The Feasibility and Reliability of Transient Elastography Using Fibroscan<sup>®</sup>: A Practice Audit of 2335 Examinations

Pang, Jack X Q; Pradhan, Faruq; Zimmer, Scott; Niu, Sophia; Crotty, Pam; Tracey, Jenna; Schneider, Christopher; Heitman, Steven J.; Kaplan, Gilaad G.; Swain, Mark G.; Myers, Robert P.

doi:10.1155/2014/952684

Cited by 54 publications

(46 citation statements)

References 38 publications

(48 reference statements)

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“…However, as of TE, optimal feasibility and applicability is reached after >500 examinations . For point shear‐wave elastography this may be after >130 examinations even if more evidence is needed to completely confirm this point.…”

Section: Discussionmentioning

confidence: 99%

Liver stiffness measurement reliability and main determinants of point shear‐wave elastography in patients with chronic liver disease

Fraquelli

Baccarin

Casazza³

et al. 2016

Aliment Pharmacol Ther

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Section: Discussionmentioning

confidence: 99%

Liver stiffness measurement reliability and main determinants of point shear‐wave elastography in patients with chronic liver disease

Fraquelli

Baccarin

Casazza³

et al. 2016

Aliment Pharmacol Ther

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“…Moreover, to our knowledge, there has been no study focusing on reference CAP values in children. Obesity, metabolic syndrome, gender, and aging are known to affect LSM values in adults [15, 16], and young age should therefore be evaluated as a factor affecting TE values. In this study, we aimed to determine age-dependent reference values for both LSM and CAP in children by using FibroScan® with a 3.5-MHz standard M probe (diameter, 7 mm) designed for simultaneous measurement of LSM and CAP.…”

Section: Introductionmentioning

confidence: 99%

Transient Elastography-Based Liver Stiffness Age-Dependently Increases in Children

2016

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Background and AimsPediatric use of liver transient elastography (TE) is attractive for its non-invasiveness, but reference values have not been established. We aimed to determine reference values for TE in children.MethodsIn pediatric patients (1 to 18 years), TE (FibroScan®) with an M probe was used for both liver stiffness measurement (LSM) and measurement of hepatic fat deposition by using a controlled attenuation parameter (CAP). The patients were divided into three relevant age groups: preschoolers (1 to 5 years), elementary school children (6 to 11 years), and adolescents (12 to 18 years). Overweight or obese patients or those with known liver disease, elevated serum liver enzymes, or hepatic echogenic abnormality were excluded from the study.ResultsAmong 139 children, 123 (88.5%; 62 male; median age, 11.7 years; age range, 1.3 to 17.2 years) were successfully subjected to M-probe TE without anesthesia. Median LSM increased with age: it was 3.4 kPa (2.3 to 4.6 kPa, 5th to 95th percentiles) at ages 1 to 5 years; 3.8 (2.5 to 6.1) kPa at ages 6 to 11; and 4.1 (3.3 to 7.9) kPa at ages 12 to 18 (P = 0.001). Median CAP was not age dependent: it was 183 (112 to 242) for ages 1 to 18 years.ConclusionsM-probe TE is suitable in a wide age range of children from age 1 year up. In children without evidence of liver disease, LSM has an age-dependent increase, whereas CAP does not differ between ages 1 and 18.

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“…Only the examinations with at least 10 valid measurements and a success rate of 60% or higher, were considered reliable. In addition, the median value of successful measurements was considered representative of SS in any given patient only if the IQR of all validated measurements was less than 30% of the median values …”

Section: Methodsmentioning

confidence: 99%

“…In addition, the median value of successful measurements was considered representative of SS in any given patient only if the IQR of all validated measurements was less than 30% of the median values. [26][27][28]…”

Section: Transient Elastographymentioning

confidence: 99%

Assessing spleen stiffness by point shear‐wave elastography: Is it feasible and reproducible in patients with chronic liver disease? Is it useful to predict portal hypertension?

et al. 2019

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Summary Background and aims To assess the feasibility and reproducibility of the spleen stiffness (SS) measurement by point shear‐wave elastography (pSWE) in a cohort of compensated chronic liver disease (CLD) patients [Cohort 1] and to investigate pSWE accuracy to predict clinically relevant portal hypertension (PH) in a consecutive cohort of cirrhotics with endoscopic signs of portal hypertension [Cohort 2]. Methods [Cohort 1]: 186 consecutive CLD patients underwent abdominal ultrasound (US), liver stiffness (LS) and SS measurement by pSWE and transient elastography (TE) and liver biopsy. Inter‐rater agreement of SS (pSWE) was evaluated by intra‐class correlation coefficient (ICC). [Cohort 2]: 80 cirrhotics underwent US, LS and SS (by pSWE and TE), hepatic venous pressure gradient (HVPG) measurement and upper endoscopy. Linear correlations between LS or SS and HVPG and linear regression analysis were performed to establish determinants of HVPG > 16. Results [Cohort 1] SS measurement failure was 3.4% for pSWE and 13.8% for TE. For pSWE the ICC between two independent examiners was 0.74 (95% CI, 0.66‐0.80). [Cohort 2]: SS measurement failure was 2.5% for pSWE and 48% for TE. HVPG and LS did not correlate. Significant correlation was observed between HVPG and SS (r = 0.36, P = .001). At multivariate analysis only the presence of ascites and SS values significantly correlated with HVPG > 16, a threshold of high mortality risk cirrhosis. Conclusions Measuring SS by pSWE is feasible and reproducible in CLD and is applicable in most cirrhosis cases as a promising tool of prognosis and a surrogate marker of the HVPG threshold related to survival‐ and liver‐related outcomes.

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The Feasibility and Reliability of Transient Elastography Using Fibroscan^®: A Practice Audit of 2335 Examinations

Abstract: FibroScan failure and poorly reliable LSM are uncommon. The most important determinants of poorly reliable results are older age, obesity, higher liver stiffness and the operator, the latter emphasizing the need for adequate training.

Cited by 54 publications

References 38 publications

Liver stiffness measurement reliability and main determinants of point shear‐wave elastography in patients with chronic liver disease

Liver stiffness measurement reliability and main determinants of point shear‐wave elastography in patients with chronic liver disease

Transient Elastography-Based Liver Stiffness Age-Dependently Increases in Children

Assessing spleen stiffness by point shear‐wave elastography: Is it feasible and reproducible in patients with chronic liver disease? Is it useful to predict portal hypertension?

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The Feasibility and Reliability of Transient Elastography Using Fibroscan®: A Practice Audit of 2335 Examinations

Abstract: FibroScan failure and poorly reliable LSM are uncommon. The most important determinants of poorly reliable results are older age, obesity, higher liver stiffness and the operator, the latter emphasizing the need for adequate training.

Cited by 54 publications

References 38 publications

Liver stiffness measurement reliability and main determinants of point shear‐wave elastography in patients with chronic liver disease

Liver stiffness measurement reliability and main determinants of point shear‐wave elastography in patients with chronic liver disease

Transient Elastography-Based Liver Stiffness Age-Dependently Increases in Children

Assessing spleen stiffness by point shear‐wave elastography: Is it feasible and reproducible in patients with chronic liver disease? Is it useful to predict portal hypertension?

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The Feasibility and Reliability of Transient Elastography Using Fibroscan^®: A Practice Audit of 2335 Examinations