scholarly journals Comparative evaluation of fibroscan, liver biopsy and non-invasive serum markers for assessment of hepatic fibrosis in chronic liver disease

2020 ◽  
Vol 5 (3) ◽  
pp. 213-218
Author(s):  
Renuka Verma ◽  
◽  
Nisha Marwah ◽  
Gurupriya J ◽  
Praveen Malhotra ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Chronic Liver Disease ◽  
Hepatic Fibrosis ◽  
Comparative Evaluation ◽  
Serum Markers ◽  
Chronic Liver ◽  
Non Invasive

scholarly journals The role of elastography in the assessment of chronic liver disease in children

2019 ◽  
Vol 19 (3) ◽  
pp. 2806-2311
Author(s):  
Süleyman Sönmez ◽  
Merve Boşat ◽  
Nihal Yurtseven ◽  
Eray Yurtseven
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Chronic Liver Disease ◽  
Real Time ◽  
Correlation Coefficient ◽  
Hepatic Fibrosis ◽  
Pearson Correlation ◽  
Chronic Liver ◽  
Liver Biopsies

Background: Conventional ultrasonography is a method preferred for the investigation of chronic liver diseases in pediatric groups, as it is non-invasive, cheap, feasible and available. The purpose of this study is to present the role of Share-wave Elastography (SWE) in terms of diagnostic value in children diagnosed with “chronic liver disease.”Methods: We studied patients who had been diagnosed with chronic liver disease between March 2012-September 2015, and who had undergone liver biopsy and had their pathology results, compared with 26 healthy subjects. Statistical analysis was performed with IBM SPSS Statistics for Windows, Version 20.0. “Pearson Correlation Analysis” was performed in order to measure the relationship between elastography values and Brunt level.Results: This study had 107 subjects in total, consisting of 81 patients between 0-204 months of age Pearson correlation coefficient level was determined as r = 0.644. Since the correlation coefficient is positive, there is a same-directional relationship between Elastography level and Brunt degree. This means that while one of the variables is increasing, the other one will also increase.Conclusion: Since it is known that development of hepatic fibrosis is a dynamic process, and that many hepatic fibrosis etiologies are known to continue throughout the course of life, the application of Real time SWE method instead of repeated liver biopsies on patients is a much simpler and smart method. Increasing the clinical use of Real Time SWE method with future studies might provide an opportunity for preventing unnecessary liver biopsies since the patients are evaluated in a shorter time and in a cost-effective manner.Keywords: Shear-Wave Elastography, Brunt degree, chronic liver disease, liver biopsy.

scholarly journals A review of the clinical utility of the Enhanced Liver Fibrosis test in multiple aetiologies of chronic liver disease

2019 ◽  
Vol 57 (1) ◽  
pp. 36-43
Author(s):  
Preya Janubhai Patel ◽  
Declan Connoley ◽  
Freya Rhodes ◽  
Ankur Srivastava ◽  
William Rosenberg
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Chronic Liver Disease ◽  
Clinical Utility ◽  
Chronic Liver ◽  
Biliary Cirrhosis ◽  
Alcoholic Fatty Liver ◽  
Functional Changes ◽  
Non Invasive

The rising incidence of chronic liver disease continues to be an increasing health burden. The morbidity and mortality associated with chronic liver disease typically occur in patients with advanced fibrosis. Hence, early identification of those at-risk is of vital importance to ensure appropriate ongoing management. Currently, tools for appropriate risk stratification remain limited. Increasing awareness of the limitations of liver biopsy has driven research into alternative non-invasive methods of fibrosis assessment including serological markers assessing functional changes. One such biomarker, the Enhanced Liver Fibrosis test, was initially validated in a cohort of 1021 patients with mixed aetiology chronic liver disease and shown to perform well. Since this pathfinder study, it has been independently validated in cohorts of hepatitis C, non-alcoholic fatty liver disease, alcoholic liver disease, primary biliary cirrhosis and primary sclerosing cholangitis. In addition to performing well as a diagnostic tool, the Enhanced Liver Fibrosis test has been shown to outperform liver biopsy in prognostic studies and is the only non-invasive marker to do so. However, questions remain regarding the use of this test, particularly regarding the possible effect age and alcohol may have on test scores. This review examines the current literature published in relation to the Enhanced Liver Fibrosis test and its clinical utility and highlights areas requiring further study.

