Diagnostic value of controlled attenuation parameter for liver steatosis in patients with chronic hepatitis B

Wang, Chunyan; Lu, Wei; Hu, Dongsheng; Wang, Guangdong; Cheng, Xiaojing

doi:10.3748/wjg.v20.i30.10585

Cited by 20 publications

(17 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study confirms, on a series of Romanian patients, the preliminary results of previous studies [20,[22][23][24][25][26][27][28][29][30][31], namely that, among all histopathological parameters assessed during various diffuse liver diseases, CAP is independently influenced only by the amount of steatosis, not by fibrosis, necroinflammatory activity, ballooning or lobular inflammation (quantified according to liver disease etiology). The CAP value increased alongside the increase in the steatosis degree.…”

Section: Discussionsupporting

confidence: 89%

“…In all patients, steatosis was estimated by visual assessment as a percentage of hepatocytes with fatty accumulation; to be able to pool all patients, steatosis was converted into the following grading system: S0: steatosis in less than 10% of hepatocytes, S1: 11%-33%, S2: 34%-66% and S3: 67%-100% of hepatocytes, a system which was also used in other studies [12,20,22,24,26,27]. The histological type of steatosis was specified, as pure macrovesicular, mixed (i.e.…”

Section: Histological Studymentioning

confidence: 99%

“…Since the development of this method, some studies have been performed on patients with various diffuse liver diseases [20,[22][23][24][25][26][27][28][29][30]. Among histopathological parameters, these studies analyzed mainly the influence of steatosis and fibrosis on CAP and, in some studies, also that of necroinflammatory activity.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic Accuracy of Controlled Attenuation Parameter Measured by Transient Elastography for the Non-invasive Assessment of Liver Steatosis: a Prospective Study

Lupșor-Platon

Feier

Ştefănescu

et al. 2015

JGLD

View full text Add to dashboard Cite

Background & Aims: A novel non-invasive tool based on the evaluation of ultrasound attenuation using transient elastography (TE) has been developed, called controlled attenuation parameter (CAP). We aim to establish the histopathological parameters that significantly influence CAP, the cutoff values and their performance in predicting each steatosis grade on a group of biopsied patients with chronic liver diseases (CLD) from Romania.Methods. We prospectively analyzed 201 consecutive CLD patients who underwent CAP measurements using TE. Steatosis, liver fibrosis and necroinflammatory activity were staged and graded during the pathological analysis of bioptic specimens. Univariate and multivariate regression analyses were applied to identify the variables correlated with CAP values. The diagnostic performance of CAP for steatosis prediction was assessed using an AUC analysis.Results. Among the histopathological factors correlating with CAP, the multivariate analysis found steatosis as the only factor independently influencing CAP values (p<0.001). Maximal diagnostic accuracy (DA) was obtained for the prediction of ≥34-66% (S2) fatty load and of 67-100% (S3) fatty load (82.06%, respectively 81.59%) while, for the prediction of ≥11-33% (S1) fatty load, DA reached only 76.11%. The negative predictive value for the exclusion of ≥S2 and S3 was 93.5% and 98.7%, respectively. AUCs calculated between each two steatosis grades were: 0.772 (S0 vs S1), 0.874 (S0 vs S2), 0.904 (S0 vs S3), 0.659 (S1vs S2), 0.777 (S1 vs S3), and 0.665 (S2 vs S3).Conclusion. Steatosis is the only histopathological factor independently influencing CAP. Maximal DA could be obtained for the prediction of ≥S2 and S3 (82.06% and 81.59%), while for the prediction of S1, the accuracy reached only 76.11%.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Histological Studymentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Accuracy of Controlled Attenuation Parameter Measured by Transient Elastography for the Non-invasive Assessment of Liver Steatosis: a Prospective Study

Lupșor-Platon

Feier

Ştefănescu

et al. 2015

JGLD

View full text Add to dashboard Cite

show abstract

“…To solve this problem, a novel non‐invasive procedure of NAFLD diagnosis has been developed, the controlled attenuation parameter (CAP). The CAP is quantitated by transient elastography (TE) and has been proven to be a substitute for ultrasonography and liver biopsy in epidemiological investigations of NAFLD …”

