scholarly journals Options of non-invasive assessment of liver fibrosis based on the clinical data

2015 ◽  
Vol 156 (2) ◽  
pp. 43-52 ◽  
Author(s):  
Anna Egresi ◽  
Gabriella Lengyel ◽  
Krisztina Hagymási
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Gold Standard ◽  
Liver Diseases ◽  
Causes Of Death ◽  
Therapeutic Response ◽  
Transient Elastography ◽  
Chronic Liver Diseases ◽  
Indirect Methods ◽  
Non Invasive

Liver cirrhosis is one of the leading causes of death worldwide. Liver biopsy is considered as the gold standard for the diagnosis of chronic liver diseases. Studies have focused on non-invasive markers for liver fibrosis because of the dangers and complications of liver biopsy. The authors review the non-invasive direct as well as indirect methods for liver fibrosis assessment and present the positive and negative predictive value, sensitivity and specificity of those. Clinical utilities of transient elastography (Fibrsocan) is also reviewed. Non-invasive methods are useful in the assessment of liver fibrosis, monitoring disease progression and therapeutic response. Their accuracy can be increased by the combined or sequential use of non-invasive markers. Orv. Hetil., 2015, 156(2), 43–52.

scholarly journals Transient elastography correlated to four different histological fibrosis scores in children with liver disease

2021 ◽  
Author(s):  
Ulrike Teufel-Schäfer ◽  
Christa Flechtenmacher ◽  
Alexander Fichtner ◽  
Georg Friedrich Hoffmann ◽  
Jens Peter Schenk ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Aspartate Aminotransferase ◽  
Gold Standard ◽  
Scoring System ◽  
Transient Elastography ◽  
Non Invasive ◽  
Apri Score ◽  
Severe Fibrosis

AbstractCurrently, liver histology is the gold standard for the detection of liver fibrosis. In recent years, new methods such as transient elastography (TE) have been introduced into clinical practice, which allow a non-invasive assessment of liver fibrosis. The aim of the present study was to investigate the predictive value of TE for higher grade fibrosis and whether there is any relevance which histologic score is used for matching. For this purpose, we compared TE with 4 different histologic scores in pediatric patients with hepatopathies. Furthermore, we also determined the aspartate aminotransferase-to-platelet ratio (APRI) score, another non-invasive method, to investigate whether it is equally informative. Therefore, liver fibrosis in 75 children was evaluated by liver biopsy, TE and laboratory values. Liver biopsies were evaluated using four common histological scoring systems (Desmet, Metavir, Ishak and Chevalier’s semi-quantitative scoring system). The median age of the patients was 12.3 years. TE showed a good correlation to the degree of fibrosis severity independent of the histological scoring system used. The accuracy of the TE to distinguish between no/minimal fibrosis and severe fibrosis/cirrhosis was good (p = 0.001, AUC-ROCs > 0.81). The optimal cut-off value for the prediction of severe fibrosis was 10.6 kPa. In contrast, the APRI score in our collective showed no correlation to fibrosis.Conclusion: TE shows a good correlation to the histological findings in children with hepatopathy, independent of the used histological scoring system. What is Known:• The current gold standard for detecting liver fibrosis is liver biopsy. Novel non-invasive ultrasound-based methods are introduced to clinical diagnostics.• Most histological scores have been developed and evaluated in adult populations and for only one specific liver disease.What is New:• Transient elastography (TE) in children showed a good correlation to fibrosis severity irrespective of the utilized histological scoring system.• The aspartate aminotransferase-to-platelet ratio (APRI) showed no correlation with different stages of liver fibrosis in children.

New non-invasive tool for assessment of liver fibrosis: transient elastography

2011 ◽  
Vol 152 (22) ◽  
pp. 860-865 ◽  
Author(s):  
Gábor Horváth
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Disease Progression ◽  
Liver Diseases ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Chronic Viral Hepatitis ◽  
Non Invasive ◽  
Life Threatening ◽  
Invasive Method

Formation of connective tissue causing liver fibrosis is the common trait of chronic liver diseases. The „gold-standard” of the evaluation of liver fibrosis is liver biopsy, but it is an invasive, painful procedure, and carries a significant, although small risk of life-threatening complications. It may have contraindications, and it is certainly not the ideal procedure for serially repeated assessment of disease progression. A new, non-invasive method for the assessment of liver fibrosis by measuring liver stiffness is the transient elastography. The velocity of the propagation of a shear wave is measured by ultrasound. The procedure is painless, rapid, and no needs any preparation. So far, transient elastography has been mostly validated in chronic hepatitis C, but it is applicable in liver diseases with other etiologies. The diagnostic accuracy of transient elastography increases with stage of fibrosis, and is more accurate in advanced fibrosis (F≥2, Metavir score) and in cirrhosis. Indication of antiviral therapy for chronic viral hepatitis B and C are the main field of the application of the transient elastography, and it is also a useful tool for follow-up the disease progression. It is applicable for early, non-invasive detection of graft damage after liver transplantation. Evaluation of liver damage, the stage of liver fibrosis by transient elastography may have an important role in the decision before surgery, or application of potentially hepatotoxic drugs. Histological examination of the liver tissue is not substituted in every case by transient elastography, but liver biopsy is supplanted by measuring liver stiffness for evaluation of liver fibrosis in many cases. Orv. Hetil., 2011, 152, 860–865.

