Accuracy of transient elastography in assessing liver fibrosis in chronic viral hepatitis

A multicentre, retrospective study

The Korean Transient Elastography Study Group

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background/Aims: Transient elastography (TE) has become an alternative to liver biopsy (LB). This study investigated the diagnostic performance of liver stiffness (LS) measurement using TE in Korean patients with chronic hepatitis B and C (CHB and CHC). Methods: From April 2006 to June 2014, 916 patients (567 CHB and 349 CHC) who underwent LB and TE at 15 centres were analyzed. The Batts and Ludwig scoring system was used for histologic assessment. Aspartate aminotransferase (AST)-to-platelet ratio indexes (APRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used. Results: The median age, LS value, and APRI score were 45 years, 8.8 kPa, and 0.61, respectively, in CHB patients vs. 51 years, 6.8 kPa and 0.55, respectively, in CHC patients. TE was significantly superior to APRI in CHB patients (AUROC 0.774 vs. 0.72 for ≥F2, 0.849 vs. 0.812 for ≥F3, and 0.902 vs. 0.707 for F4, respectively; all P < 0.05). Furthermore, TE was significantly superior for predicting ≥ F3 stage (AUROC 0.865 vs. 0.840, P = 0.009) whereas it was similar for predicting ≥ F2 and F4 stage (AUROC 0.822 vs. 0.796; 0.910 vs. 0.884; all P > 0.05) in CHC patients. In CHB patients, optimal cut-off LS values were 7.8 kPa for ≥F2, 8.2 kPa for ≥ F3, and 11.6 kPa for F4, vs. 6.8 kPa, 8.6 kPa, and 14.5 kPa, respectively, in CHC patients. Conclusions: TE can accurately assess the degree of liver fibrosis in Korean patients with CVH. TE was superior to APRI for predicting each fibrosis stage.

Original languageEnglish
Pages (from-to)2246-2255
Number of pages10
JournalLiver International
Volume35
Issue number10
DOIs
Publication statusPublished - 2015 Oct 1

Fingerprint

Elasticity Imaging Techniques
Chronic Hepatitis
Liver Cirrhosis
Multicenter Studies
Retrospective Studies
Blood Platelets
Liver
ROC Curve
Biopsy
Chronic Hepatitis B
Chronic Hepatitis C
Aspartate Aminotransferases
Fibrosis

Keywords

  • Chronic liver disease
  • Cirrhosis
  • Fibroscan
  • Liver fibrosis
  • Liver stiffness
  • Performance
  • Transient elastography

ASJC Scopus subject areas

  • Hepatology

Cite this

Accuracy of transient elastography in assessing liver fibrosis in chronic viral hepatitis : A multicentre, retrospective study. / The Korean Transient Elastography Study Group.

In: Liver International, Vol. 35, No. 10, 01.10.2015, p. 2246-2255.

Research output: Contribution to journalArticle

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title = "Accuracy of transient elastography in assessing liver fibrosis in chronic viral hepatitis: A multicentre, retrospective study",
abstract = "Background/Aims: Transient elastography (TE) has become an alternative to liver biopsy (LB). This study investigated the diagnostic performance of liver stiffness (LS) measurement using TE in Korean patients with chronic hepatitis B and C (CHB and CHC). Methods: From April 2006 to June 2014, 916 patients (567 CHB and 349 CHC) who underwent LB and TE at 15 centres were analyzed. The Batts and Ludwig scoring system was used for histologic assessment. Aspartate aminotransferase (AST)-to-platelet ratio indexes (APRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used. Results: The median age, LS value, and APRI score were 45 years, 8.8 kPa, and 0.61, respectively, in CHB patients vs. 51 years, 6.8 kPa and 0.55, respectively, in CHC patients. TE was significantly superior to APRI in CHB patients (AUROC 0.774 vs. 0.72 for ≥F2, 0.849 vs. 0.812 for ≥F3, and 0.902 vs. 0.707 for F4, respectively; all P < 0.05). Furthermore, TE was significantly superior for predicting ≥ F3 stage (AUROC 0.865 vs. 0.840, P = 0.009) whereas it was similar for predicting ≥ F2 and F4 stage (AUROC 0.822 vs. 0.796; 0.910 vs. 0.884; all P > 0.05) in CHC patients. In CHB patients, optimal cut-off LS values were 7.8 kPa for ≥F2, 8.2 kPa for ≥ F3, and 11.6 kPa for F4, vs. 6.8 kPa, 8.6 kPa, and 14.5 kPa, respectively, in CHC patients. Conclusions: TE can accurately assess the degree of liver fibrosis in Korean patients with CVH. TE was superior to APRI for predicting each fibrosis stage.",
keywords = "Chronic liver disease, Cirrhosis, Fibroscan, Liver fibrosis, Liver stiffness, Performance, Transient elastography",
author = "{The Korean Transient Elastography Study Group} and Seo, {Yeon Seok} and Kim, {Moon Young} and Kim, {Seung Up} and Hyun, {Bae Si} and Jang, {Jae Young} and Lee, {Jin Woo} and Lee, {Jung Il} and Suh, {Sang Jun} and Park, {Soo Young} and Hana Park and Jung, {Eun Uk} and Kim, {Byung Seok} and Kim, {In Hee} and Lee, {Tae Hee} and Soon-Ho Um and Han, {Kwang Hyub} and Kim, {Sang Gyune} and Paik, {Soon Koo} and Choi, {Jong Young} and Jeong, {Soung Won} and Jin, {Young Joo} and Lee, {Kwan Sik} and Yim, {Hyung Joon} and Tak, {Won Young} and Hwang, {Seong Gyu} and Lee, {Youn Jae} and Lee, {Chang Hyeong} and Kim, {Dae Ghon} and Kang, {Young Woo} and Kim, {Young Seok}",
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T1 - Accuracy of transient elastography in assessing liver fibrosis in chronic viral hepatitis

