Utility of transient elastography in the non-invasive evaluation of cystic fibrosis liver disease

2013 ◽  
Vol 33 (5) ◽  
pp. 698-705 ◽  
Author(s):  
Matthew T. Kitson ◽  
William W. Kemp ◽  
David M. Iser ◽  
Eldho Paul ◽  
John W. Wilson ◽  
...  
PLoS ONE ◽  
2012 ◽  
Vol 7 (7) ◽  
pp. e42139 ◽  
Author(s):  
Thomas Karlas ◽  
Marie Neuschulz ◽  
Annett Oltmanns ◽  
Andrea Güttler ◽  
David Petroff ◽  
...  

2021 ◽  
Vol 8 ◽  
Author(s):  
Ágnes Rita Martonosi ◽  
Alexandra Soós ◽  
Zoltán Rumbus ◽  
Péter Hegyi ◽  
Vera Izsák ◽  
...  

Background and Aims: Cystic fibrosis-related liver disease (CFLD) is one of the leading causes of morbidity and mortality in cystic fibrosis (CF). Several non-invasive diagnostic methods have been proposed as screening tools for CFLD. Our aim was to rank all available non-invasive modalities for diagnostic performance.Methods: A systematic search was performed in five medical databases to find studies which reported on any single or composite non-invasive diagnostic test (as an index test) compared to the Debray, the EuroCare or the Colombo criteria (as a reference standard). Ranking was carried out with a Bayesian diagnostic test accuracy network meta-analysis based on superiority indices, calculated for pooled sensitivity (Se) and specificity (Sp) with a 95% confidence interval (CI). The study was registered under CRD42020155846 in PROSPERO.Results: Fifteen studies with 15 index tests and a combination of them were included. The New criteria proposed by Koh et al. – which represent a composite diagnostic definition for CFLD including liver biochemistry, ultrasonography, transient elastography and fibrosis markers—had the best performance for detecting CFLD (Se:94%[CI:58–100], Sp:72%[CI:52–84]); while transient elastography (Se:65%[CI:56–74], Sp:88%[CI:84–91]) and a combination of it with a tissue inhibitor of metalloproteinase-4 measurement (Se:78%[CI:30–100], Sp:64%[CI:18–95%]) proved to be the second and third best options, respectively. In the imaging techniques subgroup, transient elastography (Se:66%[CI:57–72], Sp:88%[CI:85–91%]), acoustic radiation force impulse in the right lobe (Se:54%[CI:33–74], Sp:88%[CI:66–96]) and that in the left lobe (Se:55%[CI:23–81], Sp:82%[CI:50–95]) were ranked the highest. Comparing biochemical markers/fibrosis indices, the measurement of the Forns index (Se:72%[CI:25–99], Sp:63%[CI:16–94]), the aspartate aminotransferase-to-platelet ratio (Se:55%[CI:41–68], Sp:83%[CI:66–89]) and alkaline phosphatase (Se:63%[CI:18–93], Sp:64%[CI:19–95]) were ranked the highest.Conclusion: The New criteria show the best diagnostic performance. In clinical practice, transient elastography seems to be a simple, cheap and non-invasive tool, outperforming imaging, biochemical and fibrosis tests for detecting CFLD. Further studies are needed to validate our findings.


2012 ◽  
Vol 44 (9) ◽  
pp. 780-787 ◽  
Author(s):  
Timo Rath ◽  
Katrin Menendez Menendez ◽  
Marion Kügler ◽  
Lisa Hage ◽  
Christian Wenzel ◽  
...  

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-38
Author(s):  
A Zoughlami ◽  
J Serero ◽  
G Sebastiani ◽  
M Deschenes ◽  
P Wong ◽  
...  

