Diagnosis of liver fibrosis: an emphasis on elastography

In the strategy of managing patients with chronic diffuse liver diseases, the priority areas are the determination of the diagnosis with the determination of the main risk factors, the activity of the process (steatosis, steatohepatitis), as well as the degree of fibrous transformation. The rate of progression of liver fibrosis is a decisive factor that will determine the prognosis, treatment tactics and the likelihood of severe complications. The “gold standard” for diagnosing chronic liver pathology is a puncture liver biopsy with morphological examination of the liver tissue. At the same time, potential complications, contraindications to the procedure, low patient compliance, as well as errors in the interpretation of the results obtained due to various reasons are significant limitations of this diagnostic method. These shortcomings were the reason for the search for reliable non-invasive methods for diagnosing liver fibrosis both during the initial examination and during subsequent monitoring in dynamics. Modern methods of liver elastography are widely used for non-invasive assessment of fibrosis, demonstrating good diagnostic capabilities and significantly reducing the need for liver biopsy. Various elastography methods, which have their own advantages and disadvantages, effectively complement each other, which is successfully used in clinical practice in the diagnosis of fibrous transformation. The combined use of elastographic methods and commercial predictive diagnostic panels will increase the diagnostic accuracy in the determination of liver fibrosis.

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

Romanian Journal of Infectious Diseases ◽

10.37897/rjid.2016.3.2 ◽

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.

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848 RELATIONSHIP BETWEEN LIVER BIOPSY AND NON-INVASIVE BIOCHEMICAL METHODS IN DETERMINATION OF LIVER FIBROSIS IN TREATMENT-NAIVE CHRONIC HEPATITIS C PATIENTS; A MULTICENTRE STUDY

Journal of Hepatology ◽

10.1016/s0168-8278(12)60860-5 ◽

2012 ◽

Vol 56 ◽

pp. S331

Author(s):

I. Koksal ◽

G. Yilmaz ◽

M. Parlak ◽

T. Demirdal ◽

S. Kinikli ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Liver Fibrosis ◽

Liver Biopsy ◽

Multicentre Study ◽

Chronic Hepatitis C ◽

Non Invasive ◽

Treatment Naïve ◽

Chronic Hepatitis C Patients

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Faculty Opinions recommendation of Non-invasive biomarkers of liver fibrosis in haemophilia patients with hepatitis C: can you avoid liver biopsy?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.30418.486917 ◽

2006 ◽

Author(s):

David Kershenobich

Keyword(s):

Hepatitis C ◽

Liver Fibrosis ◽

Liver Biopsy ◽

Non Invasive

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MEG/EEG in the Study of Brain Function

MEG-EEG Primer ◽

10.1093/med/9780190497774.003.0020 ◽

2017 ◽

pp. 304-310

Author(s):

Riitta Hari ◽

Aina Puce

Keyword(s):

Human Brain ◽

Brain Function ◽

Social Neuroscience ◽

Future Research ◽

Noninvasive Methods ◽

Advantages And Disadvantages ◽

Non Invasive ◽

Combined Use ◽

Eeg Recordings ◽

Two Sides

This chapter summarizes some relative advantages and disadvantages of MEG and EEG, most of which have been previously elaborated. MEG and EEG are the two sides of the same coin and provide complementary information about the human brain’s neurodynamics. The combined use of MEG or EEG together and with other noninvasive methods used to study human brain function is advocated to be important for future research in systems and cognitive/social neuroscience. This chapter also examines combined use and interpretation of MEG/EEG with MRI/fMRI, and performing EEG recordings during non-invasive brain stimulation.

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Ultrasound-based liver elastography: current results and future perspectives

Abdominal Radiology ◽

10.1007/s00261-020-02717-x ◽

2020 ◽

Vol 45 (11) ◽

pp. 3463-3472

Author(s):

Cheng Fang ◽

Paul S. Sidhu

Keyword(s):

Liver Disease ◽

Liver Fibrosis ◽

Liver Biopsy ◽

Chronic Liver Disease ◽

Research Direction ◽

Chronic Liver ◽

Current Evidence ◽

Diffuse Liver Disease ◽

Disease Spectrum ◽

Liver Elastography

Abstract Chronic liver disease affects 185 million population worldwide. It encompasses a heterogenous disease spectrum, but all can lead to the development of liver fibrosis. The degree of liver fibrosis is not only a prognosticator, but has also been used to guide the treatment strategy and to evaluate treatment response. Traditionally, staging of liver fibrosis is determined on histological analysis using samples obtained from an invasive liver biopsy. Ultrasound-based liver elastography is a non-invasive method of assessing diffuse liver disease in patients with known chronic liver disease. The use of liver elastography has led to a significant reduction in the number of liver biopsies performed to assess the severity of liver fibrosis and a liver biopsy is now reserved for only select sub-groups of patients. The aim of this review article is to discuss the key findings and current evidence for ultrasound-based elastography in diffuse liver disease as well as the technical challenges and to evaluate the potential research direction.

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Toward Non-Invasive Measurement of Atmospheric Temperature Using Vibro-Rotational Raman Spectra of Diatomic Gases

Remote Sensing ◽

10.3390/rs12244129 ◽

2020 ◽

Vol 12 (24) ◽

pp. 4129

Author(s):

Tyler Capek ◽

Jacek Borysow ◽

Claudio Mazzoleni ◽

Massimo Moraldi

Keyword(s):

Continuous Wave ◽

Molecular Nitrogen ◽

Atmospheric Temperature ◽

Precise Determination ◽

Gas Temperature ◽

Advantages And Disadvantages ◽

Non Invasive ◽

Potential Applications ◽

532 Nm

We demonstrate precise determination of atmospheric temperature using vibro-rotational Raman (VRR) spectra of molecular nitrogen and oxygen in the range of 292–293 K. We used a continuous wave fiber laser operating at 10 W near 532 nm as an excitation source in conjunction with a multi-pass cell. First, we show that the approximation that nitrogen and oxygen molecules behave like rigid rotors leads to erroneous derivations of temperature values from VRR spectra. Then, we account for molecular non-rigidity and compare four different methods for the determination of air temperature. Each method requires no temperature calibration. The first method involves fitting the intensity of individual lines within the same branch to their respective transition energies. We also infer temperature by taking ratios of two isolated VRR lines; first from two lines of the same branch, and then one line from the S-branch and one from the O-branch. Finally, we take ratios of groups of lines. Comparing these methods, we found that a precision up to 0.1 K is possible. In the case of O2, a comparison between the different methods show that the inferred temperature was self-consistent to within 1 K. The temperature inferred from N2 differed by as much as 3 K depending on which VRR branch was used. Here we discuss the advantages and disadvantages of each method. Our methods can be extended to the development of instrumentation capable of non-invasive monitoring of gas temperature with broad potential applications, for example, in laboratory, ground-based, or airborne remote sensing.

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