Quantitative magnetic resonance imaging for chronic liver disease

2021 ◽  
pp. 20201377
Author(s):  
Guilherme Moura Cunha ◽  
Patrick J Navin ◽  
Kathryn J Fowler ◽  
Sudhakar K Venkatesh ◽  
Richard L Ehman ◽  
...  
Keyword(s):  
Liver Disease ◽  
Magnetic Resonance ◽  
Liver Biopsy ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Quantitative Magnetic Resonance Imaging ◽  
Liver Iron ◽  
Non Invasive ◽  
The Past ◽  
Current State

Chronic liver disease (CLD) has rapidly increased in prevalence over the past two decades, resulting in significant morbidity and mortality worldwide. Historically, the clinical gold standard for diagnosis, assessment of severity, and longitudinal monitoring of CLD has been liver biopsy with histological analysis, but this approach has limitations that may make it suboptimal for clinical and research settings. Magnetic resonance (MR)-based biomarkers can overcome the limitations by allowing accurate, precise, and quantitative assessment of key components of CLD without the risk of invasive procedures. This review briefly describes the limitations associated with liver biopsy and the need for non-invasive biomarkers. It then discusses the current state-of-the-art for MRI-based biomarkers of liver iron, fat, and fibrosis, and inflammation.

Combining hepatic surface nodularity and serum tests better predicts hepatic fibrosis stages in chronic liver disease

2021 ◽  
Author(s):  
Hyo Jung Cho ◽  
Jaewon Choi ◽  
Bohyun Kim ◽  
JeongGil Ko ◽  
Joon-Il Choi ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Hepatic Fibrosis ◽  
Chronic Liver

Mac‐2 Binding Protein Glycan Isomer as non‐invasive tool to assess liver fibrosis in children with chronic liver disease

2021 ◽  
Author(s):  
Ola G Behairy ◽  
Soha A El‐Gendy ◽  
Dalia Y Ibrahim ◽  
Amira I Mansour ◽  
Ola S El‐Shimi
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Chronic Liver Disease ◽  
Binding Protein ◽  
Chronic Liver ◽  
Non Invasive

scholarly journals A72 NON-INVASIVE PREDICTION OF ESOPHAGEAL VARICES BY TRANSIENT ELASTOGRAPHY AND PLATELET COUNT IN PATIENTS WITH HEPATITIS B AND ADVANCED CHRONIC LIVER DISEASE: VALIDATION OF BAVENO VI AND EXPANDED BAVENO VI CRITERIA

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-38
Author(s):  
A Zoughlami ◽  
J Serero ◽  
G Sebastiani ◽  
M Deschenes ◽  
P Wong ◽  
...  
Keyword(s):  
Platelet Count ◽  
Liver Disease ◽  
Hepatitis B ◽  
Chronic Liver Disease ◽  
Esophageal Varices ◽  
Diagnostic Performance ◽  
Transient Elastography ◽  
Chronic Liver ◽  
Non Invasive ◽  
Chronic Hepatitis B Virus

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

scholarly journals P16 Non-invasive evaluation of fibrosis in paediatric chronic liver disease

Gut ◽  
2011 ◽  
Vol 60 (Suppl 2) ◽  
pp. A8-A8
Author(s):  
E. Fitzpatrick ◽  
M.-S. Basso ◽  
A. Quaglia ◽  
R. R. Mitry ◽  
A. Dhawan
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Non Invasive ◽  
Invasive Evaluation

scholarly journals Motion – All Patients with NASH Need to Have a Liver Biopsy: Arguments against the Motion

2002 ◽  
Vol 16 (10) ◽  
pp. 722-726 ◽  
Author(s):  
Jacqueline Laurin
Keyword(s):  
Liver Disease ◽  
Liver Biopsy ◽  
Chronic Liver Disease ◽  
Chronic Liver ◽  
Nonalcoholic Fatty Liver ◽  
Histological Assessment ◽  
Clinical Benefits ◽  
Liver Biopsies ◽  
Alpha 1 Antitrypsin ◽  
Iron Profile

Most cases of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are suspected on the basis of the exclusion of viral, autoimmune, metabolic and genetic causes of chronic liver disease in patients with chronic elevation of aminotransferase enzymes. However, the definitive diagnosis of NASH requires liver biopsy. Valuable blood tests include hepatitis B and C serology, iron profile, alpha 1-antitrypsin phenotype, ceruloplasmin, antinuclear antibody and antismooth muscle antibody, and serum protein electrophoresis. If these tests are negative or normal, and if there are no symptoms or signs of chronic liver disease, it is unlikely that a specifically treatable liver disease would be discovered at biopsy. The prevalence of NAFLD in the general population appears to be approximately 20%, and 2% to 3% of people have NASH. There is no proven specific therapy for the spectrum of nonalcoholic liver disease; therefore, the management of the patient with NASH is not likely to be changed after histological assessment. Bleeding, sometimes fatal, and other complications requiring hospitalization can occur, and liver biopsies should not be undertaken without clear clinical indications. The high cost of undertaking histological assessment of all persons with asymptomatic elevations of liver enzymes cannot be justified in view of the risks and limited clinical benefits.

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