Abstract Background Patients with compensated advanced chronic liver disease (cACLD) are at higher risk of developing complications from portal hypertension, including esophageal varices (EV). Baveno VI and expanded Baveno VI criteria, based on liver stiffness measurement (LSM) by transient elastography combined with platelet count, have been proposed to avoid unnecessary esophagogastroduodenoscopy (EGD) screening for large esophageal varices needing treatment (EVNT). This approach has not been validated in patients with chronic hepatitis B virus (HBV) infection, who have etiology-specific cut-off of LSM for liver fibrosis. Aims We aimed to validate the Baveno VI and expanded Baveno VI criteria for EVNT in HBV patients with cACLD. Methods We performed a retrospective analysis of HBV patients who underwent LSM in 2014–2020. Inclusion criteria were: a) diagnosis of cACLD, defined as LSM >9 kPa; b) availability of EGD and platelets within 1 year of LSM. Baveno VI (LSM <20 kPa and platelets >150,000) and expanded Baveno VI criteria (LSM <25 kPa and platelets >110,000) were tested for EGD sparing. Diagnostic performance of these criteria against gold standard (EGD) was computed and compared to patients with hepatitis C virus (HCV) infection and nonalcoholic steatohepatitis (NASH) etiologies, where these criteria have been widely validated. In these patients, the threshold for cACLD definition was >10 kPa. Results A total of 287 patients (mean age 56, 95% Child A) were included, comprising of 43 HBV (58% on antiviral therapy), 134 HCV and 110 NASH patients. The prevalence of any grade EV and EVNT was 25% and 8% in the whole cohort, with 19% and 5% in HBV patients, respectively. Table 1 reports diagnostic performance, spared EGD and missed EVNT according to non-invasive criteria and cACLD etiology. Both Baveno VI and expanded Baveno VI criteria performed well in patients with HBV-related cACLD. There was no significant difference on diagnostic performance of these non-invasive criteria across the cACLD etiologies. Conclusions These results support use of non-invasive criteria based on LSM and platelets to spare unnecessary EGD in patients with HBV and cACLD. Baveno VI and expanded Baveno VI criteria can improve resource utilization and avoid invasive testing in context of screening EGD for patients with HBV-related cACLD. Funding Agencies None


2021 ◽  
pp. 43-47
Author(s):  
Veenit Kumar Prasad ◽  
Bapilal Bala ◽  
Biswadev Basumazumder ◽  
Achintya Narayan Ray

INTRODUCTION: Alcoholic liver disease is one of the major causes of premature deaths worldwide. Alcohol induced liver injury is the most prevalent cause of liver disease and effects 10% to 20% of population worldwide. Alcoholic liver disease comprises a wide spectrum of pathological changes ranging from steatosis, alcoholicsteato-hepatitis, Cirrhosis and nally hepatocellular carcinoma. Our aims in this study are to detect this change by non invasive method by liver broscan and its clinical implications. MATERIALS AND METHODS: Total 200 patients were taken for observational study, conducted at Coochbehar Government Medical college and hospital both outpatient department and indoor patients from May 2019 to January 2020. Liver stiffness was assessed by ultrasound based method of transient elastography using Fibroscan machine. Gradation of liver stiffness was expressed in kilopascals (KPa). RESULTS: Maximum number of patients of alcoholic liver disease were between 40 - 49 years of age (42.5%). Male patients is 87.5% and female patients 12.5%. distribution of Rural population is 36 % and Urban population is 64%. Majority of population85 patients (42.5%) had fatty liver and 40 patients (20%) have hepatomegaly, 41 patients (20.5%) had Coarse echotexture of liver parenchyma and 54 patients (27%) had Splenomegaly, 62 patients (31%) had Nodular liver and 62 patients. It is observed that 11 patients (5.5%) had Fibroscan score ≤7.5 and 47 patients (23.5%) had broscan score 7.6 -9.9 and 40 patients (20%) had broscan score 10-12.4, 36 patients (18 %) had broscan score 12.5 – 14.6 and 66 patients (33%) have broscan score ≥ 14.7. CONCLUSIONS: Transient Elastography (TE) is a newer non invasive assessment technique to detect the progression of brosis or brosis in alcoholic liver disease patient. Major advantage is it is noninvasive (costeffective) so that we can early detect progression of this cirrhosis and can give efforts to halt the disease progression.


Gut ◽  
2011 ◽  
Vol 60 (Suppl 2) ◽  
pp. A8-A8
Author(s):  
E. Fitzpatrick ◽  
M.-S. Basso ◽  
A. Quaglia ◽  
R. R. Mitry ◽  
A. Dhawan

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Antonella Tosco ◽  
Angela Sepe ◽  
Alice Castaldo ◽  
Andrea Catzola ◽  
Chiara Cimbalo ◽  
...  

2019 ◽  
Vol 493 ◽  
pp. S367
Author(s):  
A. Guerra-Ruiz ◽  
A. Maiztegi ◽  
N. Fañanas ◽  
S. Perez ◽  
H. Sentissi ◽  
...  

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