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.

scholarly journals Elast PQ Ultrasound - a Noninvasive, Reproducible, Easily Performed Method and a New Era in Liver Fibrosis Assessment

2018 ◽  
Vol 13 (1) ◽  
pp. 44-46
Author(s):  
Hafizur Rahman
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Viral Hepatitis ◽  
Ultrasound Imaging ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Invasive Technique ◽  
Liver Imaging ◽  
Chronic Liver Diseases

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 infection 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 weakness of each modality is needed to correctly interpret the results in appropriate clinical content. A new technique called Elast PQ uses ultrasound shear wave elastography to provide a noninvasive, reproducible, easily performed method of assessing liver fibrosis. It can easily combine a routine ultrasound imaging exam of the liver anatomy with targeted tissue stiffness values, assess liver fibrosis in patient with clinically suspected disease even before abnormalities are detected with ultrasound imaging, evaluate and obtain a baseline stiffness value in patients with chronic liver disease, follow up patients under treatment to monitor progression, stabilization or regression of liver disease and help avoid the need for liver biopsies when elastography results are consistent with other clinical findings. Both the prognosis and potential treatment of chronic liver diseases greatly depend on the progression of liver fibrosis, which is the ultimate outcome of chronic liver damage. Historically, liver biopsy has been instrumental in adequately assessing patients allows clinicians both to obtain diagnosis information and initiate adequate therapy. However, the technique is not exempt of deleterious effects. Multiple diagnostic tests have been developed for the staging of fibrosis using noninvasive methods, most of them in the setting of chronic hepatitis C. The goal of this paper is to review available data on the staging and assessment of liver fibrosis with two methods: serum markers & transient elastography (FibroScan).Faridpur Med. Coll. J. Jan 2018;13(1): 44-46

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.

Accuracy of transient elastography in assessing liver fibrosis in chronic viral hepatitis: A multicentre, retrospective study

2015 ◽  
Vol 35 (10) ◽  
pp. 2246-2255 ◽  
Author(s):  
Yeon Seok Seo ◽  
Moon Young Kim ◽  
Seung Up Kim ◽  
Bae Si Hyun ◽  
Jae Young Jang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Liver Fibrosis ◽  
Viral Hepatitis ◽  
Hepatitis A ◽  
Transient Elastography ◽  
Chronic Viral Hepatitis ◽  
Viral Hepatitis A ◽  
Multicentre Retrospective Study

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.

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