Liver biopsy: past, present and future

Ravindran, Srivathsan; Hancox, Sarah; Howlett, David

doi:10.12968/hmed.2016.77.2.90

Cited by 11 publications

(12 citation statements)

References 29 publications

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“…Histopathologic examination of liver biopsy tissue remains the reference standard for staging hepatic fibrosis. However, liver biopsy has a number of limitations, including invasiveness,(Actis et al 2007) (Ravindran et al 2016) high cost, inter-pathologist variation (Burt et al 2015; Kaswala et al 2016) and sampling error (Brunt 2016; Parikh et al 2017; Shiha et al 2017). As a result, alternative non-invasive staging methods have been proposed including blood tests (Chin et al 2016; Rosenberg et al 2004), magnetic resonance elastography (MRE)(Dulai et al 2016; Petitclerc et al 2017), and ultrasound elastography (UE)(Crespo et al 2012; Dhyani et al 2015; Sigrist et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Shear Wave Elastography: Variations of Liver Fibrosis Assessment as a Function of Depth, Force and Distance from Central Axis of the Transducer with a Comparison of Different Systems

Dhyani

Xiang

et al. 2018

Ultrasound in Medicine & Biology

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We evaluated variation in fibrosis staging caused by depth, pre-load force and measurement off-axis distance on different ultrasound shear wave elastography (SWE) systems prospectively in 20 patients with diffuse liver disease. Shear wave speed (SWS) was measured with transient elastography, acoustic radiation force impulse (ARFI) and 2-D shear wave elastography (SWE). ARFI and 2-D-SWE measurements were obtained at different depths (3, 5 and 7 cm), with different pre-load forces (4, 7 and 10N and variable) and at 0, 2 and 4cm off the central axis of the transducer. A single, blinded pathologist staged fibrosis using the METAVIR system (F0-F4). Area under the receiver operating characteristic curve was charted to differentiate significant fibrosis (F ≥ 2). Depth was the only factor found to influence ARFI-derived values; no acquisition factors were found to affect 2-D-SWE SWS values. ARFI and 2-D-SWE for diagnosis of significant fibrosis at a depth of 7cm along the central axis had good diagnostic performance (areas under the receiver operating characteristic curve: 0.92 and 0.82, respectively), comparable to that of transient elastography. Further investigation of this finding will likely be of interest.

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Section: Introductionmentioning

confidence: 99%

Ultrasound Shear Wave Elastography: Variations of Liver Fibrosis Assessment as a Function of Depth, Force and Distance from Central Axis of the Transducer with a Comparison of Different Systems

Dhyani

Xiang

et al. 2018

Ultrasound in Medicine & Biology

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“…However, these imaging strategies are limited, as structural changes often occur relatively late in the course of a disease. Although liver biopsy is still considered the gold standard for diagnosis and staging of diffuse chronic liver diseases (CLDs) (2), it has several major limitations, including its invasive nature, high cost, poor patient acceptance, and sampling error . Furthermore, the accurate histological evaluation of liver biopsy specimens requires experienced, sub‐specialized pathologists.…”

mentioning

confidence: 99%

“…Even so, it may be subjective, and is prone to relatively low inter‐observer agreement . These drawbacks may challenge the role of liver biopsy for monitoring disease progression, therapy response assessment, and longitudinal follow‐up studies . Blood markers of parenchymal liver disease are a noninvasive diagnostic alternative to liver biopsy, as they are easily obtained, are unaffected by sampling error, and can be repeated serially.…”

mentioning

confidence: 99%

Hepatic gadoxetic acid uptake as a measure of diffuse liver disease: Where are we?

Ba‐Ssalamah

Bastati

Wibmer

et al. 2016

Magnetic Resonance Imaging

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“…as a result, there is strong desire for the application of more sensitive and acceptable techniques for early detection and diagnosis of aFL [4]. although liver biopsy is useful as the golden standard for diagnosis of aFL, the technique is greatly limited because of its nondynamic characterization and invasiveness, which potentially causes issues, such as organ trauma, infection, and bleeding [25]. in contrast, a noninvasive technique is more suitable for assessment of temporal changes of aFL in terms of patient' compliance.…”

Section: Discussionmentioning

confidence: 99%

Chinese tree shrews as a primate experimental animal eligible for the study of alcoholic liver disease: characterization and confirmation by MRI

Shi

Xing

et al. 2020

Exp. Anim.

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There has been a lack of suitable fatty liver models and characterization techniques for histopathological evaluation of alcoholic fatty liver (AFL). This work aimed to exploit an magnetic resonance imaging (MRI) technique for characterizing an alcohol-induced fatty liver model established in tree shrews (Tupaia belangeri chinese). The animals were treated with 15% alcohol for two weeks instead of drinking water to induce AFL. Blood alanine aminotransferase (ALT), aspartate aminotransferase (AST), alcohol, and liver malondialdehyde (MDA) concentrations were determined, and the histopathology of the liver was checked by hematoxylin & eosin (HE) and Oil red O staining on day 0 and on the 4th, 7th and 14th days after alcohol feeding. MRI was used to trace the histopathological changes in the liver of tree shrews in real time. Compared with the control group, the levels of ALT, AST, and MDA significantly increased in the alcohol-induced group and were positively correlated with the induction time. HE and Oil red O staining revealed that a moderate fatty lesion occurred in the liver on the 4th day and that a serious AFL was successfully induced on the 14th day. MRI further confirmed the formation of AFL. MRI, as noninvasive examination technique, provides an alternative tool for accurate characterization of AFL in live subjects. It is comparable to HE or Oil red O staining for histopathological examination, but is more suitable by virtue of its high flexibility and compliance. The AFL model of tree shrews combined with MRI characterization can work as a platform for studying fatty liver diseases and medications for their treatment.

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Liver biopsy: past, present and future

Cited by 11 publications

References 29 publications

Ultrasound Shear Wave Elastography: Variations of Liver Fibrosis Assessment as a Function of Depth, Force and Distance from Central Axis of the Transducer with a Comparison of Different Systems

Ultrasound Shear Wave Elastography: Variations of Liver Fibrosis Assessment as a Function of Depth, Force and Distance from Central Axis of the Transducer with a Comparison of Different Systems

Hepatic gadoxetic acid uptake as a measure of diffuse liver disease: Where are we?

Chinese tree shrews as a primate experimental animal eligible for the study of alcoholic liver disease: characterization and confirmation by MRI

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