scholarly journals Factors That Could Impact on Liver Fibrosis Staging by Transient Elastography

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Hugo Perazzo ◽  
Valdilea G. Veloso ◽  
Beatriz Grinsztejn ◽  
Chris Hyde ◽  
Rodolfo Castro
Keyword(s):  
Liver Fibrosis ◽  
Liver Diseases ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Noninvasive Methods ◽  
Extrahepatic Cholestasis ◽  
The Impact ◽  
Fibrosis Staging

Transient elastography (TE) based on liver stiffness measurement (LSM) is one of the most validated noninvasive methods for liver fibrosis staging in patients with chronic liver diseases. This method is painless, has no potential complications, is rapid (<10 min), and can be performed at the patient’s bedside. However, several points should be considered when interpreting TE results. This review aims to discuss the critical points that might influence liver stiffness and TE results. Spectrum bias and the impact of the prevalence of fibrosis stages should be taken into account when interpreting the studies that validated this method using liver biopsy as a gold-standard. LSM might be influenced by nonfasting status, flare of transaminases, heart failure, extrahepatic cholestasis, presence of steatosis, aetiology of liver disease, type and position of probe, and operator’s experience. In addition, interobserver variability can impact on the management of patients with chronic liver diseases. TE should be performed by an experienced operator (>100 exams), in a 3-hour fasting status, and its results should be handled by specialist clinicians that are aware of the limitations of this method.

scholarly journals Elastography in Hepatology

2007 ◽  
Vol 21 (12) ◽  
pp. 839-842 ◽  
Author(s):  
Ludovico Abenavoli ◽  
Christophe Corpechot ◽  
Raoul Poupon
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Liver Diseases ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Factors Associated ◽  
History Of ◽  
Elastic Shear

A common characteristic of all chronic liver diseases is the occurrence and progression of fibrosis toward cirrhosis. Consequently, liver fibrosis assessment plays an important role in hepatology. Besides its importance for prognosis, determining the level of fibrosis reveals the natural history of the disease and the risk factors associated with its progression, to guide the antifibrotic action of different treatments. Currently, in clinical practice, there are three available methods for the evaluation of liver fibrosis: liver biopsy, which is still considered to be the ‘gold standard’; serological markers of fibrosis and their mathematical combination – suggested in recent years to be an alternative to liver biopsy – and, more recently, transient elastography (TE). TE is a new, simple and noninvasive method used to measure liver stiffness. This technique is based on the progressing speed of an elastic shear wave within the liver. Currently, there are only a few studies that have evaluated TE effectiveness in chronic liver diseases, mostly in patients infected with the hepatitis C virus. Further studies are needed in patients with chronic liver disease, to assess the effectiveness of the fibrosis treatment.

Potential impact of screening for fatty liver disease by transient elastography with liver stiffness and controlled attenuation parameter measurements: a pilot study

2017 ◽  
Vol 55 (08) ◽  
pp. 754-760
Author(s):  
Moritz Peiseler ◽  
Anna Creutzfeldt ◽  
Insa Cassens ◽  
Claudia Glaubke ◽  
Claudia Kroll ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Pilot Study ◽  
Liver Diseases ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Normal Range ◽  
Controlled Attenuation Parameter ◽  
Attenuation Parameter

Abstract Background The prevalence of chronic liver diseases is high in developed countries, and the leading causes are amenable to prevention. The German Lebertag is to increase awareness of the burden of chronic liver diseases in the general public. We performed a pilot study using transient elastography with liver stiffness measurement (LSM) and the controlled attenuation parameter (CAP) as a screening tool for previously unrecognized liver diseases. Patients and methods LSM and CAP was performed in 60 individuals, and participants filled in a questionnaire reporting basic characteristics and past medical history. Results Median LSM and CAP values were within the normal range. Participants with self-reported diabetes mellitus had significantly elevated LSM (p = 0.02) and CAP values (p = 0.002). Participants with a BMI > 30 kg/m2 or dyslipidemia had significantly elevated CAP values (p = 0.007 and p = 0.01, respectively) with normal LSM values. Overall, 35 % of participants had elevated CAP values, indicating a high prevalence of hepatic steatosis. Discussion In a German pilot study, diabetes mellitus was a key risk factor for increased LSM and CAP values. Prevalence of steatosis was high and comparable to other Western countries. Transient elastography is a valuable tool to identify patients with increased risk for metabolic liver diseases. In people without risk factors, LSM and CAP values were within the normal range, indicating that screening for chronic liver injury was not warranted.

