Performance of transient elastography (TE) and factors associated with discordance in non-alcoholic fatty liver disease
Objective To determine the accuracy of transient elastography (TE) and factors associated with discordance between TE and liver histology in patients with non‐alcoholic fatty liver disease (NAFLD). Methods The accuracy of TE was assessed and compared with the aspartate aminotransferase‐to‐platelet r...
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| Veröffentlicht in: | Journal of digestive diseases 2013-11, Vol.14 (11), p.604-610 |
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| container_title | Journal of digestive diseases |
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| creator | Mahadeva, Sanjiv Mahfudz, Anis Shafina Vijayanathan, Anushya Goh, Khean-Lee Kulenthran, Arumugam Cheah, Phaik-Leng |
| description | Objective
To determine the accuracy of transient elastography (TE) and factors associated with discordance between TE and liver histology in patients with non‐alcoholic fatty liver disease (NAFLD).
Methods
The accuracy of TE was assessed and compared with the aspartate aminotransferase‐to‐platelet ratio index (APRI) in patients with histologically proven NAFLD. Factors associated with discordance between liver histology and TE were analyzed.
Results
Altogether 131 patients with a mean age of 49.9 years, including 69 men and 62 women, with NAFLD underwent liver stiffness measurement (LSM) by TE. Among all patients, 120 (91.6%) had a successful LSM with an interquartile to median ratio of 0.15. The accuracy of TE in detecting ≥F3 and F4 fibrosis, assessed by the area under the receiver operating characteristic curve, were 0.77 and 0.95, respectively. The sensitivity and specificity of the optimal LSM cut‐off values for detecting ≥F3 fibrosis (sensitivity 70.4% and specificity 66.6%) and F4 (sensitivity 87.5% and specificity 89.3%) were modest, but better than those of APRI. Discordance between TE and histology for fibrosis grading was observed in 22.5% of patients, but it could not be explained by body mass index, alanine aminotransferase level, the length of the biopsied specimens or the grade of steatosis.
Conclusion
TE plays an important role in the detection of advanced fibrosis and cirrhosis in patients with NAFLD and its accuracy does not appear to be influenced by components of the disease. |
| doi_str_mv | 10.1111/1751-2980.12088 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1443413776</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1443413776</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4098-2e753b63b2a6b34495ce61f827bdcbc3a29a2da98a1750ea4f7554d6ef525ae33</originalsourceid><addsrcrecordid>eNqFkUFvEzEQhVcIREvhzA1Z4lIO267ttb17hKSUSlEbiSKO1qx3lrhs7NR2CPn3OE2bA5f6Yo_1vaeZeUXxnlZnNJ9zqgQtWdvkklVN86I4Pvy8PLwVOyrexHhXVUKqRr4ujhhvRFu3_LjYzDEMPizBGSR-ICmAixZdIjhCTP5XgNViS05vLz4RcD0ZwCQfIoEYvbGQsCcbmxakt9H40D_YWEecdyWMxi_8aE0WpbQlo_2DYQciRHxbvBpgjPju8T4pfny9uJ18K2c3l1eTz7PS1FXblAyV4J3kHQPZ8bpuhUFJh4aprjed4cBaYD20DeRZK4R6UELUvcRBMAHI-UlxuvddBX-_xpj0MneK4wgO_TpqWte8plwpmdGP_6F3fh1c7k5TVUnGGa3aTJ3vKRN8jAEHvQp2CWGraaV3mejd1vUuAf2QSVZ8ePRdd0vsD_xTCBkQe2BjR9w-56cn0-mTcbnX2Zjw70EH4beWiiuhf15f6u_zL9PZdTvRc_4PD0ul9A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1706232109</pqid></control><display><type>article</type><title>Performance of transient elastography (TE) and factors associated with discordance in non-alcoholic fatty liver disease</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Mahadeva, Sanjiv ; Mahfudz, Anis Shafina ; Vijayanathan, Anushya ; Goh, Khean-Lee ; Kulenthran, Arumugam ; Cheah, Phaik-Leng</creator><creatorcontrib>Mahadeva, Sanjiv ; Mahfudz, Anis Shafina ; Vijayanathan, Anushya ; Goh, Khean-Lee ; Kulenthran, Arumugam ; Cheah, Phaik-Leng</creatorcontrib><description>Objective
To determine the accuracy of transient elastography (TE) and factors associated with discordance between TE and liver histology in patients with non‐alcoholic fatty liver disease (NAFLD).
