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Vibration-Controlled Transient Elastography to Assess Fibrosis and Steatosis in Patients With Nonalcoholic Fatty Liver Disease
| Content Provider | Scilit |
|---|---|
| Author | Siddiqui, Mohammad S. Vuppalanchi, Raj Natta, Mark L. Van Hallinan, Erin Kowdley, Kris V. Abdelmalek, Manal Neuschwander-Tetri, Brent A. Loomba, Rohit Dasarathy, Srinivasan Brandman, Danielle Doo, Edward Tonascia, James A. Kleiner, David E. Chalasani, Naga Sanyal, Arun J. |
| Copyright Year | 2018 |
| Description | Journal: Clinical Gastroenterology and Hepatology Background & Aims Vibration-controlled transient elastography (VCTE), which measures liver stiffness, has become an important tool for evaluating patients with nonalcoholic fatty liver disease (NAFLD). We aimed to determine the diagnostic accuracy of VCTE in detection of NAFLD in a multicenter cohort of patients. Methods We performed a prospective study of 393 adults with NAFLD who underwent VCTE within 1 year of liver histology analysis (median time, 49 d; interquartile range, 25–78 d), from July 1, 2014, through July 31, 2017. Liver stiffness measurement (LSM) cut-off values for pairwise fibrosis stage and controlled attenuation parameter cut-off values for pairwise steatosis grade were determined using cross-validated area under the receiver operating characteristics curve (AUROC) analyses. Diagnostic statistics were computed at a sensitivity fixed at 90% and a specificity fixed at 90%. Results LSM identified patients with advanced fibrosis with an AUROC of 0.83 (95% CI, 0.79– 0.87) and patients with cirrhosis with an AUROC of 0.93 (95% CI, 0.90–0.97). At a fixed sensitivity, a cut-off LSM of 6.5 kPa excluded advanced fibrosis with a negative predictive value of 0.91, and a cut-off LSM of 12.1 kPa excluded cirrhosis with a negative predictive value of 0.99. At a fixed specificity, LSM identified patients with advanced fibrosis with a positive predictive value of 0.71 and patients with cirrhosis with a positive predictive value of 0.41. Controlled attenuation parameter analysis detected steatosis with an AUROC of 0.76 (95% CI, 0.64–0.87). In contrast, the VCTE was less accurate in distinguishing lower fibrosis stages, higher steatosis grades, or the presence of NASH. Conclusions In a prospective study of adults with NAFLD, we found VCTE to accurately distinguish advanced vs earlier stages of fibrosis, using liver histology as the reference standard. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203668/pdf http://www.cghjournal.org/article/S1542356518304051/pdf |
| ISSN | 15423565 |
| e-ISSN | 15427714 |
| DOI | 10.1016/j.cgh.2018.04.043 |
| Journal | Clinical Gastroenterology and Hepatology |
| Issue Number | 1 |
| Volume Number | 17 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2018-04-26 |
| Access Restriction | Open |
| Subject Keyword | Journal: Clinical Gastroenterology and Hepatology Gastroenterology and Hepatology Vibration Controlled Transient Elastography Controlled Attenuation Parameter Area Under the Receiver Operating Characteristics Curve Body Mass Index Interquartile Range Liver Stiffness Measurement Nonalcoholic Fatty Liver |
| Content Type | Text |
| Resource Type | Article |
| Subject | Hepatology Gastroenterology |