Section: Introductionmentioning

confidence: 99%

Hypertension and non‐alcoholic fatty liver disease proven by transient elastography

Wang

Zeng

Lin

et al. 2016

Hepatology Research

View full text Add to dashboard Cite

show abstract

“…The controlled attenuation parameter (CAP) is a recently developed quantitative, objective NIT for liver steatosis assessment, which measures the attenuation of ultrasound waves transmitted at a known frequency in the liver parenchyma . The CAP values are obtained simultaneously to LSM using the same device, and the estimation of liver fat through this method is reliable . The CAP values of 215 to 238 dB/m hold a high sensitivity for the detection of steatosis in patients with chronic liver disease of different etiologies, and in one study CAP and proton magnetic resonance spectroscopy showed comparable accuracy for the detection of hepatic steatosis in patients …”

mentioning

confidence: 99%

Prognostic Significance of Controlled Attenuation Parameter in Patients With Compensated Advanced Chronic Liver Disease

Margini

Murgia

Stirnimann

et al. 2018

Hepatology Communications

View full text Add to dashboard Cite

Obesity and steatosis have been associated with liver disease progression in patients with compensated advanced chronic liver disease (cACLD) (liver stiffness measurement [LSM] ≥ 10 kPa). The controlled attenuation parameter (CAP) estimates steatosis during LSM by transient elastography. We aimed to evaluate whether CAP is associated with the development of clinically relevant events in cACLD. Consecutive patients with cACLD and CAP measurements observed between September 2013 and September 2015 were retrospectively studied. Classical decompensation and severe bacterial infections on follow‐up were recorded. A predefined CAP cut‐off for steatosis was used (220 dB/m; 90% sensitivity). The association among LSM, CAP, and events was assessed by univariate and multivariate Cox regression. Among the 193 patients (viral etiology = 58%; median Child score = 5; LSM = 15.1 kPa; CAP = 255 ± 62 dB/m) who were followed up in median for 18 months, 18 developed clinically relevant events (11 liver decompensation, 7 severe bacterial infections). Patients developing events had higher LSM (median: 30.8 versus 14.3 kPa, P < 0.001) and showed trends for higher CAP (275 ± 46 versus 252 ± 63 dB/m, P = 0.07), lower platelet count (134 ± 74 versus 167 ± 74 G/L, P = 0.07), and worse liver function versus patients remaining compensated. Body mass index was similar in the two groups. All events were more frequent in patients with CAP being greater than or equal to 220 dB/m (12.9% versus 1.6% in CAP < 220; P = 0.013), and 10 of 11 episodes of liver decompensation occurred in patients with CAP being greater than or equal to 220 dB/m. Following multivariate analysis, LSM and CAP greater than or equal to 220 dB/m remained independently associated with clinical events in the whole population and in patients with clinically significant portal hypertension. Conclusion: The CAP being greater than or equal to 220 dB/m is associated with increased risk of clinical decompensation and bacterial infections independent of LSM in patients with cACLD and allows refining the noninvasive risk stratification in this population. (Hepatology Communications 2018; 00:000‐000)

show abstract

Diagnostic value of controlled attenuation parameter for liver steatosis in patients with chronic hepatitis B

Abstract: CAP is a novel tool that can be used to assess the degree of steatosis.

Cited by 20 publications

References 22 publications

Diagnostic Accuracy of Controlled Attenuation Parameter Measured by Transient Elastography for the Non-invasive Assessment of Liver Steatosis: a Prospective Study

Diagnostic Accuracy of Controlled Attenuation Parameter Measured by Transient Elastography for the Non-invasive Assessment of Liver Steatosis: a Prospective Study

Hypertension and non‐alcoholic fatty liver disease proven by transient elastography

Prognostic Significance of Controlled Attenuation Parameter in Patients With Compensated Advanced Chronic Liver Disease

Contact Info

Product

Resources

About