Methods
The accuracy of TE was assessed and compared with the aspartate aminotransferase‐to‐platelet ratio index (APRI) in patients with histologically proven NAFLD. Factors associated with discordance between liver histology and TE were analyzed.
Results
Altogether 131 patients with a mean age of 49.9 years, including 69 men and 62 women, with NAFLD underwent liver stiffness measurement (LSM) by TE. Among all patients, 120 (91.6%) had a successful LSM with an interquartile to median ratio of 0.15. The accuracy of TE in detecting ≥F3 and F4 fibrosis, assessed by the area under the receiver operating characteristic curve, were 0.77 and 0.95, respectively. The sensitivity and specificity of the optimal LSM cut‐off values for detecting ≥F3 fibrosis (sensitivity 70.4% and specificity 66.6%) and F4 (sensitivity 87.5% and specificity 89.3%) were modest, but better than those of APRI. Discordance between TE and histology for fibrosis grading was observed in 22.5% of patients, but it could not be explained by body mass index, alanine aminotransferase level, the length of the biopsied specimens or the grade of steatosis.
Conclusion
TE plays an important role in the detection of advanced fibrosis and cirrhosis in patients with NAFLD and its accuracy does not appear to be influenced by components of the disease.</description><identifier>ISSN: 1751-2972</identifier><identifier>EISSN: 1751-2980</identifier><identifier>DOI: 10.1111/1751-2980.12088</identifier><identifier>PMID: 23859493</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Accuracy ; Adult ; Biopsy, Fine-Needle - methods ; Cross-Sectional Studies ; Elasticity Imaging Techniques - methods ; Fatty Liver - complications ; Fatty Liver - diagnostic imaging ; Fatty Liver - pathology ; Female ; Histology ; Humans ; Liver - pathology ; Liver cirrhosis ; Liver Cirrhosis - diagnostic imaging ; Liver Cirrhosis - etiology ; Liver Cirrhosis - pathology ; Liver diseases ; liver fibrosis ; liver stiffness measurement ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; nonalcoholic fatty liver disease ; noninvasive ; Reproducibility of Results ; Severity of Illness Index ; transient elastography ; Ultrasonography, Interventional - methods</subject><ispartof>Journal of digestive diseases, 2013-11, Vol.14 (11), p.604-610</ispartof><rights>2013 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd</rights><rights>2013 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.</rights><rights>Journal of Digestive Diseases © 2013 Wiley Publishing Asia Pty Ltd and Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4098-2e753b63b2a6b34495ce61f827bdcbc3a29a2da98a1750ea4f7554d6ef525ae33</citedby><cites>FETCH-LOGICAL-c4098-2e753b63b2a6b34495ce61f827bdcbc3a29a2da98a1750ea4f7554d6ef525ae33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1751-2980.12088$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1751-2980.12088$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23859493$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mahadeva, Sanjiv</creatorcontrib><creatorcontrib>Mahfudz, Anis Shafina</creatorcontrib><creatorcontrib>Vijayanathan, Anushya</creatorcontrib><creatorcontrib>Goh, Khean-Lee</creatorcontrib><creatorcontrib>Kulenthran, Arumugam</creatorcontrib><creatorcontrib>Cheah, Phaik-Leng</creatorcontrib><title>Performance of transient elastography (TE) and factors associated with discordance in non-alcoholic fatty liver disease</title><title>Journal of digestive diseases</title><addtitle>Journal of Digestive Diseases</addtitle><description>Objective
To determine the accuracy of transient elastography (TE) and factors associated with discordance between TE and liver histology in patients with non‐alcoholic fatty liver disease (NAFLD).
Methods
The accuracy of TE was assessed and compared with the aspartate aminotransferase‐to‐platelet ratio index (APRI) in patients with histologically proven NAFLD. Factors associated with discordance between liver histology and TE were analyzed.
