Accuracy of FibroScan controlled attenuation parameter and liver stiffness measurement in assessing steatosis and fibrosis in patients with nonalcoholic fatty liver disease
| Autor: | Jeremy F. L. Cobbold, Quentin M. Anstee, Michael Allison, Emmanouil Tsochatzis, Philip N. Newsome, Valérie Paradis, Jonathan J Deeks, Indra Neil Guha, Peter J Eddowes, Magali Sasso, Pierre Bedossa, David Sheridan |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Liver Cirrhosis Male 0301 basic medicine medicine.medical_specialty Biopsy Gastroenterology Likelihood ratios in diagnostic testing Young Adult 03 medical and health sciences Liver disease 0302 clinical medicine Non-alcoholic Fatty Liver Disease Predictive Value of Tests Positive predicative value Internal medicine Nonalcoholic fatty liver disease Humans Medicine Prospective Studies Aged Hepatology medicine.diagnostic_test Receiver operating characteristic business.industry Middle Aged medicine.disease Elasticity 030104 developmental biology Liver ROC Curve Area Under Curve Liver biopsy Elasticity Imaging Techniques Female 030211 gastroenterology & hepatology Steatosis business Transient elastography |
| Zdroj: | Gastroenterology. 156(6) |
| ISSN: | 1528-0012 0016-5085 |
| Popis: | Background & Aims: We estimated the accuracy of FibroScan vibration-controlled transient elastography controlled attenuation parameter (CAP) and liver stiffness measurement (LSMs) in assessing steatosis and fibrosis in patients with suspected nonalcoholic liver disease (NAFLD).Methods: We collected data from 450 consecutive adults who underwent liver biopsy analysis for suspected NAFLD at 7 centers in the United Kingdom from March 2014 through January 2017. FibroScan examinations with M or XL probe were completed within the 2 weeks of the biopsy analysis (404 had a valid examination). The biopsies were scored by 2 blinded expert pathologists according to nonalcoholic steatohepatitis clinical research network criteria. Diagnostic accuracy was estimated using the area under the receiver operating characteristic curves (AUROCs) for the categories of steatosis and fibrosis. We assessed effects of disease prevalence on positive and negative predictive values. For LSM, the effects of histological parameters and probe type were appraised using multivariable analysis.Results: Using biopsy analysis as the reference standard, we found that CAP identified patients with steatosis with an AUROC of 0.87 (95% confidence interval [CI] 0.82–0.92) for S≥S1, 0.77 (95% CI 0.71–0.82) for S≥S2, and 0.70 (95% CI 0.64–0.75) for S=S3. Youden cutoff values for S≥S1, S≥S2, and S≥S3 were 302 dB/m, 331 dB/m, and 337 dB/m, respectively. LSM identified patients with fibrosis with AUROCs of 0.77 (95% CI 0.72–0.82) for F≥F2, 0.80 (95% CI 0.75–0.84) for F≥F3, and 0.89 (95% CI 0.84–0.93) for F=F4. Youden cutoff values for F≥F2, F≥F3, and F=F4 were 8.2 kPa, 9.7 kPa, and 13.6 kPa, respectively. Applying the optimal cutoff values, determined from this cohort, to populations of lower fibrosis prevalence increased negative predictive values and reduced positive predictive values. Multivariable analysis found that the only parameter that significantly affected LSMs was fibrosis stage (PConclusions: In a prospective analysis of patients with NAFLD, we found CAP and LSM by FibroScan to assess liver steatosis and fibrosis, respectively, with AUROC values ranging from 0.70 to 0.89. Probe type and steatosis did not affect LSM. Study registration: ClinicalTrials.gov Identifier: NCT01985009. |
| Databáze: | OpenAIRE |
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