What to expect from FibroScan (transient elastography) for the evaluation of chronic hepatopathies?

Ioan Sporea, Roxana Șirli

Abstract


Currently, liver biopsy is considered to be the gold-standard method for the evaluation of fibrosis in chronic
liver disease, but other, non-invasive methods are being developed, among them, liver stiffness (LS) evaluation
by means of the FibroScan device.
We will present our department’s experience regarding the use of FibroScan in a 10 month period:
A. The rate of valid measurements (VM) by FibroScan. Failure to obtain VM of the liver stiffness was observed
in 6.9% of the 1461 patients we investigated. Female gender, older age and higher Body Mass Index were statistically
significant associated with failure to obtain VM.
B. A study comparing the FibroScan results to liver biopsy in patients with chronic hepatitis C showed that
for a cut-off value of 6.8 kPa, the LS measurement had a PPV of 97.2%, a NPV of 34.2%, a sensitivity of 59.2%,
a specificity of 92.6% for the presence of significant fibrosis (at least F2 Metavir), with a diagnostic performance
of 76.1% (AUROC 0,761).
C. The FibroScan evaluation of patients with liver cirrhosis proved that LS is a good predictive factor for the
presence of cirrhosis, with a sensitivity of approximately 88% for a cut-off value of 14 kPa. Also, we found that
the LS was significantly higher in patients with grade II and III EV (that have to be treated with beta-blockers)
than in patients without EV or grade I EV (32.9±17.8 kPa vs. 44.4±24.2 kPa, p = 0.0009).
In conclusion, transient elastography is a promising method for the evaluation of patients with chronic C viral
hepatopathies, enabling an accurate enough staging of liver cirrhosis and the differentiation of mild and no fibrosis
(F01) from significant fibrosis (F2-4), important for the decision of antiviral treatment.


Keywords


fibrosis; hepatitis C; liver stiffness; transient elastography

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