scholarly journals Diagnostic Accuracy of FibroScan and Factors Affecting Measurements

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 940 ◽  
Author(s):  
Satoshi Oeda ◽  
Kenichi Tanaka ◽  
Ayaka Oshima ◽  
Yasue Matsumoto ◽  
Eisaburo Sueoka ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Liver Steatosis ◽  
Liver Stiffness ◽  
The Body ◽  
Liver Stiffness Measurement ◽  
Alcoholic Fatty Liver ◽  
Factors Affecting ◽  
Non Invasive ◽  
Significant Difference ◽  
Alcoholic Fatty Liver Disease

Evaluating liver steatosis and fibrosis is important for patients with non-alcoholic fatty liver disease. Although liver biopsy and pathological assessment is the gold standard for these conditions, this technique has several disadvantages. The evaluation of steatosis and fibrosis using ultrasound B-mode imaging is qualitative and subjective. The liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) determined using FibroScan are the evidence-based non-invasive measures of liver fibrosis and steatosis, respectively. The LSM and CAP measurements are carried out simultaneously, and the median values of more than ten valid measurements are used to quantify liver fibrosis and steatosis. Here, we demonstrate that the reliability of the LSM depends on the interquartile range to median ratio (IQR/Med), but CAP values do not depend on IQR/Med. In addition, the LSM is affected by inflammation, congestion, and cholestasis in addition to fibrosis, while CAP values are affected by the body mass index in addition to steatosis. We also show that the M probe provides higher LSM values but lower CAP values than the XL probe in the same population. However, there was no statistically significant difference between the diagnostic accuracies of the two probes. These findings are important to understand the reliability of FibroScan measurements and the factors influencing measurement values for all patients.

Unified interpretation of liver stiffness measurement by M and XL probes in non-alcoholic fatty liver disease

Gut ◽  
2019 ◽  
Vol 68 (11) ◽  
pp. 2057-2064 ◽  
Author(s):  
Vincent Wai-Sun Wong ◽  
Marie Irles ◽  
Grace Lai-Hung Wong ◽  
Sarah Shili ◽  
Anthony Wing-Hung Chan ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
The Body ◽  
Liver Stiffness Measurement ◽  
Alcoholic Fatty Liver ◽  
Stiffness Measurement ◽  
Alcoholic Fatty Liver Disease

ObjectiveThe latest model of vibration-controlled transient elastography (VCTE) automatically selects M or XL probe according to patients’ body built. We aim to test the application of a unified interpretation of VCTE results with probes appropriate for the body mass index (BMI) and hypothesise that this approach is not affected by hepatic steatosis.DesignWe prospectively recruited 496 patients with non-alcoholic fatty liver disease who underwent VCTE by both M and XL probes within 1 week before liver biopsy.Results391 (78.8%) and 433 (87.3%) patients had reliable liver stiffness measurement (LSM) (10 successful acquisitions and IQR:median ratio ≤0.30) by M and XL probes, respectively (p<0.001). The area under the receiver operating characteristic curves was similar between the two probes (0.75–0.88 for F2–4, 0.83–0.91 for F4). When used in the same patient, LSM by XL probe was lower than that by M probe (mean difference 2.3 kPa). In contrast, patients with BMI ≥30 kg/m2 had higher LSM regardless of the probe used. When M and XL probes were used in patients with BMI <30 and ≥30 kg/m2, respectively, they yielded nearly identical median LSM at each fibrosis stage and similar diagnostic performance. Severe steatosis did not increase LSM or the rate of false-positive diagnosis by XL probe.ConclusionHigh BMI but not severe steatosis increases LSM. The same LSM cut-offs can be used without further adjustment for steatosis when M and XL probes are used according to the appropriate BMI.

Non-Invasive Approaches to Estimate Liver Steatosis and Stiffness in Children with Non-Alcoholic Fatty Liver Disease

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Toshifumi Yodoshi ◽  
Sarah Orkin ◽  
Andrew T. Trout ◽  
Ana Catalina Arce-Clachar ◽  
Kristin Bramlage ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Steatosis ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Alcoholic Fatty Liver Disease

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 markers associated with liver fibrosis in non-alcoholic fatty liver disease

Gut ◽  
2006 ◽  
Vol 55 (11) ◽  
pp. 1650-1660 ◽  
Author(s):  
I N Guha ◽  
J Parkes ◽  
P R Roderick ◽  
S Harris ◽  
W M Rosenberg
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Alcoholic Fatty Liver Disease

Non-invasive assessment of liver steatosis in non-alcoholic fatty liver disease

2014 ◽  
Vol 44 (14) ◽  
pp. E420-E427 ◽  
Author(s):  
Hiromi Kan ◽  
Yuki Kimura ◽  
Hideyuki Hyogo ◽  
Takayuki Fukuhara ◽  
Hatsue Fujino ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Steatosis ◽  
Alcoholic Fatty Liver ◽  
Non Invasive ◽  
Alcoholic Fatty Liver Disease
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