scholarly journals Strain Elastography (SE) for liver fibrosis estimation – which elastic score to calculate?

2016 ◽  
Vol 18 (4) ◽  
pp. 481 ◽  
Author(s):  
Mariana M. Gersak ◽  
Monica Lupșor-Platon ◽  
Radu Badea ◽  
Anca Ciurea ◽  
Sorin M Dudea
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Quantitative Method ◽  
Estimation Method ◽  
Daily Practice ◽  
Ultrasound Elastography ◽  
Fibrosis Score ◽  
Strain Elastography ◽  
Non Invasive ◽  
Similar Accuracy

Liver fibrosis scoring by liver biopsy has become a rarity in daily practice mainly because many non-invasive methods with similar accuracy have been developed. Among all ultrasound elastography imaging methods, Strain Elastography (SE) is the most widely available. Although SE is a qualitative and semi-quantitative method, there is reliable applicability for liver fibrosis estimation and multiple ways to transform SE into a quantitative method, in order to obtain a fibrosis score. The aim of this review is to briefly introduce all these methods and to offer support in choosing the best estimation method for liver fibrosis, with SE.

scholarly journals Comparative study between liver biopsy and non-invasive biomarkers in assessment of hepatic fibrosis in children with chronic liver diseases

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Ola Galal Behairy ◽  
Ola Samir El-Shimi ◽  
Naglaa Hamed Shalan
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Liver Diseases ◽  
Area Under The Curve ◽  
Chronic Liver ◽  
Fibrosis Score ◽  
Chronic Liver Diseases ◽  
Non Invasive ◽  
Advanced Liver Fibrosis ◽  
Early Fibrosis

Abstract Background Liver biopsy is the gold standard for detecting the degree of liver fibrosis; however, invasiveness constitutes its main limiting factor in clinical application, so we aimed to evaluate the non-invasive biomarker formulas (APRI and FIB-4) and their modified forms by BMI z-score (M-APRI, M-FIB-4, and B-AST) compared to liver biopsy in the assessment of liver fibrosis in children with chronic liver diseases. Two hundred children aged 6.3 ± 3.8 years (98 males, 102 females) with chronic liver diseases underwent liver biopsy. The stage of fibrosis was assessed according to the METAVIR system for all children, and the following non-invasive biomarker formulas were calculated: APRI, modified APRI (M-APRI: BMI z-score × APRI), Fibrosis-4 index (FIB-4), modified FIB-4 (M-FIB-4: BMI z-score × FIB-4), and B-AST (BMI z-score × AST). The best cutoff value was calculated to detect early fibrosis (F1–F2) from advanced liver fibrosis (F3–F4). Results There were positive correlations between all studied non-invasive biomarker models (APRI, FIB-4, M-APRI, M-FIB-4, B-AST) and fibrosis score as an increase in fibrosis score was associated with an increase in mean ± SD of all studied biomarker formulas. The best cutoff values of non-invasive biomarker models in the diagnosis of early fibrosis (F1–F2) were APRI > 0.96, M-APRI > 0.16, FIB-4 > 0.019, M-FIB-4 > 0.005, and B-AST > −8 with an area under the curve above 0.7 each, while the best cutoff values of non-invasive biomarker models (APRI, M-APRI, FIB-4, M-FIB-4, and B-AST) in the diagnosis of advanced liver fibrosis (F3–F4) were >1.96, >2.2, >0.045, and >0.015, >92.1, respectively, with an area under the curve above 0.8 each. Conclusion APRI, M-APRI, FIB-4, M-FIB-4, and B-AST are good non-invasive alternatives to liver biopsy in the detection of liver fibrosis in children with chronic liver diseases of different etiologies especially those that include BMI z-scores in their formulas.

scholarly journals NON INVASIVE ASSESSMENT OF LIVER FIBROSIS USING ULTRASOUND POINT SHEAR WAVE ELASTOGRAPHY

2021 ◽  
pp. 1-3
Author(s):  
Sunil Patel ◽  
Chinmay Kulkarni ◽  
Srikanth Moorthy
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Shear Wave ◽  
Hepatic Fibrosis ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Non Invasive ◽  
Elevated Liver Enzymes ◽  
Clinically Significant

