Comparison of liver stiffness, fibrotest and liver biopsy for assessment of liver fibrosis in kidney-transplant patients with chronic viral hepatitis

2009 ◽  
Vol 22 (5) ◽  
pp. 568-573 ◽  
Author(s):  
Laurent Alric ◽  
Nassim Kamar ◽  
Delphine Bonnet ◽  
Marie Danjoux ◽  
Florence Abravanel ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Viral Hepatitis ◽  
Kidney Transplant ◽  
Liver Stiffness ◽  
Chronic Viral Hepatitis ◽  
Transplant Patients ◽  
Kidney Transplant Patients

scholarly journals NON-INVASIVE ASSESSMENT OF LIVER FIBROSIS USING LIVER ELASTOGRAPHY (FIBROSCAN) IN PATIENTS WITH CHRONIC INFECTION HBV AND HCV

2016 ◽  
Vol 19 (3) ◽  
pp. 55-59
Author(s):  
Andreea Rădășan ◽  
◽  
Mihai Voiculescu ◽  
Laura Elena Iliescu ◽  
◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Viral Hepatitis ◽  
Chronic Viral Hepatitis ◽  
Economic Problem ◽  
Non Invasive ◽  
Treatment And Prevention ◽  
Viral Hepatitis C ◽  
B Virus ◽  
Liver Elastography

Introduction. In recent years there have been major advances in the treatment and prevention of viral hepatitis, but this pathology is still a major health and socio-economic problem. The defining element for this disease is the liver fibrosis, a histological component of particular importance due to its role in the formation of liver lesions of cirrhosis. Thus, an essential step in the management of chronic viral hepatitis is the detection and measurement of liver fibrosis. Today we have invasive methods for detecting liver fibrosis, the liver puncture biopsy, and non-invasive methods, which in turn are divided into serum methods and imaging methods (2). Purpose of the Study. The aim of this study is to determine if transcutaneous elastography (FibroScan) is equally reliable in case of viral hepatitis B, as with viral hepatitis C. Material and Method: The study comprises a total of 1,127 patients with liver disease of HBV and HCV aetiology. These patients were examined using FibroScan in the period July 2009 - April 2011. Results: Of the 1,177 patients investigated using FibroScan, 40 underwent liver biopsy as well. Of these, 82% have obtained same stages of liver fibrosis in these two investigations, and 18% achieved different stages of fibrosis in these two tests. For the patients with HCV infection, we obtained a 67.81% match of the two non-invasive tests, FibroScan and FibroMax, and a 79.16% match of FibroScan compared to the Liver Biopsy. For the B virus, the compliance is even better, of 75% (FibroScan - FibroMax), and 80% for FibroScan - LB. Conclusions: FibroScan is one of the non-invasive assessment methods of liver fibrosis with diagnose accuracy similar to FibroMax and close to Liver Biopsy.

scholarly journals Diffusion-weighted magnetic resonance imaging for the assessment of liver fibrosis in chronic viral hepatitis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248024
Author(s):  
Phunchai Charatcharoenwitthaya ◽  
Kamonthip Sukonrut ◽  
Pornpim Korpraphong ◽  
Ananya Pongpaibul ◽  
Pairash Saiviroonporn
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Viral Hepatitis ◽  
Predictive Value ◽  
Chronic Viral Hepatitis ◽  
Fibrosis Stage ◽  
Resonance Imaging ◽  
Weighted Magnetic Resonance Imaging

Background Accurate noninvasive methods for the assessment of liver fibrosis are urgently needed. This prospective study evaluated the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DWI) for the staging of liver fibrosis and proposed a diagnostic algorithm using DWI to identify cirrhosis in patients with chronic viral hepatitis. Methods One hundred twenty-one treatment-naïve patients with chronic hepatitis B or C were evaluated with DWI followed by liver biopsy on the same day. Breath-hold single-shot echo-planar DWI was performed to measure the apparent diffusion coefficient (ADC) of the liver and spleen. Normalized liver ADC was calculated as the ratio of liver ADC to spleen ADC. Results There was an inverse correlation between fibrosis stage and normalized liver ADC (p<0.05). For the prediction of fibrosis stage ≥2, stage ≥3, and cirrhosis, the area under the receiver-operating curve of normalized liver ADC was 0.603, 0.704, and 0.847, respectively. The normalized liver ADC value ≤1.02×10−3 mm2/s had 88% sensitivity, 81% specificity, 25% positive predictive value (PPV), and 99% negative predictive value (NPV) for the diagnosis of cirrhosis. Using a sequential approach with the Fibrosis-4 index followed by DWI, normalized liver ADC ≤1.02×10−3 mm2/s in patients with Fibrosis-4 >3.25 yielded an 80% PPV for cirrhosis, and a 100% NPV to exclude cirrhosis in patients with Fibrosis-4 between 1.45 and 3.25. Only 15.7% of patients would require a liver biopsy. This sequential strategy can reduce DWI examinations by 53.7%. Conclusion Normalized liver ADC measurement on DWI is an accurate and noninvasive tool for the diagnosis of cirrhosis in patients with chronic viral hepatitis.

