Controlled attenuation parameter for the detection of steatosis severity in chronic liver disease: A meta‐analysis of diagnostic accuracy

Shi, Ke‐Qing; Tang, Junzhou; Zhu, Xuelian; Li, Ying; Li, Dewei; Gao, Jian; Fang, Yaping; Li, Guiling; Song, Yi-Jiang; Deng, Zifeng; Wu, Jianmin; Tang, Kai-Fu

doi:10.1111/jgh.12519

Cited by 137 publications

(116 citation statements)

References 43 publications

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“…A major limitation of CAP is its failure rate, which occurred in approximately 20% of the patients with NAFLD [13]. This was higher than that reported for other etiologies of liver disease where the rate was 7.7% [15].…”

Section: Controlled Attenuation Parametercontrasting

confidence: 49%

“…A meta-analysis including nine studies assessing CAP in patients with chronic liver disease of varying etiologies found overall summary sensitivity and specificity values of 78 and 79% for ≥ S1, 85 and 79% for ≥ S2 and 83 and 79% for S3 [13]. A limitation of this study was that CAP cut-off values were different across the studies and were not validated [13].…”

Section: Controlled Attenuation Parametermentioning

confidence: 95%

“…A limitation of this study was that CAP cut-off values were different across the studies and were not validated [13]. In order to address the limitations of this study, a meta-analysis of individual patient data was conducted to establish CAP cut-off values for the diagnosis of steatosis and define values for distinguishing between steatosis grades [14•].…”

Section: Controlled Attenuation Parametermentioning

confidence: 99%

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Imaging-Based Assessment of Steatosis, Inflammation and Fibrosis in NAFLD

Hardy

McPherson

2017

Curr Hepatology Rep

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Purpose of Review Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the Western world. Invasive liver biopsy remains the gold standard method for the diagnosis and staging of NAFLD. The aim of this review is to summarize recent research regarding imagingbased assessment of NAFLD. Recent Findings Novel methods such as controlled attenuation parameter (CAP) and magnetic resonance imaging proton-derived fat fraction (MRI-PDFF) appear promising for steatosis assessment and are currently undergoing validation in NAFLD. Fibrosis can be non-invasively assessed by transient elastography (TE), which is currently the best validated test in NAFLD. MR elastography (MRE) appears very sensitive for fibrosis detection. No imaging technique can accurately detect NASH. Summary TE is inexpensive and relatively widely available and can reliably exclude advanced fibrosis in NAFLD. MRI offers the most promise for steatosis and fibrosis quantification, but further validation of these techniques is needed.

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Section: Controlled Attenuation Parametercontrasting

confidence: 49%

Section: Controlled Attenuation Parametermentioning

confidence: 95%

Section: Controlled Attenuation Parametermentioning

confidence: 99%

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Imaging-Based Assessment of Steatosis, Inflammation and Fibrosis in NAFLD

Hardy

McPherson

2017

Curr Hepatology Rep

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“…85%-os érzékenység és 79%-os fajlagosság mutatkozott 11-33%-os elzsírosodás esetén. 67-100%-os steatosis esetén 83%-os érzékenységet és 79%-os fajlagossá-got közöltek [54]. A májbiopsziához képest 100-szor nagyobb májszövetet jellemez.…”