Results
Altogether 131 patients with a mean age of 49.9 years, including 69 men and 62 women, with NAFLD underwent liver stiffness measurement (LSM) by TE. Among all patients, 120 (91.6%) had a successful LSM with an interquartile to median ratio of 0.15. The accuracy of TE in detecting ≥F3 and F4 fibrosis, assessed by the area under the receiver operating characteristic curve, were 0.77 and 0.95, respectively. The sensitivity and specificity of the optimal LSM cut‐off values for detecting ≥F3 fibrosis (sensitivity 70.4% and specificity 66.6%) and F4 (sensitivity 87.5% and specificity 89.3%) were modest, but better than those of APRI. Discordance between TE and histology for fibrosis grading was observed in 22.5% of patients, but it could not be explained by body mass index, alanine aminotransferase level, the length of the biopsied specimens or the grade of steatosis.
Conclusion
TE plays an important role in the detection of advanced fibrosis and cirrhosis in patients with NAFLD and its accuracy does not appear to be influenced by components of the disease.</description><subject>Accuracy</subject><subject>Adult</subject><subject>Biopsy, Fine-Needle - methods</subject><subject>Cross-Sectional Studies</subject><subject>Elasticity Imaging Techniques - methods</subject><subject>Fatty Liver - complications</subject><subject>Fatty Liver - diagnostic imaging</subject><subject>Fatty Liver - pathology</subject><subject>Female</subject><subject>Histology</subject><subject>Humans</subject><subject>Liver - pathology</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - diagnostic imaging</subject><subject>Liver Cirrhosis - etiology</subject><subject>Liver Cirrhosis - pathology</subject><subject>Liver diseases</subject><subject>liver fibrosis</subject><subject>liver stiffness measurement</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Non-alcoholic Fatty Liver Disease</subject><subject>nonalcoholic fatty liver disease</subject><subject>noninvasive</subject><subject>Reproducibility of Results</subject><subject>Severity of Illness Index</subject><subject>transient elastography</subject><subject>Ultrasonography, Interventional - methods</subject><issn>1751-2972</issn><issn>1751-2980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUFvEzEQhVcIREvhzA1Z4lIO267ttb17hKSUSlEbiSKO1qx3lrhs7NR2CPn3OE2bA5f6Yo_1vaeZeUXxnlZnNJ9zqgQtWdvkklVN86I4Pvy8PLwVOyrexHhXVUKqRr4ujhhvRFu3_LjYzDEMPizBGSR-ICmAixZdIjhCTP5XgNViS05vLz4RcD0ZwCQfIoEYvbGQsCcbmxakt9H40D_YWEecdyWMxi_8aE0WpbQlo_2DYQciRHxbvBpgjPju8T4pfny9uJ18K2c3l1eTz7PS1FXblAyV4J3kHQPZ8bpuhUFJh4aprjed4cBaYD20DeRZK4R6UELUvcRBMAHI-UlxuvddBX-_xpj0MneK4wgO_TpqWte8plwpmdGP_6F3fh1c7k5TVUnGGa3aTJ3vKRN8jAEHvQp2CWGraaV3mejd1vUuAf2QSVZ8ePRdd0vsD_xTCBkQe2BjR9w-56cn0-mTcbnX2Zjw70EH4beWiiuhf15f6u_zL9PZdTvRc_4PD0ul9A</recordid><startdate>201311</startdate><enddate>201311</enddate><creator>Mahadeva, Sanjiv</creator><creator>Mahfudz, Anis Shafina</creator><creator>Vijayanathan, Anushya</creator><creator>Goh, Khean-Lee</creator><creator>Kulenthran, Arumugam</creator><creator>Cheah, Phaik-Leng</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201311</creationdate><title>Performance of transient elastography (TE) and factors associated with discordance in non-alcoholic fatty liver disease</title><author>Mahadeva, Sanjiv ; Mahfudz, Anis Shafina ; Vijayanathan, Anushya ; Goh, Khean-Lee ; Kulenthran, Arumugam ; Cheah, Phaik-Leng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4098-2e753b63b2a6b34495ce61f827bdcbc3a29a2da98a1750ea4f7554d6ef525ae33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Accuracy</topic><topic>Adult</topic><topic>Biopsy, Fine-Needle - methods</topic><topic>Cross-Sectional Studies</topic><topic>Elasticity Imaging Techniques - methods</topic><topic>Fatty Liver - complications</topic><topic>Fatty Liver - diagnostic imaging</topic><topic>Fatty Liver - pathology</topic><topic>Female</topic><topic>Histology</topic><topic>Humans</topic><topic>Liver - pathology</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis - diagnostic imaging</topic><topic>Liver Cirrhosis - etiology</topic><topic>Liver Cirrhosis - pathology</topic><topic>Liver