T2 - A multicentre, retrospective study

AU - The Korean Transient Elastography Study Group

AU - Seo, Yeon Seok

AU - Kim, Moon Young

AU - Kim, Seung Up

AU - Hyun, Bae Si

AU - Jang, Jae Young

AU - Lee, Jin Woo

AU - Lee, Jung Il

AU - Suh, Sang Jun

AU - Park, Soo Young

AU - Park, Hana

AU - Jung, Eun Uk

AU - Kim, Byung Seok

AU - Kim, In Hee

AU - Lee, Tae Hee

AU - Um, Soon-Ho

AU - Han, Kwang Hyub

AU - Kim, Sang Gyune

AU - Paik, Soon Koo

AU - Choi, Jong Young

AU - Jeong, Soung Won

AU - Jin, Young Joo

AU - Lee, Kwan Sik

AU - Yim, Hyung Joon

AU - Tak, Won Young

AU - Hwang, Seong Gyu

AU - Lee, Youn Jae

AU - Lee, Chang Hyeong

AU - Kim, Dae Ghon

AU - Kang, Young Woo

AU - Kim, Young Seok

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Background/Aims: Transient elastography (TE) has become an alternative to liver biopsy (LB). This study investigated the diagnostic performance of liver stiffness (LS) measurement using TE in Korean patients with chronic hepatitis B and C (CHB and CHC). Methods: From April 2006 to June 2014, 916 patients (567 CHB and 349 CHC) who underwent LB and TE at 15 centres were analyzed. The Batts and Ludwig scoring system was used for histologic assessment. Aspartate aminotransferase (AST)-to-platelet ratio indexes (APRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used. Results: The median age, LS value, and APRI score were 45 years, 8.8 kPa, and 0.61, respectively, in CHB patients vs. 51 years, 6.8 kPa and 0.55, respectively, in CHC patients. TE was significantly superior to APRI in CHB patients (AUROC 0.774 vs. 0.72 for ≥F2, 0.849 vs. 0.812 for ≥F3, and 0.902 vs. 0.707 for F4, respectively; all P < 0.05). Furthermore, TE was significantly superior for predicting ≥ F3 stage (AUROC 0.865 vs. 0.840, P = 0.009) whereas it was similar for predicting ≥ F2 and F4 stage (AUROC 0.822 vs. 0.796; 0.910 vs. 0.884; all P > 0.05) in CHC patients. In CHB patients, optimal cut-off LS values were 7.8 kPa for ≥F2, 8.2 kPa for ≥ F3, and 11.6 kPa for F4, vs. 6.8 kPa, 8.6 kPa, and 14.5 kPa, respectively, in CHC patients. Conclusions: TE can accurately assess the degree of liver fibrosis in Korean patients with CVH. TE was superior to APRI for predicting each fibrosis stage.

AB - Background/Aims: Transient elastography (TE) has become an alternative to liver biopsy (LB). This study investigated the diagnostic performance of liver stiffness (LS) measurement using TE in Korean patients with chronic hepatitis B and C (CHB and CHC). Methods: From April 2006 to June 2014, 916 patients (567 CHB and 349 CHC) who underwent LB and TE at 15 centres were analyzed. The Batts and Ludwig scoring system was used for histologic assessment. Aspartate aminotransferase (AST)-to-platelet ratio indexes (APRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used. Results: The median age, LS value, and APRI score were 45 years, 8.8 kPa, and 0.61, respectively, in CHB patients vs. 51 years, 6.8 kPa and 0.55, respectively, in CHC patients. TE was significantly superior to APRI in CHB patients (AUROC 0.774 vs. 0.72 for ≥F2, 0.849 vs. 0.812 for ≥F3, and 0.902 vs. 0.707 for F4, respectively; all P < 0.05). Furthermore, TE was significantly superior for predicting ≥ F3 stage (AUROC 0.865 vs. 0.840, P = 0.009) whereas it was similar for predicting ≥ F2 and F4 stage (AUROC 0.822 vs. 0.796; 0.910 vs. 0.884; all P > 0.05) in CHC patients. In CHB patients, optimal cut-off LS values were 7.8 kPa for ≥F2, 8.2 kPa for ≥ F3, and 11.6 kPa for F4, vs. 6.8 kPa, 8.6 kPa, and 14.5 kPa, respectively, in CHC patients. Conclusions: TE can accurately assess the degree of liver fibrosis in Korean patients with CVH. TE was superior to APRI for predicting each fibrosis stage.

KW - Chronic liver disease

KW - Cirrhosis

KW - Fibroscan

KW - Liver fibrosis

KW - Liver stiffness

KW - Performance

KW - Transient elastography

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U2 - 10.1111/liv.12808

DO - 10.1111/liv.12808

M3 - Article

VL - 35

SP - 2246

EP - 2255

JO - Liver International

JF - Liver International

SN - 1478-3223

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