectively. For advanced fibrosis, AUROCs were 0.977, 0.883 and 0.781, respectively. Spearman's correlation testing for all classes and levels of fibrosis demonstrated significant independent association (r = -.95, P < .01). Our study is the first to propose measurable quality criteria for VTCE and to validate them against objective assessment of liver biopsy through digital morphometric imaging analysis. We concluded that VCTE performance is significantly influenced by quality assessment of individual measurements. Considering these criteria in clinical practice may improve accuracy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Elastogram quality assessment score in vibration‐controlled transient elastography: Diagnostic performance compared to digital morphometric analysis of liver biopsy in chronic hepatitis C

Mendes

Ferreira

Miotto

et al. 2017

Journal of Viral Hepatitis

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“…Warna biru menunjukkan area jaringan hati dengan konsistensi yang keras, warna hijau menunjukkan konsistensi sedang dan warna merah menunjukkan konsistensi yang lunak. 11,13 Elastografi kuantitatif disebut juga elastografi mekanik. Pemeriksaan ini membutuhkan alat yang lebih kompleks, yakni alat untuk memberikan "shear wave" pada jaringan hati dan alat radio imaging untuk melihat gambaran jaringan hati selama diberikan penekanan.…”

Section: Elastografi Kualitatif Disebut Juga Dengan Real-time Elastogunclassified

“…Untuk jenis radioimaging, dapat digunakan USG dan MRI. 11,14 Fibroscan, merupakan alat elastografi yang pertama dan banyak digunakan. Alat ini menggunakan metode "shear wave" berupa getaran mekanik, yang bekerja dengan cara memberikan stress getaran mekanik dengan frekuensi rendah, yaitu 50 Hz, yang disebarkan pada jaringan hati.…”

Section: Elastografi Kualitatif Disebut Juga Dengan Real-time Elastogunclassified

Role of Elastography in Early Detection of Liver Cirrhosis

Susanto¹,

Irawan²

2017

Journal of Medicine and Health

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“…Therefore simpler, cheaper methods for the prediction of hepatic fibrosis were sought for. As a fact, Fibroscan is more and more used in routine clinical practice as an alternative method to liver biopsy in patients with chronic liver diseases [7]. Main physical limitation is linked to the presence of ascites as liquids prevent the propagation of shear waves.…”

Section: Introductionmentioning

confidence: 99%

Comparison between FIB-4 Index and Fibroscan as Marker of Fibrosis in Chronic HCV Infection in Egyptian Patients

Nakeeb¹,

Helmy²,

Saleh³

et al. 2014

OJGas

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The FIB-4 index is a simple and noninvasive algorithm consisting to evaluate liver fibrosis in chronic HCV infection. Aim: To evaluate the utility of FIB-4 index as a noninvasive marker to assess liver fibrosis in chronic HCV infection in comparison to transient elastography. Patients and Methods: We studied 30 patients having chronic HCV infection based on clinical features, laboratory tests, diagnostics images, Fibroscan and FIB-4 score. According to the results of Fibroscan, the 30 patients were classified into two groups in order to obtain a cutoff value to exclude patient with significant fibrosis: group Ia: 7 patients with no or mild liver fibrosis (F0-F1) and group Ib: 23 patients with significant fibrosis or cirrhosis (F2-F3-F4). Group IIa: 17 patients with no or significant fibrosis (F0-F1-F2-F3) and group IIb (F4): 13 patients with cirrhosis (F4). Results: The mean of FIB-4 index increased with the increase of the fibrosis score. FIB-4 index proved to be sensitive and specific in differentiation between patients with no or mild fibrosis (F0-F1) and patients with significant fibrosis or cirrhosis (F2-F3-F4) with the best cutoff value at 1.61. It also proved to be sensitive and specific in differentiation between patients with no or significant fibrosis (F0-F1-F2-F3) and patients with cirrhosis (F4) with cutoff value at 1.88. Conclusion: The FIB-4 index enabled the correct identification of extreme types of fibrosis. Using these cutoffs (1.61 -1.88), 87% of patients fell outside these ranges and could thus avoid liverbiopsy with an overall accuracy of 70%.

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Non-Invasive Assessment of Liver Fibrosis by Vibration-Controlled Transient Elastography (Fibroscan®)

Cited by 11 publications

References 56 publications

Elastogram quality assessment score in vibration‐controlled transient elastography: Diagnostic performance compared to digital morphometric analysis of liver biopsy in chronic hepatitis C

Elastogram quality assessment score in vibration‐controlled transient elastography: Diagnostic performance compared to digital morphometric analysis of liver biopsy in chronic hepatitis C

Role of Elastography in Early Detection of Liver Cirrhosis

Comparison between FIB-4 Index and Fibroscan as Marker of Fibrosis in Chronic HCV Infection in Egyptian Patients

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