NONINVASIVE ASSESSMENT OF HEPATIC FIBROSIS

2014 ◽  
pp. 5-11
Author(s):  
Thi Khanh Tuong Tran ◽  
Trong Thang Hoang
Keyword(s):  
Clinical Practice ◽  
Liver Fibrosis ◽  
Hepatic Fibrosis ◽  
Liver Stiffness ◽  
Treatment Decision ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Noninvasive Methods ◽  
Non Invasive ◽  
Noninvasive Assessment

Staging of hepatic fibrosis is crucial for prognosis, surveillance and treatment decision in patients with chronic liver diseases in clinical practice. Liver biopsy has still the gold standard for assessment of hepatic fibrosis, but it has some limitations. To overcome this, non-invasive methods were developed. The methods of noninvasive assessment of liver fibrosis were divided into two main groups: serum biomarkers and techniques measuring liver stiffness. Each method has its own advantages and limits. Some studies suggest that the effectiveness of noninvasive methods for assessing liver fibrosis may increase when they are combined. The aim of this article is to review and update the different non invasive methods for assessment of hepatic fibrosis, their advantages, disadvantages, diagnostic accuracy and their applications in clinical practice. Key words: hepatic fibrosis, liver stiffness, chronic liver disease

scholarly journals Serum Biomarkers of Liver Fibrosis Staging in the Era of the Concept “Compensated Advanced Chronic Liver Disease”

2021 ◽  
Vol 10 (15) ◽  
pp. 3340
Author(s):  
Koji Fujita ◽  
Tsutomu Masaki
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Chronic Liver Disease ◽  
Liver Diseases ◽  
Serum Biomarkers ◽  
Chronic Liver ◽  
World Health ◽  
Chronic Liver Diseases ◽  
Fibrosis Staging ◽  
Severe Fibrosis

Non-invasive indexes of liver fibrosis based on blood examinations have been developed for decades, partially replacing liver biopsy examinations. Recently, the concept of liver cirrhosis was revised and converted to “compensated advanced chronic liver diseases” since the Baveno VI consensus statement in 2015. The term “compensated advanced chronic liver diseases” was established based on the premise that serum biomarkers were not able to differentiate cirrhosis from severe fibrosis. The difficulty to histologically distinguish cirrhosis from severe fibrosis had been pointed out in 1977, when the definition and nomenclatures of cirrhosis had been determined by the World Health Organization. That was decades before serum biomarkers available at present were investigated. Though we are accustomed to differentiating the fibrosis stage as stage 1, 2, 3 (severe fibrosis), and 4 (cirrhosis), differentiation of cirrhosis from severe fibrosis is difficult even by histopathological examination. The current review will provide readers a framework to revise how to apply serum biomarkers on liver fibrosis staging in an era of the concept of “compensated advanced chronic liver disease”.

scholarly journals Antioxidant preconditioning improves therapeutic outcomes of adipose tissue-derived mesenchymal stem cells through enhancing intrahepatic engraftment efficiency in a mouse liver fibrosis model

2020 ◽  
Author(s):  
Naishun Liao ◽  
Yingjun Shi ◽  
Yingchao Wang ◽  
Fangyu Liao ◽  
Bixing Zhao ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Liver Fibrosis ◽  
Liver Diseases ◽  
Histopathological Examination ◽  
Oxidative Injury ◽  
Chronic Liver ◽  
Therapeutic Effects ◽  
Chronic Liver Diseases ◽  
Therapeutic Outcomes ◽  
The Impact

Abstract Background: Although it has been pre-clinically suggested that adipose tissue-derived mesenchymal stem cell (ADSCs)-based therapy could effectively treat chronic liver diseases, the hepatic engraftment of ADSCs is still extremely low, which severely limits their long-term efficacy for chronic liver diseases. This study was designed to investigate the impact of antioxidant preconditioning on hepatic engraftment efficiency and therapeutic outcomes of ADSC transplantation in liver fibrotic mice. Methods: Liver fibrosis model was established by using intraperitoneal injection of carbon tetrachloride (CCl 4 ) in the male C57BL/6 mice. Subsequently, the ADSCs with or without antioxidant pretreatment (including melatonin and reduced glutathione (GSH)) were administrated into fibrotic mice via tail vein injection. Afterwards, the ADSC transplantation efficiency was analyzed by ex vivo imaging, and the liver functions were assessed by biochemical analysis and histopathological examination, respectively. Additionally, a typical hydrogen peroxide (H 2 O 2 )-induced cell injury model was applied to mimic the cell oxidative injury to further investigate the protective effects of antioxidant preconditioning on cell migration, proliferation and apoptosis of ADSCs. Results: Our data showed that antioxidant preconditioning could enhance the therapeutic effects of ADSCs on liver function recovery by reducing the level of AST, ALT and TBIL, as well as the content of hepatic hydroxyproline and fibrotic area in liver tissues. Particularly, we also found that antioxidant preconditioning could enhance hepatic engraftment efficiency of ADSCs in liver fibrosis model through inhibiting oxidative injury. Conclusions: Antioxidant preconditioning could effectively improve therapeutic effects of ADSC transplantation for liver fibrosis through enhancing intrahepatic engraftment efficiency by reducing oxidative injuries. These findings might provide a practical strategy for enhancing ADSC transplantation and therapeutic efficiency.