Section: Controlled Attenuation Parameter (Cap)unclassified

Non-invasive assessment of fatty liver

2015

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A májat érő különböző károsító hatások miatt (fertőző ágensek, anyagcserezavarok, nem megfelelő táplálkozás, elhí-zás, toxikus ártalmak, autoimmun folyamatok) kóros májműködés, májkárosodás jön létre, amely a máj elzsírosodá-sához, illetve kötőszövetes átépüléséhez vezethet. A májműködés zavarainak leggyakoribb okai a hepatitis B-és Cvírusok, az alkoholfogyasztás, illetve a nem alkoholos zsírmájbetegség. Napjainkban a májbetegségek kórisméjének arany standardja a szövettani vizsgálat. A májbiopszia veszélyei és szövődményei miatt azonban világszerte nagy az igény olyan, nem invazív jelzőmolekulák, pontrendszerek kidolgozására, képalkotó eljárások fejlesztésére, amelyek az elzsírosodás mértékét, illetve későbbiekben a betegség lefolyását, a gyulladásos aktivitást és a fi brosis fokát is jól jelzik. A szerzők összefoglaló közleményükben áttekintik a májelzsírosodás nem invazív jellemzésének lehetőségeit. Bemutatják a próbák mutatóit (pozitív, negatív prediktív érték, érzékenység, fajlagosság). Kitérnek a képalkotó eljárások klinikai alkalmazásaira is. Az ismertetett módszerek közül több hasznos, nem invazív eljárás a steatosis értékelésében, a betegség lefolyásának és a terápiás válasz nyomon követésében, de pontos megítélésükre további vizsgálatok szük-ségesek. Orv. Hetil., 2015, 156(14), 543-551. Kulcsszavak: májelzsírosodás, steatosis hepatis, nem invazív próbák, képalkotó eljárások Non-invasive assessment of fatty liverAs the result of various harmful effects (infectious agents, metabolic diseases, unhealthy diet, obesity, toxic agents, autoimmune processes) hepatic damage may develop, which can progress towards liver steatosis, and fi brosis as well. The most common etiological factors of liver damages are hepatitis B and C infection, alcohol consumption and nonalcoholic fatty liver disease. Liver biopsy is considered as the gold standard for the diagnosis of chronic liver diseases. Due to the dangers and complications of liver biopsy, studies are focused on non-invasive markers and radiological imaging for liver steatosis, progression of fatty liver, activity of the necroinfl ammation and the severity of the fi brosis. Authors review the possibilities of non-invasive assessment of liver steatosis. The statistical features of the probes (positive, negative predictive values, sensitivity, specifi city) are reviewed. The role of radiological imaging is also discussed. Although the non-invasive methods discussed in this article are useful to assess liver steatosis, further studies are needed to validate to follow progression of the diseases and to control therapeutic response. Keywords: liver steatosis, fatty liver, non-invasive methods, radiological imagingEgresi, A., Lengyel, G., Hagymási, K. [Non-invasive assessment of fatty liver]. Orv. Hetil., 2015, 156(14), 543-551. ÖSSZEFOGLALÓ KÖZLEMÉNYRövidítések AFLD = alkoholos zsírmájbetegség; AGA = American Gastroenterological Association; ALP = alkalikus foszfatáz; ALT = alanin-aminotranszferáz; AST = aszpartát-aminotranszferáz; ATP = adenozin-trifoszfát; BMI = t...

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“…In a recent meta-analysis [68] assessing the CAP accuracy for steatosis detection, the summarized sensitivity and specificity values were 0.78 (95% confidence In comparison to other modalities, CAP is non-invasive, quantitative, and non-ionising. Furthermore, the procedure is easy to perform and provides immediate results; it is also machine-independent and does not require corrections to be made for gain, frequency, focusing or beam diffraction, and is also not subject to operator interpretation [65].…”

Section: Controlled Attenuation Parameter (Cap)mentioning

confidence: 99%

Noninvasive assessment of liver steatosis using ultrasound methods

2014

Med Ultrason

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Hepatic steatosis is a condition frequently encountered in clinical practice, with potential progression towards chirrhosis and hepatocellular carcinoma. Ultrasonography (US) is one of the noninvasive imaging techniques used in the diagnosis of steatosis. We will review the US diagnostic criteria, the US performance in the diagnosis and grading of hepatic steatosis, the US steatosis models, but also its limitations in the diagnosis of steatosis. In addition, we will discuss 2 modern methods of assessing hepatic steatosis using ultrasounds, namely the computerized processing of data forming the US image and the controlled attenuation parameter measured with unidimensional transient elastography.

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Controlled attenuation parameter for the detection of steatosis severity in chronic liver disease: A meta‐analysis of diagnostic accuracy

Abstract: CAP has good sensitivity and specificity for detecting hepatic steatosis; however, based on a meta-analysis, CAP was limited in their accuracy of steatosis, which precluded widespread use in clinical practice.

Cited by 137 publications

References 43 publications

Imaging-Based Assessment of Steatosis, Inflammation and Fibrosis in NAFLD

Imaging-Based Assessment of Steatosis, Inflammation and Fibrosis in NAFLD

Non-invasive assessment of fatty liver

Noninvasive assessment of liver steatosis using ultrasound methods

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