diseases</topic><topic>liver fibrosis</topic><topic>liver stiffness measurement</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Non-alcoholic Fatty Liver Disease</topic><topic>nonalcoholic fatty liver disease</topic><topic>noninvasive</topic><topic>Reproducibility of Results</topic><topic>Severity of Illness Index</topic><topic>transient elastography</topic><topic>Ultrasonography, Interventional - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mahadeva, Sanjiv</creatorcontrib><creatorcontrib>Mahfudz, Anis Shafina</creatorcontrib><creatorcontrib>Vijayanathan, Anushya</creatorcontrib><creatorcontrib>Goh, Khean-Lee</creatorcontrib><creatorcontrib>Kulenthran, Arumugam</creatorcontrib><creatorcontrib>Cheah, Phaik-Leng</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of digestive diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mahadeva, Sanjiv</au><au>Mahfudz, Anis Shafina</au><au>Vijayanathan, Anushya</au><au>Goh, Khean-Lee</au><au>Kulenthran, Arumugam</au><au>Cheah, Phaik-Leng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Performance of transient elastography (TE) and factors associated with discordance in non-alcoholic fatty liver disease</atitle><jtitle>Journal of digestive diseases</jtitle><addtitle>Journal of Digestive Diseases</addtitle><date>2013-11</date><risdate>2013</risdate><volume>14</volume><issue>11</issue><spage>604</spage><epage>610</epage><pages>604-610</pages><issn>1751-2972</issn><eissn>1751-2980</eissn><abstract>Objective
To determine the accuracy of transient elastography (TE) and factors associated with discordance between TE and liver histology in patients with non‐alcoholic fatty liver disease (NAFLD).
Methods
The accuracy of TE was assessed and compared with the aspartate aminotransferase‐to‐platelet ratio index (APRI) in patients with histologically proven NAFLD. Factors associated with discordance between liver histology and TE were analyzed.
Results
Altogether 131 patients with a mean age of 49.9 years, including 69 men and 62 women, with NAFLD underwent liver stiffness measurement (LSM) by TE. Among all patients, 120 (91.6%) had a successful LSM with an interquartile to median ratio of 0.15. The accuracy of TE in detecting ≥F3 and F4 fibrosis, assessed by the area under the receiver operating characteristic curve, were 0.77 and 0.95, respectively. The sensitivity and specificity of the optimal LSM cut‐off values for detecting ≥F3 fibrosis (sensitivity 70.4% and specificity 66.6%) and F4 (sensitivity 87.5% and specificity 89.3%) were modest, but better than those of APRI. Discordance between TE and histology for fibrosis grading was observed in 22.5% of patients, but it could not be explained by body mass index, alanine aminotransferase level, the length of the biopsied specimens or the grade of steatosis.
Conclusion
TE plays an important role in the detection of advanced fibrosis and cirrhosis in patients with NAFLD and its accuracy does not appear to be influenced by components of the disease.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>23859493</pmid><doi>10.1111/1751-2980.12088</doi><tpages>7</tpages></addata></record> |
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| ispartof | Journal of digestive diseases, 2013-11, Vol.14 (11), p.604-610 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Accuracy Adult Biopsy, Fine-Needle - methods Cross-Sectional Studies Elasticity Imaging Techniques - methods Fatty Liver - complications Fatty Liver - diagnostic imaging Fatty Liver - pathology Female Histology Humans Liver - pathology Liver cirrhosis Liver Cirrhosis - diagnostic imaging Liver Cirrhosis - etiology Liver Cirrhosis - pathology Liver diseases liver fibrosis liver stiffness measurement Male Middle Aged Non-alcoholic Fatty Liver Disease nonalcoholic fatty liver disease noninvasive Reproducibility of Results Severity of Illness Index transient elastography Ultrasonography, Interventional - methods |
| title | Performance of transient elastography (TE) and factors associated with discordance in non-alcoholic fatty liver disease |
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