scholarly journals Antioxidant preconditioning improves therapeutic outcomes of adipose tissue-derived mesenchymal stem cells through enhancing intrahepatic engraftment efficiency in a mouse liver fibrosis model

2020 ◽  
Author(s):  
Naishun Liao ◽  
Yingjun Shi ◽  
Yingchao Wang ◽  
Fangyu Liao ◽  
Bixing Zhao ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Liver Fibrosis ◽  
Liver Diseases ◽  
Cell Injury ◽  
Histopathological Examination ◽  
Chronic Liver ◽  
Therapeutic Effects ◽  
Chronic Liver Diseases ◽  
Therapeutic Outcomes ◽  
The Impact

Abstract Background: Although it has been pre-clinically suggested that adipose tissue-derived mesenchymal stem cell (ADSCs)-based therapy could effectively treat chronic liver diseases, the hepatic engraftment of ADSCs is still extremely low, which severely limits their long-term efficacy for chronic liver diseases. This study was designed to investigate the impact of antioxidant preconditioning on hepatic engraftment efficiency and therapeutic outcomes of ADSC transplantation in liver fibrotic mice.Methods: Liver fibrosis model was established by using intraperitoneal injection of carbon tetrachloride (CCl 4 ) in the male C57BL/6 mice. Subsequently, the ADSCs with or without antioxidant pretreatment (including melatonin and reduced glutathione (GSH)) were administrated into fibrotic mice via tail vein injection. Afterwards, the ADSC transplantation efficiency was analyzed by ex vivo imaging, and the liver functions were assessed by biochemical analysis and histopathological examination, respectively. Additionally, a typical H 2 O 2 -induced cell injury model was applied to mimic the cell oxidative injury to further investigate the protective effects of antioxidant preconditioning on cell migration, proliferation and apoptosis of ADSCs.Results: Our data showed that antioxidant preconditioning could enhance the therapeutic effects of ADSCs on liver function recovery by reducing the level of AST, ALT and TBIL, as well as the content of hepatic hydroxyproline and fibrotic area in liver tissues. Particularly, we also found that antioxidant preconditioning could enhance hepatic engraftment efficiency of ADSCs in liver fibrosis model through inhibiting oxidative injury.Conclusions: Antioxidant preconditioning could effectively improve therapeutic effects of ADSC transplantation for liver fibrosis through enhancing intrahepatic engraftment efficiency by reducing oxidative injuries. These findings might provide a practical strategy for enhancing ADSC transplantation and therapeutic efficiency.

scholarly journals Physicians’ Practices for Diagnosing Liver Fibrosis in Chronic Liver Diseases: A Nationwide, Canadian Survey

2014 ◽  
Vol 28 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Giada Sebastiani ◽  
Peter Ghali ◽  
Philip Wong ◽  
Marina B Klein ◽  
Marc Deschenes ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Liver Biopsy ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Chronic Liver Diseases ◽  
Noninvasive Methods ◽  
Routine Assessment

OBJECTIVE: To determine practices among physicians in Canada for the assessment of liver fibrosis in patients with chronic liver diseases.METHODS: Hepatologists, gastroenterologists, infectious diseases specialists, members of the Canadian Gastroenterology Association and/or the Canadian HIV Trials Network who manage patients with liver diseases were invited to participate in a web-based, national survey.RESULTS: Of the 237 physicians invited, 104 (43.9%) completed the survey. Routine assessment of liver fibrosis was requested by the surveyed physicians mostly for chronic hepatitis C (76.5%), followed by autoimmune/cholestatic liver disease (59.6%) and chronic hepatitis B (52.9%). Liver biopsy was the main diagnostic tool for 46.2% of the respondents, Fibroscan (Echosens, France) for 39.4% and Fibrotest (LabCorp, USA) for 7.7%. Etiology-specific differences were observed: noninvasive methods were mostly used for hepatitis C (63% versus 37% liver biopsy) and hepatitis B (62.9% versus 37.1% liver biopsy). For 42.7% of respondents, the use of noninvasive methods reduced the need for liver biopsy by >50%. Physicians’ characteristics associated with higher use of noninvasive methods were older age and being based at a university hospital or in private practice versus community hospital. Physicians’ main concerns regarding noninvasive fibrosis assessment methods were access/availability (42.3%), lack of guidelines for clinical use (26.9%) and cost/lack of reimbursement (14.4%).CONCLUSIONS: Physicians who manage patients with chronic liver diseases in Canada require routine assessment of liver fibrosis stage. Although biopsy remains the primary diagnostic tool for almost one-half of respondents, noninvasive methods, particularly Fibroscan, have significantly reduced the need for liver biopsy in Canada. Limitations in access to and availability of the noninvasive methods represent a significant barrier. Finally, there is a need for clinical guidelines and a better reimbursement policy to implement noninvasive tools to assess liver fibrosis.

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