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 Elastography in Hepatology

2007 ◽  
Vol 21 (12) ◽  
pp. 839-842 ◽  
Author(s):  
Ludovico Abenavoli ◽  
Christophe Corpechot ◽  
Raoul Poupon
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Liver Diseases ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Factors Associated ◽  
History Of ◽  
Elastic Shear

A common characteristic of all chronic liver diseases is the occurrence and progression of fibrosis toward cirrhosis. Consequently, liver fibrosis assessment plays an important role in hepatology. Besides its importance for prognosis, determining the level of fibrosis reveals the natural history of the disease and the risk factors associated with its progression, to guide the antifibrotic action of different treatments. Currently, in clinical practice, there are three available methods for the evaluation of liver fibrosis: liver biopsy, which is still considered to be the ‘gold standard’; serological markers of fibrosis and their mathematical combination – suggested in recent years to be an alternative to liver biopsy – and, more recently, transient elastography (TE). TE is a new, simple and noninvasive method used to measure liver stiffness. This technique is based on the progressing speed of an elastic shear wave within the liver. Currently, there are only a few studies that have evaluated TE effectiveness in chronic liver diseases, mostly in patients infected with the hepatitis C virus. Further studies are needed in patients with chronic liver disease, to assess the effectiveness of the fibrosis treatment.

scholarly journals Matrix metalloproteinase-1 as a non-invasive biomarker to assess liver fibrosis in children with chronic liver disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ola Galal Behairy ◽  
Mohamed Mostafa El-Bakry ◽  
Amira Ibrahim Mansour ◽  
Amira M. N. Abdelrahman ◽  
Ghada Mansour Emam
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Liver Diseases ◽  
Serum Biomarkers ◽  
Chronic Liver ◽  
Control Group ◽  
Chronic Liver Diseases ◽  
Non Invasive ◽  
Matrix Metalloproteinase 1 ◽  
The Mean

Abstract Background Abnormal extracellular matrix (ECM) turnover is linked to liver fibrosis as it reflects an imbalance between repair and progressive substitution of the liver parenchyma by scar tissue. Matrix metalloproteinases (MMPs) are the primary enzymes involved in ECM breakdown. So, this study aims to measure the value of serum matrix metalloproteinase-1 (MMP-1) in children with chronic liver diseases (CLD) in comparison with liver biopsy and serum biomarkers. A hundred twenty children with chronic liver diseases and sixty healthy children as a control group were included in this study. Both groups were evaluated via medical history, clinical, radiological, laboratory investigations, and serum MMP-1 level was measured by ELISA. Liver biopsy was performed for studied patients only. Results The mean MMP-1 was 15.2 ± 5.1 ng/ml in children with CLD, and 64.7 ± 27.4 ng/ml in the control group. MMP-1 was statistically lower in the children with CLD than controls (p < 0.001). The mean ± SD of aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 (FIB-4) scores in all studied cases showed a significant trend of increase with progressive fibrosis stage evident with histological METAVIR scoring system, while serum MMP-1 concentration was decreased significantly with increasing the degree of fibrosis in CLD group (P 0.001). Serum MMP-1 was indirectly correlated with serum biomarkers and the degree of fibrosis in patients. Conclusions MMP-1 is a useful non-invasive marker for detection of the stage of liver fibrosis in children with chronic liver diseases.

CHANGES IN CONCENTRATION OF SERUM FIBROSIS DIRECT BIOMARKERS IN CHRONIC LIVER DISEASES IN CHILDREN

2021 ◽  
Vol 100 (2) ◽  
pp. 112-118
Author(s):  
E.A. Kulebina ◽  
◽  
A.N. Surkov ◽  
N.M. Alyabeva ◽  
I.V. Zubkova ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Blood Serum ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Type I ◽  
Chronic Liver Diseases ◽  
Non Invasive ◽  
Study Characteristics ◽  
A Prospective Study

It is assumed that serum concentrations of type I, III, IV collagen (Col I, Col III, Col IV) and hyaluronic acid (HA) can provide informative evidence for the diagnosis of liver fibrosis (LF) using non-invasive procedures, however, there is insufficient data on the subject in paediatrics. Objectives: to study characteristics of changes in concentrations of Col I, Col III, Col IV and HA in blood serum in accordance with the stages of liver fibrosis in children. Materials and methods of research: a prospective study was carried out, which included 80 patients aged 5 to 17 years with chronic liver diseases of various etiologies, who underwent marginal resection of liver tissue under laparoscopic control, then a morphological study of the obtained biopsy was performed with determination of the stage of fibrosis on the METAVIR scale and the content of Col I, Col III, Col IV and HA in blood serum by the method of enzyme immunoassay. Results: the assessment of the content of K-I in the blood serum allows differentiating the stage F1 and F3 from F4 (p=0,025, p=0,006), Col IV – F1 from F2 (p=0,011), F3 (p=0,002) and F4 (p<0,001), HA – F1 from F3 (p=0,041), and also F4 from F1 (p<0,001), F2 (p<0,001) and F3 (p<0,001). There were no statistically significant differences in the content of Col III at different stages of LF (p=0,061). Statistically significant correlations of the histological stage of LF with changes in serological levels of Col I (ρ=–0,267, p=0,023), Col IV (ρ=0,409, p<0,001), and HA (ρ=0,575, p<0,001), and also the relationship between the concentrations of Col IV and HA (ρ=0,265, p=0,023). Conclusions: the correlations found in the histological phase of LF with changes in serological levels of Col I, Col IV and HA lead to the conclusion that fibrosis direct biomarkers are of diagnostic importance in determining the stage of LF, which is of great importance for practical medicine, especially in pediatrics.

Sign in / Sign up

Export Citation Format

Share Document