Prevalence, risk factors and causes of discordance in fibrosis staging by transient elastography and liver biopsy

Myers, Robert P.; Crotty, Pam; Pomier‐Layrargues, Gilles; Ma, Mang; Urbanski, Stefan J.; Elkashab, Magdy

doi:10.1111/j.1478-3231.2010.02331.x

Cited by 92 publications

(117 citation statements)

References 34 publications

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“…Indeed, only when this criterion was not fulfilled, the sensitivity of the method significantly decreased. On the other hand, by using VCTE and liver biopsy as the reference standard, it has been shown that the number of measurements or the success rate had no significant influence on the staging of liver fibrosis [6,9,10]. In particular, Kettaneh et al compared the AUROCs for the prediction of cirrhosis between the median values of the 3 first, the 5 first and the 10 first successful shots of VCTE and reported that there was no significant loss in performance if only 5 valid shots were obtained [10].…”

Section: Discussionmentioning

confidence: 99%

Accuracy of the ElastPQ® Technique for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis C: a “Real Life” Single Center Study

Ferraioli

Maiocchi

Lissandrin

et al. 2016

JGLD

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Background & Aims: Noninvasive assessment of liver stiffness has been increasingly used to evaluate fibrosis instead of liver biopsy, especially in patients with chronic viral hepatitis. The aim of this study was to assess the performance in staging liver fibrosis of the updated ElastPQ® technique (EPIQ7 ultrasound system, Philips Healthcare, Bothell, WA, USA) in the “real life” setting by using the FibroScan as the reference standard and to understand whether the use of the quality criteria improves the performance of the technique. Methods: This was a cross-sectional study: 278 patients affected by chronic hepatitis C referred for liver stiffness measurement with the FibroScan® 502 Touch device (Echosens, Paris, France) underwent measurements also with the ElastPQ® technique. For the assessment of significant fibrosis (F≥2), advanced fibrosis (F≥3) and cirrhosis (F=4), respectively, we used the cutoffs of 7.0, 9.5 and 12.0 kPa. The diagnostic performance of ElastPQ® was assessed using the area under the ROC (AUROC) curve analysis and was evaluated overall and for cases with (a) 10 measurements and IQR/M≤30%, (b) 5 measurements and IQR/M ≤30%, (c) 10 measurements and IQR/M>30%, (d) 5 measurements and IQR/M>30%. Results: The optimal cutoffs of ElastPQ® for significant fibrosis, advanced fibrosis and cirrhosis were 6.43, 9.54 and 11.34 kPa, respectively. For measurements with an IQR/M≤30%, there was no statistically significant decrease in sensitivity between 10 and 5 measurements (p=0.26, p=0.09, p=0.71, for F≥2, F≥3, and F=4, respectively). Conclusion: The ElastPQ® technique is reliable and accurate for staging liver fibrosis. The number of measurements does not affect the performance. Abbreviations: ALP: alkaline phosphatase; ALT: alanine aminotransferase; AST: aspartate aminotransferase; AUROC: area under the ROC curve; BMI: body mass index; GGT: gamma-glutamyl transferase; LR: likelihood ratio; LSM: liver stiffness measurement; pSWE: point shear wave elastography; ROC: receiver operating characteristic; VCTE: vibration controlled transient elastography; VTQ®: virtual touch quantification.

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Section: Discussionmentioning

confidence: 99%

Accuracy of the ElastPQ® Technique for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis C: a “Real Life” Single Center Study

Ferraioli

Maiocchi

Lissandrin

et al. 2016

JGLD

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“…TE has been validated in different liver diseases and has been shown to be accurate in diagnosing fibrosis in the F3-F4 stages with a specificity of 72 % and sensitivity of 86 % [5]. Previous studies have demonstrated that the patient's anthropometric characteristics and etiology of liver disease are factors that can influence the reliability of TE measurements and that these factors may influence the diagnosis of liver fibrosis [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with the Quality of Transient Elastography

et al. 2015

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“…No significant loss in performance was reported if only 5 valid acquisitions were obtained. It is likely that IQR/M is the key factor for discordance between TE and histological fibrosis stage [79,80]. In a recent large population study, new reliability criteria based on IQR/M and median LSMs were proposed [81].…”

Section: How To Measure?mentioning

confidence: 99%

“…An IQR/M ≤ 30 % of the 10 measurements is the most important reliability criterion (LoE 1b, GoR A) [79,80]. Strong consensus (17/0/0, 100 %) This document was downloaded for personal use only.…”

Section: Recommendationmentioning

confidence: 99%

Untitled

2017

Ultraschall in Med

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Prevalence, risk factors and causes of discordance in fibrosis staging by transient elastography and liver biopsy

Abstract: Discordance between liver fibrosis estimated by TE and biopsy occurs in one in seven patients. In assessing the validity of TE results, clinicians must recognize risk factors for discordance and in at-risk patients, consider alternative measures including biomarkers and possibly biopsy.

Cited by 92 publications

References 34 publications

Accuracy of the ElastPQ® Technique for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis C: a “Real Life” Single Center Study

Accuracy of the ElastPQ® Technique for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis C: a “Real Life” Single Center Study

Factors Associated with the Quality of Transient Elastography

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