New non-invasive tool for assessment of liver fibrosis: transient elastography

2011 ◽  
Vol 152 (22) ◽  
pp. 860-865 ◽  
Author(s):  
Gábor Horváth
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Disease Progression ◽  
Liver Diseases ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Chronic Viral Hepatitis ◽  
Non Invasive ◽  
Life Threatening ◽  
Invasive Method

Formation of connective tissue causing liver fibrosis is the common trait of chronic liver diseases. The „gold-standard” of the evaluation of liver fibrosis is liver biopsy, but it is an invasive, painful procedure, and carries a significant, although small risk of life-threatening complications. It may have contraindications, and it is certainly not the ideal procedure for serially repeated assessment of disease progression. A new, non-invasive method for the assessment of liver fibrosis by measuring liver stiffness is the transient elastography. The velocity of the propagation of a shear wave is measured by ultrasound. The procedure is painless, rapid, and no needs any preparation. So far, transient elastography has been mostly validated in chronic hepatitis C, but it is applicable in liver diseases with other etiologies. The diagnostic accuracy of transient elastography increases with stage of fibrosis, and is more accurate in advanced fibrosis (F≥2, Metavir score) and in cirrhosis. Indication of antiviral therapy for chronic viral hepatitis B and C are the main field of the application of the transient elastography, and it is also a useful tool for follow-up the disease progression. It is applicable for early, non-invasive detection of graft damage after liver transplantation. Evaluation of liver damage, the stage of liver fibrosis by transient elastography may have an important role in the decision before surgery, or application of potentially hepatotoxic drugs. Histological examination of the liver tissue is not substituted in every case by transient elastography, but liver biopsy is supplanted by measuring liver stiffness for evaluation of liver fibrosis in many cases. Orv. Hetil., 2011, 152, 860–865.

Acoustic Radiation Force Impulse Elastometry (ARFI Elastometry) in Chronic Viral Hepatitis

2017 ◽  
pp. 82-93
Author(s):  
A. A. Megroyan ◽  
Ju. R. Kamalov ◽  
A. V. Filin ◽  
A. V. Semenkov ◽  
M. M. Morozova ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Viral Hepatitis ◽  
Acoustic Radiation ◽  
Liver Stiffness ◽  
Radiation Force ◽  
Chronic Viral Hepatitis ◽  
Acoustic Radiation Force Impulse ◽  
Control Group ◽  
History Of

Purpose:the aim of this study was to evaluate the reliabilityof ARFI elastometry for diagnosis of fibrosis severity stages in patients with chronic viral hepatitis.Material and methods.ARFI elastometry measurements were  done in 103 patients. Mean age of patients was 39.2 ± 10.8 years.  The study included 11 patients with HBV chronic hepatitis, 87  patients with HCV chronic hepatitis and 5 patients with В+D chronic  hepatitis. Liver stiffness was measured using ARFI elastometry with  following liver biopsy which was made 1–2 after US study and  assessed according to the METAVIR score. Control group included 32  patients (20 (62.5%) volunteers and 12 (37.5%) potential liver  fragment donors). Mean age of patients was 26.9 ± 5.3 years. None  of the healthy subjects had a history of gastrointestinal, pancreatic or hepatic disease; all patients had a normal results of laboratory tests.Results.Significant correlation (r = 0.74, р < 0.001) was found  between ARFI measurements and liver fibrosis stages. The values of  ARFI elastometry for various stages of fibrosis were: F ≥ 2 – cut-off  > 1.36 m/s (AUROC – 77%, sensitivity – 65.9%, specificity – 79%),  F ≥ 3 – cut-off > 1.36 m/s (AUROC = 95%, sensitivity – 95,5%,  specificity – 81.5%), F = 4 – cut-off > 1.66 m/s (AUROC – 97%, sensitivity – 93.3%, specificity – 100%). Liver stiffness  measurements in stages F0–F2 reliably differ from stages F3–F4 (1.25 ± 0.18 m/s vs 2.0 ± 0.52 m/s, р < 0.05).Conclusion. ARFI elastometry is reliable diagnostic method for liver  fibrosis detection in stages F ≥ 2. The best performance of this  method was shown for the prediction of severe fibrosis and cirrhosis.