Aim To prospectively determine the sensitivity, specificity and accuracy of point shear wave elastography as a non-invasive method in the diagnosis of clinically significant hepatic fibrosis with various etiologies of liver using liver biopsy as gold standard.To determine the stiffness cut-off values for point shear wave elastography (pSWE) diagnosis of clinically significant hepatic fibrosis. Methods Fifty patients with elevated liver enzymes were examined by point shear wave Elastography and they subsequently underwent percutaneous liver biopsy. Ultrasound Elastography findings were correlated with the histopathology fibrosis staging (METAVIR / Brunt Scoring) Results Liver stiffness value of >7.6 kPa was cut-off for clinically significant fibrosis and had a sensitivity of 92%, a specificity of 78.3% and an accuracy of 86%. Conclusions ElastPQ is a non-invasive and sensitive technique for determining the clinically significant liver fibrosis in patients with various etiologies.

scholarly journals Evaluation of the effectiveness of ultrasound shear elastography and liver steatometry

2020 ◽  
Vol 92 (4) ◽  
pp. 17-22
Author(s):  
O. I. Tarasova ◽  
E. I. Kuhareva ◽  
S. K. Krasnitskaya ◽  
N. V. Mazurchik ◽  
M. Ya. Ngameni ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Comparative Analysis ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Liver Steatosis ◽  
Diagnostic System ◽  
Ultrasound Elastography ◽  
Cross Sectional ◽  
Ultrasonic Diagnostic System ◽  
Diagnostic Criterion

Detection of liver fibrosis and steatosis at early stages is a difficult task for clinical practice, due to the lack of early signs in routine radiation diagnostics. Aim. To evaluate the efficacy of ultrasound shear elastography and ultrasound steatometry of the liver with the use of domestic ultrasonic diagnostic system Angiodin-Sono/N-Ultra. Materials and methods. 264 people held ultrasound elastography and ultrasound steatometry. 38 patients underwent percutaneous puncture liver biopsy and subsequent pathophysiological examination. Results. High correlation of fibrosis obtained at the Angiodin-Sono/N-Ultra and the leading ultrasonic systems with shear elastography was revealed. Cross-sectional comparative analysis of elasticity with the results of liver steatometry was conducted. Conclusions. Results obtained in all groups correlate with the data obtained in studies on Fibroscan. When working with system Angiodin we got a simultaneous comparative analysis of elasticity with the results of liver steatosis. Results appear to be much more stable and compact than those obtained in studies on the Fibroscan. A new diagnostic criterion was revealed the phenomenon of independence of fibrosis and steatosis indices.

scholarly journals Advances in non-invasive assessment of hepatic fibrosis

Gut ◽  
2020 ◽  
Vol 69 (7) ◽  
pp. 1343-1352 ◽  
Author(s):  
Rohit Loomba ◽  
Leon A Adams
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Stiffness ◽  
Chronic Liver ◽  
Response To Treatment ◽  
Fibrosis Score ◽  
Alcoholic Fatty Liver ◽  
Need For Treatment ◽  
Non Invasive ◽  
Confirmatory Tests

Liver fibrosis should be assessed in all individuals with chronic liver disease as it predicts the risk of future liver-related morbidity and thus need for treatment, monitoring and surveillance. Non-invasive fibrosis tests (NITs) overcome many limitations of liver biopsy and are now routinely incorporated into specialist clinical practice. Simple serum-based tests (eg, Fibrosis Score 4, non-alcoholic fatty liver disease Fibrosis Score) consist of readily available biochemical surrogates and clinical risk factors for liver fibrosis (eg, age and sex). These have been extensively validated across a spectrum of chronic liver diseases, however, tend to be less accurate than more ‘complex’ serum tests, which incorporate direct measures of fibrogenesis or fibrolysis (eg, hyaluronic acid, N-terminal propeptide of type three collagen). Elastography methods quantify liver stiffness as a marker of fibrosis and are more accurate than simple serum NITs, however, suffer increasing rates of unreliability with increasing obesity. MR elastography appears more accurate than sonographic elastography and is not significantly impacted by obesity but is costly with limited availability. NITs are valuable for excluding advanced fibrosis or cirrhosis, however, are not sufficiently predictive when used in isolation. Combining serum and elastography techniques increases diagnostic accuracy and can be used as screening and confirmatory tests, respectively. Unfortunately, NITs have not yet been demonstrated to accurately reflect fibrosis change in response to treatment, limiting their role in disease monitoring. However, recent studies have demonstrated lipidomic, proteomic and gut microbiome profiles as well as microRNA signatures to be promising techniques for fibrosis assessment in the future.

scholarly journals NON-INVASIVE ASSESSMENT OF LIVER FIBROSIS USING LIVER ELASTOGRAPHY (FIBROSCAN) IN PATIENTS WITH CHRONIC INFECTION HBV AND HCV

