scholarly journals Transient elastography for noninvasive assessment of liver fibrosis in patients with primary biliary cirrhosis

2018 ◽  
Vol 75 (4) ◽  
pp. 374-379
Author(s):  
Tamara Milovanovic ◽  
Ana Copertino ◽  
Ivan Boricic ◽  
Biljana Milicic ◽  
Aleksandra Pavlovic-Markovic ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Primary Biliary Cirrhosis ◽  
Liver Biopsy ◽  
Transient Elastography ◽  
Fibrosis Stage ◽  
Biliary Cirrhosis ◽  
Noninvasive Methods ◽  
Significant Difference ◽  
Apri Score ◽  
Noninvasive Markers

Backgrund/Aim. In recent decades noninvasive methods for the assessment and monitoring of liver fibrosis have been developed and evaluated in numerous chronic liver diseases. The aim of this study was to evaluate the diagnostic accuracy of noninvasive markers for fibrosis assessment transient elastography (TE) and biochemical markers using liver biopsy as reference in patients with primary biliary cirrhosis (PBC). Methods. One hundred and twenty-two patients underwent both liver biopsy and blood tests on the same day and TE in a month following the biopsy and the tests. Liver biopsies were reviewed by a single pathologist using the METAVIR scoring system for assessment of liver fibrosis. Aspartate aminotransferase (AST), platelet ratio index (APRI), Forns scores, AST and alanine transaminase (ALT) ratio and TE were compared with liver fibrosis stage in order to determine the best noninvasive marker of liver fibrosis. Results. There was a statistically significant difference (p < 0.05) for the APRI score, Forns index and TE according to stages of liver fibrosis. TE showed superior diagnostic performance when compared to other surrogate markers of liver fibrosis that were investigated. Optimal cut-off for TE were 4.25 and 5.9 kPa for diagnosing the presence of fibrosis and distinguishing mild/moderate and advanced stages of fibrosis respectively. The areas under the receiver operating characteristic (AUROC) of TE were 0.963 and 0.865, respectively. Conclusion. Based on our investigation the APRI score, Forns index and TE adequately predict fibrosis stage in patients with primary biliary cirrhosis, but the most sensitive and specific parameter appears to be TE. Using noninvasive markers and methods in the evaluation of patients in daily clinical practice may reduce, but not eliminate, the need for invasive diagnostic procedures.

OC.11.4 PERFORMANCE OF TRANSIENT ELASTOGRAPHY AND NON INVASIVE MARKERS OF LIVER FIBROSIS IN PRIMARY BILIARY CIRRHOSIS

2010 ◽  
Vol 42 ◽  
pp. S96
Author(s):  
N. Cazzagon ◽  
L. Chemello ◽  
D. Martines ◽  
L. Cavalletto ◽  
V. Baldo ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Primary Biliary Cirrhosis ◽  
Transient Elastography ◽  
Biliary Cirrhosis ◽  
Non Invasive

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.

F.N.2 PERFORMANCE OF TRANSIENT ELASTOGRAPHY AND NON INVASIVE MARKERS OF LIVER FIBROSIS IN PRIMARY BILIARY CIRRHOSIS

2010 ◽  
Vol 42 ◽  
pp. S33
Author(s):  
N. Cazzagon ◽  
L. Chemello ◽  
D. Martines ◽  
L. Cavalletto ◽  
V. Baldo ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Primary Biliary Cirrhosis ◽  
Transient Elastography ◽  
Biliary Cirrhosis ◽  
Non Invasive

Noninvasive Assessment of Liver Fibrosis

2015 ◽  
Vol 33 (4) ◽  
pp. 498-503 ◽  
Author(s):  
Laurent Castera
Keyword(s):  
Clinical Practice ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Viral Hepatitis ◽  
Esophageal Varices ◽  
Transient Elastography ◽  
Antiviral Treatment ◽  
Liver Stiffness ◽  
Noninvasive Methods ◽  
Excellent Tool

