Comparison between shear wave elastography and serological findings for the evaluation of fibrosis in chronic liver disease

Abstract

Aim: In this study, we sought to examine the optimal cutoff values for predicting different stages of liver fibrosis, and to determine the level of agreement between shear wave elastography and aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4) scores in patients with chronic liver disease. Methodology: A descriptive, cross-sectional study was performed at the Radiology Department of Shaukat Khanum Memorial Hospital Lahore from 1 Jun 2019 until 1 June 2020. FIB-4 and APRI scores were determined by the following formula: FIB-4 = (age × AST) ÷ (platelet count × (√ (ALT)) and APRI = (AST÷AST upper limit of normal) ÷ platelet × 100. Data was analyzed with the help of SPSS version 24.0 and Microsoft Excel 2013. Results: Eighty individuals were conveniently selected, of which 62.5% were men and 37.5% were women. The mean age of the subjects was 43.47 SD ± 13.85 years. APRI and FIB-4 scores predicted F4 patients using the cutoff values of 0.47 (Sn. 72%, Sp. 70%) and 1.27 (Sn. 78%, Sp. 73%), respectively. The cutoff values of 0.46 for APRI and 1.27 for FIB-4 predicted F3–F4 patients (Sn. 74% and 77%; Sp. 76% and 76%), respectively. To predict F1–F4 compared to F0, the cutoff value was 0.34 (Sn. 68%, Sp. 75%) for APRI, while the cutoff value for FIB was 0.87 (Sn. 72%, Sp. 75%). The findings suggest that FIB-4 shows better diagnostic accuracy than APRI. Conclusion: This study provides optimal cutoff values for different groups of fibrosis patients for both serum markers. Also, the diagnostic accuracy of FIB-4 for predicting liver fibrosis was found to be superior to APRI in all disease stages.

Influence of elevated liver enzyme level on 30-day mortality rates in patients undergoing nonemergency orthopedic surgery

“…Consequently, we selected the SGOT as our indicator of postoperative mortality. The upper limit of normal (ULN) for SGOT was defined as 40 IU/L in accordance with previous studies (Liaqat et al 2021 ; Aliabadi et al 2021 ). Patients were separated into two groups according to the ULN for SGOT level.…”

Prevalence of hepatic steatosis and fibrosis in Turner syndrome: A prospective case–control study

“…The potential benefit of SWE compared to Fibroscan™ in TS is that ultrasound images can assess for adenomas and vascular changes in addition to providing measurements of steatosis and fibrosis that are more specific than Fib-4 and APRI. [19][20][21] Our findings suggest that continuing annual serologic evaluation and calculating fibrosis risk scores based on serologic testing is a helpful screening tool, but given its low specificity, may not diagnose steatosis or fibrosis in a subset of TS patients. Our study also shows that GGT is more sensitive than AST or ALT in identifying early liver changes.…”

“…As a result, it is widely available, cost‐effective, and could be paired with annual serologic evaluation as a standard screening tool in patients with TS. The potential benefit of SWE compared to Fibroscan™ in TS is that ultrasound images can assess for adenomas and vascular changes in addition to providing measurements of steatosis and fibrosis that are more specific than Fib‐4 and APRI 19–21 …”

Assessing the Accuracy of Fib-4 Scores to Point Shear Wave Elastography in Monitoring Different Stages of Fibrosis in Non-Alcoholic Liver Disease

“…The study also provided details related to optimal cut-off values for different stages of fibrosis for both serum markers. The diagnostic accuracies of APRI and FIB-4 for prediction were compared with APRI and FIB-4 accompanying ultrasound SWE (shear wave elastography) (12) .…”