2016 ◽  
Vol 19 (3) ◽  
pp. 55-59
Author(s):  
Andreea Rădășan ◽  
◽  
Mihai Voiculescu ◽  
Laura Elena Iliescu ◽  
◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Viral Hepatitis ◽  
Chronic Viral Hepatitis ◽  
Economic Problem ◽  
Non Invasive ◽  
Treatment And Prevention ◽  
Viral Hepatitis C ◽  
B Virus ◽  
Liver Elastography

Introduction. In recent years there have been major advances in the treatment and prevention of viral hepatitis, but this pathology is still a major health and socio-economic problem. The defining element for this disease is the liver fibrosis, a histological component of particular importance due to its role in the formation of liver lesions of cirrhosis. Thus, an essential step in the management of chronic viral hepatitis is the detection and measurement of liver fibrosis. Today we have invasive methods for detecting liver fibrosis, the liver puncture biopsy, and non-invasive methods, which in turn are divided into serum methods and imaging methods (2). Purpose of the Study. The aim of this study is to determine if transcutaneous elastography (FibroScan) is equally reliable in case of viral hepatitis B, as with viral hepatitis C. Material and Method: The study comprises a total of 1,127 patients with liver disease of HBV and HCV aetiology. These patients were examined using FibroScan in the period July 2009 - April 2011. Results: Of the 1,177 patients investigated using FibroScan, 40 underwent liver biopsy as well. Of these, 82% have obtained same stages of liver fibrosis in these two investigations, and 18% achieved different stages of fibrosis in these two tests. For the patients with HCV infection, we obtained a 67.81% match of the two non-invasive tests, FibroScan and FibroMax, and a 79.16% match of FibroScan compared to the Liver Biopsy. For the B virus, the compliance is even better, of 75% (FibroScan - FibroMax), and 80% for FibroScan - LB. Conclusions: FibroScan is one of the non-invasive assessment methods of liver fibrosis with diagnose accuracy similar to FibroMax and close to Liver Biopsy.

Non-invasive biomarkers of liver fibrosis in haemophilia patients with hepatitis C: can you avoid liver biopsy?

Haemophilia ◽  
2006 ◽  
Vol 12 (4) ◽  
pp. 372-379 ◽  
Author(s):  
Y. MAOR ◽  
D. BASHARI ◽  
G. KENET ◽  
A. LUBETSKY ◽  
J. LUBOSHITZ ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Non Invasive

scholarly journals Evaluation of the nonalcoholic fat liver disease fibrosis score for patients undergoing bariatric surgery

2010 ◽  
Vol 47 (2) ◽  
pp. 170-173 ◽  
Author(s):  
Silvania Klug Pimentel ◽  
Rodrigo Strobel ◽  
Carolina Gomes Gonçalves ◽  
Danielle Giacometti Sakamoto ◽  
Flávio Heuta Ivano ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Advanced Fibrosis ◽  
Fibrosis Score ◽  
Advanced Liver Fibrosis ◽  
Fat Liver

CONTEXT: Morbidly obese patients have an increased risk for nonalcoholic fat liver disease. Its severe form, nonalcoholic steatohepatitis may cause liver fibrosis. The diagnosis of advanced fibrosis has great value during the pre operative evaluation for bariatric surgery. Currently, liver biopsy is the gold standard for diagnosis of liver fibrosis. OBJECTIVE: To evaluate the nonalcoholic fat liver disease fibrosis score in morbidly obese patients undergoing Roux-en-Y gastric bypass in our population. METHODS: One hundred fifty-eight morbidly obese patients that had undergone bariatric surgery were included. Age, body mass index, hyperglycemia, platelet count, albumin and AST/ALT ratio were applied to the score formula. Scores above 0.676 were indicative of advanced liver fibrosis and scores under -1,455 absence of advanced liver fibrosis. These scores were compared to liver biopsy findings. RESULTS: The presence of advanced fibrosis could be diagnosed with good accuracy, with a positive predictive value of 83.7%. The score had a higher accuracy to exclude advanced fibrosis with a negative predictive value of 97%. Twenty-five patients (16%) had scores between the cutoffs points and were identified as indeterminate. The score sensibility and specificity was 83% and 97% respectively. CONCLUSIONS: The nonalcoholic fat liver disease fibrosis score has high accuracy to identify and exclude advanced liver fibrosis in morbidly obese patients subjected to bariatric surgery.

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