scholarly journals Non-invasive Diagnostic Tests in Cystic Fibrosis-Related Liver Disease: A Diagnostic Test Accuracy Network Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Ágnes Rita Martonosi ◽  
Alexandra Soós ◽  
Zoltán Rumbus ◽  
Péter Hegyi ◽  
Vera Izsák ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Liver Disease ◽  
Diagnostic Test ◽  
Diagnostic Performance ◽  
Transient Elastography ◽  
Meta Analysis ◽  
Test Accuracy ◽  
Non Invasive ◽  
Related Liver Disease ◽  
New Criteria

Background and Aims: Cystic fibrosis-related liver disease (CFLD) is one of the leading causes of morbidity and mortality in cystic fibrosis (CF). Several non-invasive diagnostic methods have been proposed as screening tools for CFLD. Our aim was to rank all available non-invasive modalities for diagnostic performance.Methods: A systematic search was performed in five medical databases to find studies which reported on any single or composite non-invasive diagnostic test (as an index test) compared to the Debray, the EuroCare or the Colombo criteria (as a reference standard). Ranking was carried out with a Bayesian diagnostic test accuracy network meta-analysis based on superiority indices, calculated for pooled sensitivity (Se) and specificity (Sp) with a 95% confidence interval (CI). The study was registered under CRD42020155846 in PROSPERO.Results: Fifteen studies with 15 index tests and a combination of them were included. The New criteria proposed by Koh et al. – which represent a composite diagnostic definition for CFLD including liver biochemistry, ultrasonography, transient elastography and fibrosis markers—had the best performance for detecting CFLD (Se:94%[CI:58–100], Sp:72%[CI:52–84]); while transient elastography (Se:65%[CI:56–74], Sp:88%[CI:84–91]) and a combination of it with a tissue inhibitor of metalloproteinase-4 measurement (Se:78%[CI:30–100], Sp:64%[CI:18–95%]) proved to be the second and third best options, respectively. In the imaging techniques subgroup, transient elastography (Se:66%[CI:57–72], Sp:88%[CI:85–91%]), acoustic radiation force impulse in the right lobe (Se:54%[CI:33–74], Sp:88%[CI:66–96]) and that in the left lobe (Se:55%[CI:23–81], Sp:82%[CI:50–95]) were ranked the highest. Comparing biochemical markers/fibrosis indices, the measurement of the Forns index (Se:72%[CI:25–99], Sp:63%[CI:16–94]), the aspartate aminotransferase-to-platelet ratio (Se:55%[CI:41–68], Sp:83%[CI:66–89]) and alkaline phosphatase (Se:63%[CI:18–93], Sp:64%[CI:19–95]) were ranked the highest.Conclusion: The New criteria show the best diagnostic performance. In clinical practice, transient elastography seems to be a simple, cheap and non-invasive tool, outperforming imaging, biochemical and fibrosis tests for detecting CFLD. Further studies are needed to validate our findings.

scholarly journals Non-Invasive Evaluation of Cystic Fibrosis Related Liver Disease in Adults with ARFI, Transient Elastography and Different Fibrosis Scores

PLoS ONE ◽  
2012 ◽  
Vol 7 (7) ◽  
pp. e42139 ◽  
Author(s):  
Thomas Karlas ◽  
Marie Neuschulz ◽  
Annett Oltmanns ◽  
Andrea Güttler ◽  
David Petroff ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Liver Disease ◽  
Transient Elastography ◽  
Non Invasive ◽  
Related Liver Disease ◽  
Invasive Evaluation

scholarly journals A72 NON-INVASIVE PREDICTION OF ESOPHAGEAL VARICES BY TRANSIENT ELASTOGRAPHY AND PLATELET COUNT IN PATIENTS WITH HEPATITIS B AND ADVANCED CHRONIC LIVER DISEASE: VALIDATION OF BAVENO VI AND EXPANDED BAVENO VI CRITERIA

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-38
Author(s):  
A Zoughlami ◽  
J Serero ◽  
G Sebastiani ◽  
M Deschenes ◽  
P Wong ◽  
...  
Keyword(s):  
Platelet Count ◽  
Liver Disease ◽  
Hepatitis B ◽  
Chronic Liver Disease ◽  
Esophageal Varices ◽  
Diagnostic Performance ◽  
Transient Elastography ◽  
Chronic Liver ◽  
Non Invasive ◽  
Chronic Hepatitis B Virus

Abstract Background Patients with compensated advanced chronic liver disease (cACLD) are at higher risk of developing complications from portal hypertension, including esophageal varices (EV). Baveno VI and expanded Baveno VI criteria, based on liver stiffness measurement (LSM) by transient elastography combined with platelet count, have been proposed to avoid unnecessary esophagogastroduodenoscopy (EGD) screening for large esophageal varices needing treatment (EVNT). This approach has not been validated in patients with chronic hepatitis B virus (HBV) infection, who have etiology-specific cut-off of LSM for liver fibrosis. Aims We aimed to validate the Baveno VI and expanded Baveno VI criteria for EVNT in HBV patients with cACLD. Methods We performed a retrospective analysis of HBV patients who underwent LSM in 2014–2020. Inclusion criteria were: a) diagnosis of cACLD, defined as LSM >9 kPa; b) availability of EGD and platelets within 1 year of LSM. Baveno VI (LSM <20 kPa and platelets >150,000) and expanded Baveno VI criteria (LSM <25 kPa and platelets >110,000) were tested for EGD sparing. Diagnostic performance of these criteria against gold standard (EGD) was computed and compared to patients with hepatitis C virus (HCV) infection and nonalcoholic steatohepatitis (NASH) etiologies, where these criteria have been widely validated. In these patients, the threshold for cACLD definition was >10 kPa. Results A total of 287 patients (mean age 56, 95% Child A) were included, comprising of 43 HBV (58% on antiviral therapy), 134 HCV and 110 NASH patients. The prevalence of any grade EV and EVNT was 25% and 8% in the whole cohort, with 19% and 5% in HBV patients, respectively. Table 1 reports diagnostic performance, spared EGD and missed EVNT according to non-invasive criteria and cACLD etiology. Both Baveno VI and expanded Baveno VI criteria performed well in patients with HBV-related cACLD. There was no significant difference on diagnostic performance of these non-invasive criteria across the cACLD etiologies. Conclusions These results support use of non-invasive criteria based on LSM and platelets to spare unnecessary EGD in patients with HBV and cACLD. Baveno VI and expanded Baveno VI criteria can improve resource utilization and avoid invasive testing in context of screening EGD for patients with HBV-related cACLD. Funding Agencies None

scholarly journals ARFI and transient elastography for characterization of cystic fibrosis related liver disease: First longitudinal follow-up data in adult patients

2013 ◽  
Vol 12 (6) ◽  
pp. 826-827 ◽  
Author(s):  
Thomas Karlas ◽  
Marie Neuschulz ◽  
Annett Oltmanns ◽  
Hubert Wirtz ◽  
Volker Keim ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Liver Disease ◽  
Transient Elastography ◽  
Adult Patients ◽  
Related Liver Disease

Correlation of Transient Elastography With Severity of Cystic Fibrosis–related Liver Disease

2017 ◽  
Vol 64 (4) ◽  
pp. 505-511 ◽  
Author(s):  
Amal Aqul ◽  
Maureen M. Jonas ◽  
Sarah Harney ◽  
Roshan Raza ◽  
Gregory S. Sawicki ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Liver Disease ◽  
Transient Elastography ◽  
Related Liver Disease
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