Background: The prognosis and management of chronic liver diseases greatly depend on the amount and progression of liver fibrosis with the risk of developing cirrhosis. Liver biopsy, traditionally considered as the reference standard for the staging of fibrosis, has been challenged over the past decade by the development of novel noninvasive methodologies. Key Messages: Noninvasive methods rely on two different but complementary approaches: a ‘biological' approach based on the dosage serum biomarkers, and a ‘physical' approach based on the measurement of liver stiffness using transient elastography (TE). There are two clinically relevant endpoints for the staging of liver fibrosis: (1) significant fibrosis (indication for antiviral treatment in viral hepatitis B and C), and (2) cirrhosis (indication for screening of esophageal varices and hepatocellular carcinoma). TE (FibroScan®), FibroTest® and APRI have been the most extensively studied and validated methods, mainly in chronic hepatitis C. Combining two unrelated methods, such as TE and biomarkers, is an attractive approach that increases diagnostic performance and limits the drawback of both methodologies. TE appears to be an excellent tool for the early detection of cirrhosis with likely prognostic value in this setting. Thus far, however, it cannot replace upper endoscopy for screening of esophageal varices. The main limitation of TE in clinical practice is the impossibility of obtaining reliable liver stiffness measurements in around 20% of cases, mainly comprising obese patients. Conclusion: An increasing number of reliable noninvasive methods are now available that are widely used in clinical practice, mostly in viral hepatitis, resulting in a significant decrease in the need for liver biopsy.

393 PERFORMANCE OF TRANSIENT ELASTOGRAPHY AND NON INVASIVE MARKERS OF LIVER FIBROSIS IN PRIMARY BILIARY CIRRHOSIS

2010 ◽  
Vol 52 ◽  
pp. S161-S162
Author(s):  
N. Cazzagon ◽  
L. Chemello ◽  
D. Martines ◽  
L. Cavalletto ◽  
V. Baldo ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Primary Biliary Cirrhosis ◽  
Transient Elastography ◽  
Biliary Cirrhosis ◽  
Non Invasive

scholarly journals THU0521 EVALUATION OF LIVER FIBROSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS UNDER METHOTREXATE TREATMENT. UTILITY OF FIBROSCAN AND BIOMARKERS IN ROUTINE CLINICAL PRACTICE.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 499.2-500
Author(s):  
A. De Diego Sola ◽  
M. Vaamonde Lorenzo ◽  
A. Castiella Eguzkiza ◽  
M. J. Sánchez Iturri ◽  
N. Alcorta Lorenzo ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Metabolic Syndrome ◽  
Liver Fibrosis ◽  
Controlled Study ◽  
Type I ◽  
Concomitant Treatment ◽  
Duration Of Treatment ◽  
Significant Difference ◽  
Apri Score ◽  
The Mean