scholarly journals Imaging Based Methods of Liver Fibrosis Assessment in Viral Hepatitis: A Practical Approach

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Hicham Khallafi ◽  
Kamran Qureshi
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Viral Hepatitis ◽  
Clinical Care ◽  
Standard Of Care ◽  
Chronic Viral Hepatitis ◽  
Invasive Technique ◽  
Liver Imaging ◽  
Clinical Utilization ◽  
Viral Hepatitis A

Liver fibrosis represents the repair mechanism in liver injury and is a feature of most chronic liver diseases. The degree of liver fibrosis in chronic viral hepatitis infections has major clinical implications and presence of advanced fibrosis or cirrhosis determines prognosis. Treatment initiation for viral hepatitis is indicated in most cases of advanced liver fibrosis and diagnosis of cirrhosis entails hepatology evaluation for specialized clinical care. Liver biopsy is an invasive technique and has been the standard of care of fibrosis assessment for years; however, it has several limitations and procedure related complications. Recently, several methods of noninvasive assessment of liver fibrosis have been developed which require either serologic testing or imaging of liver. Imaging based noninvasive techniques are reviewed here and their clinical use is described. Some of the imaging based tests are becoming widely available, and collectively they are shown to be superior to liver biopsy in important aspects. Clinical utilization of these methods requires understanding of performance and quality related parameters which can affect the results and provide wrong assessment of the extent of liver fibrosis. Familiarity with the strengths and weaknesses of each modality is needed to correctly interpret the results in appropriate clinical context.

YKL-40 and hyaluronic acid (HA) as noninvasive markers of liver fibrosis in kidney transplant patients with HCV chronic infection

2010 ◽  
Vol 45 (5) ◽  
pp. 615-622 ◽  
Author(s):  
Leonardo L. Schiavon ◽  
Roberto J. Carvalho-Filho ◽  
Janaína L. Narciso-Schiavon ◽  
José O. Medina-Pestana ◽  
Valéria P. Lanzoni ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Liver Fibrosis ◽  
Kidney Transplant ◽  
Chronic Infection ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Noninvasive Markers

Noninvasive Assessment of Liver Fibrosis

2015 ◽  
Vol 33 (4) ◽  
pp. 498-503 ◽  
Author(s):  
Laurent Castera
Keyword(s):  
Clinical Practice ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Viral Hepatitis ◽  
Esophageal Varices ◽  
Transient Elastography ◽  
Antiviral Treatment ◽  
Liver Stiffness ◽  
Noninvasive Methods ◽  
Excellent Tool

Background: The prognosis and management of chronic liver diseases greatly depend on the amount and progression of liver fibrosis with the risk of developing cirrhosis. Liver biopsy, traditionally considered as the reference standard for the staging of fibrosis, has been challenged over the past decade by the development of novel noninvasive methodologies. Key Messages: Noninvasive methods rely on two different but complementary approaches: a ‘biological' approach based on the dosage serum biomarkers, and a ‘physical' approach based on the measurement of liver stiffness using transient elastography (TE). There are two clinically relevant endpoints for the staging of liver fibrosis: (1) significant fibrosis (indication for antiviral treatment in viral hepatitis B and C), and (2) cirrhosis (indication for screening of esophageal varices and hepatocellular carcinoma). TE (FibroScan®), FibroTest® and APRI have been the most extensively studied and validated methods, mainly in chronic hepatitis C. Combining two unrelated methods, such as TE and biomarkers, is an attractive approach that increases diagnostic performance and limits the drawback of both methodologies. TE appears to be an excellent tool for the early detection of cirrhosis with likely prognostic value in this setting. Thus far, however, it cannot replace upper endoscopy for screening of esophageal varices. The main limitation of TE in clinical practice is the impossibility of obtaining reliable liver stiffness measurements in around 20% of cases, mainly comprising obese patients. Conclusion: An increasing number of reliable noninvasive methods are now available that are widely used in clinical practice, mostly in viral hepatitis, resulting in a significant decrease in the need for liver biopsy.

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