Background:Despite therapeutic advances in recent years, methotrexate (MTX) remains the gold standard for the treatment of rheumatoid arthritis (RA). Among the side effects that have been blamed on it are liver fibrosis (LF) and cirrhosis, although late studies have failed to show such a relation1,2. The only validated test in the diagnosis of LF is biopsy. Given the relevance of MTX in the treatment of RA, it is important to evaluate non-invasive diagnostic options for LF such as transitional elastography (FibroScan, FS).Objectives:To evaluate the percentage of LF in RA patients treated with MTX. Secondly, to assess the correlation between altered liver function, RA activity, and LF. To determine whether dose and/or duration of treatment with MTX may affect the development of LF in such patients.Methods:We did a prospective study between February 2019 and January 2020. Patients affected of RA treated with MTX were included. Patients with basal liver disease (hepatitis B, hepatitis C and steatohepatitis), alcohol consumption, type I diabetes mellitus, chronic renal failure, heart failure, obesity and concomitant treatment with leflunomide or antiretrovirals were excluded. Demographic, clinical, analytical and therapeutic variables were collected. Liver fibrosis was assessed by FS in kilopascals (kpa) and using the APRI score. RA activity was assessed by DAS28 score. Continuous variables are described with mean and standard deviation (SD), and qualitative variables are shown with absolute value and percentage. Spearman’s and Mann-Whitney’s U tests were used for the bivariate analysis.Results:Fifty patients were included (Table 1 and 2). Of these, 38 were women (76%) with mean age of 61.8 years (SD 11.7) and mean RA evolution time of 13.7 years (SD 8.2). The mean DAS28 at the visit was 2.39 (SD 1.1). The FS showed an average of 4.8 kpa (SD 2). The mean duration of treatment with MTX was 85.8 months (SD 93.3) and that of AD-MTX was 5414.6mg (SD 5011). Patients were divided into those with DA-MTX greater than 4000mg (21, 42%) and less than 4000mg (29, 58%) and no significant differences were found in terms of LF in FS (p 0.637) or APRI scale (p 0.806). No significant differences were found in terms of treatment duration either. Six patients (12%) had elevated aspartate aminotransferase (AST) and 9 (18%) had elevated alanine aminotransferase (ALT). No significant difference was found in FS values in relation to ALT, but it was with elevated AST (p 0.021). Similarly, differences were found in APRI based on AST (p 0.045). Metabolic syndrome was collected in 4 patients (8%) without significant differences with FS or APRI values. There were no significant differences in LF depending on gamma-glutamyl transpeptidase (GGT) values.Conclusion:FS and APRI score are useful for the determination of LF in RA patients treated with MTX. There is no evidence of a relationship between AD-MTX and LF by FS or APRI. AST values may be related to the presence of fibrosis as determined by FS or APRI. and the presence of the metabolic syndrome are not.References:[1]G.L. Erre, et al. Methotrexate therapy is not associated with increased liver stiffness and significant liver fibrosis in rheumatoid arthritis patients: A cross-sectional controlled study with real-time two-dimensional shear wave elastography. European Journal of Internal Medicine 69 (2019) 57–63. Internet.[2]R. Conway et al. Risk of liver injury among methotrexate users: a meta-analysis of randomised controlled trials. Semin Arthritis Rheum 2015 Oct;45(2):156–62. Internet.Disclosure of Interests:None declared

Reliability of Transient Elastography as a non-Invasive Technique for Detection of Fibrosis in Budd Chiari Syndrome Patients after Endovascular Intervention

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed F Montasser ◽  
Eman M Barakat ◽  
Mohamed S Ghazy ◽  
Sara M Abdelhakam ◽  
Hend E Ebada ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Endovascular Intervention ◽  
Invasive Technique ◽  
Budd Chiari Syndrome ◽  
Metavir Score ◽  
Before And After ◽  
Chiari Syndrome

Abstract Aim of the work To test the reliability of fibroscan in detection of fibrosis in patients with Budd Chiari syndrome before and after endovascular intervention (after elimination of hepatic congestion). Background transient elastography (TE) is a noninvasive methodology that has been used to monitor liver stiffness in patients with chronic viral hepatitis. One of the limitations for accurate assessment of liver fibrosis by TE is the liver congestion. Liver congestion can result from Budd Chiari syndrome (BCS).The treatment of BCS is through restoring the flow of the blood between the portal vein to the inferior vena cava, which will lead to decongestion of the liver.TE, will be tested after liver decongestion for proper detection of liver fibrosis. Patients and methods This was a prospective cohort study conducted on 25 Egyptian patients with confirmed diagnosis of primary Budd-Chiari Syndrome (BCS) in the period from June 2017 to September 2019. TE was performed three days before endovascular intervention and three months after it. Liver biopsy was taken during the intervention for assessment of METAVIR score. Comparison was done between TE assessments before and after intervention in detection of the degree of liver fibrosis in comparison to METAVIR score measured in liver biopsy. Results FVLM was the most common hypercoagulable cause in the involved patients. There was significant drop in Liver Stiffness Measurements (LSM) measured three months post-intervention indicating improvement of liver fibrosis after relieving liver congestion but still not correlated to the METAVIR scores measured in the liver biopsy. Conclusion Liver congestion has high impact on Liver stiffness measurement giving overestimation which improves significantly after decongestion of the liver by the endovascular intervention.

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