Optimal linear combination of ARFI, transient elastography and APRI for the assessment of fibrosis in chronic hepatitis B
Background & Aims Accurate assessment of liver fibrosis in patients with chronic hepatitis B (CHB) is necessary not only to predict the long‐term clinical course but also to determine an appropriate antiviral therapy scheme. Several noninvasive approaches – serum markers and elastography – have...
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| Veröffentlicht in: | Liver international 2015-03, Vol.35 (3), p.816-825 |
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| creator | Liu, Yingxia Dong, Chang feng Yang, Guilin Liu, Jing Yao, Simin Li, Han ying Yuan, Jing Li, Shaxi Le, Xiaohua Lin, Yimin Zeng, Wen Lin, Haoming Zhang, Xinyu Chen, Xin |
| description | Background & Aims
Accurate assessment of liver fibrosis in patients with chronic hepatitis B (CHB) is necessary not only to predict the long‐term clinical course but also to determine an appropriate antiviral therapy scheme. Several noninvasive approaches – serum markers and elastography – have been proposed as alternatives for the histopathological analysis of liver biopsies. The aim of this study was to evaluate two ultrasound elastography methods (ARFI and TE) and one biochemical test (APRI), as well as their optimal linear combination, in the assessment of liver fibrosis in CHB.
Methods
Ninety five patients with CHB and 16 volunteers underwent ARFI, TE and APRI; and liver fibrosis was staged in the patients by a liver biopsy. An optimal linear combination of the three methods was developed, and its diagnostic performance was evaluated by a 10‐fold cross‐validation.
Results
The accuracy of the linear combination was 83.86% and 91.88% for significant fibrosis (≥F2) and cirrhosis (F4), respectively, higher than those obtained for ARFI (83.50%, 88.76%), TE (75.27%, 87.61%) and APRI (73.29% and 81.67%). The combination also increased the sensitivity and the negative predictive values for the diagnosis of significant fibrosis and cirrhosis.
Conclusions
The optimal linear combination algorithm is effective for noninvasive staging of liver fibrosis in CHB. However, linear combination has its own limitations; nonlinear methods may eventually reveal even clearer diagnostic results. |
| doi_str_mv | 10.1111/liv.12564 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1655522269</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1655522269</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4334-8d54ddd90a492b2b2e36e427bc85229e4c238252e6138895139c4e805a121a0e3</originalsourceid><addsrcrecordid>eNp1kM1OGzEUhS3UCijtgheovCxSB8Z_87MMUYFIUUGohYiN5fHcaQwz9mA7bfP2GALZYS9sWd_5dH0QOiT5MUnrpDd_jwkVBd9B-4SXVcYoIx-2d8r20KcQ7vOc1LUgu2iP8lIQWtX7aH05RjOoHvfGgvJYu6ExVkXjLHYdnlyfzb7j6JUNBmzE0KsQ3R-vxuUaK9viydX1DHfO47gErEKAEIZnMGU703gXTMDGYr30zhqNlzAmd0yPp5_Rx071Ab68ngfo99mPX9OLbH55PptO5pnmjPGsagVv27bOFa9pkzawAjgtG10JSmvgmrKKCgoFYVWVvsdqzaHKhSKUqBzYAfq28Y7ePa4gRDmYoKHvlQW3CpIUQiQTLeqEHm1QnQYPHjo5-lSOX0uSy-emZWpavjSd2K-v2lUzQLsl36pNwMkG-Gd6WL9vkvPZzZsy2yRMiPB_m1D-QRYlK4W8_XkuF4u74uLmdiGn7AkCLpcA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1655522269</pqid></control><display><type>article</type><title>Optimal linear combination of ARFI, transient elastography and APRI for the assessment of fibrosis in chronic hepatitis B</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Liu, Yingxia ; Dong, Chang feng ; Yang, Guilin ; Liu, Jing ; Yao, Simin ; Li, Han ying ; Yuan, Jing ; Li, Shaxi ; Le, Xiaohua ; Lin, Yimin ; Zeng, Wen ; Lin, Haoming ; Zhang, Xinyu ; Chen, Xin</creator><creatorcontrib>Liu, Yingxia ; Dong, Chang feng ; Yang, Guilin ; Liu, Jing ; Yao, Simin ; Li, Han ying ; Yuan, Jing ; Li, Shaxi ; Le, Xiaohua ; Lin, Yimin ; Zeng, Wen ; Lin, Haoming ; Zhang, Xinyu ; Chen, Xin</creatorcontrib><description>Background & Aims
Accurate assessment of liver fibrosis in patients with chronic hepatitis B (CHB) is necessary not only to predict the long‐term clinical course but also to determine an appropriate antiviral therapy scheme. Several noninvasive approaches – serum markers and elastography – have been proposed as alternatives for the histopathological analysis of liver biopsies. The aim of this study was to evaluate two ultrasound elastography methods (ARFI and TE) and one biochemical test (APRI), as well as their optimal linear combination, in the assessment of liver fibrosis in CHB.
Methods
Ninety five patients with CHB and 16 volunteers underwent ARFI, TE and APRI; and liver fibrosis was staged in the patients by a liver biopsy. An optimal linear combination of the three methods was developed, and its diagnostic performance was evaluated by a 10‐fold cross‐validation.
Results
The accuracy of the linear combination was 83.86% and 91.88% for significant fibrosis (≥F2) and cirrhosis (F4), respectively, higher than those obtained for ARFI (83.50%, 88.76%), TE (75.27%, 87.61%) and APRI (73.29% and 81.67%). The combination also increased the sensitivity and the negative predictive values for the diagnosis of significant fibrosis and cirrhosis.
Conclusions
The optimal linear combination algorithm is effective for noninvasive staging of liver fibrosis in CHB. However, linear combination has its own limitations; nonlinear methods may eventually reveal even clearer diagnostic results.</description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/liv.12564</identifier><identifier>PMID: 24751289</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>acoustic radiation force impulse ; Adult ; Aged ; aspartate aminotransferase-to-platelet ratio index ; Biomarkers - blood ; Biopsy ; chronic hepatitis B ; Elasticity Imaging Techniques - methods ; Female ; Hepatitis B, Chronic - complications ; Humans ; Liver - pathology ; Liver Cirrhosis - diagnosis ; liver fibrosis ; Male ; Middle Aged ; ROC Curve ; Severity of Illness Index ; transient elastography ; Young Adult</subject><ispartof>Liver international, 2015-03, Vol.35 (3), p.816-825</ispartof><rights>2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4334-8d54ddd90a492b2b2e36e427bc85229e4c238252e6138895139c4e805a121a0e3</citedby><cites>FETCH-LOGICAL-c4334-8d54ddd90a492b2b2e36e427bc85229e4c238252e6138895139c4e805a121a0e3</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%2Fliv.12564$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fliv.12564$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24751289$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Yingxia</creatorcontrib><creatorcontrib>Dong, Chang feng</creatorcontrib><creatorcontrib>Yang, Guilin</creatorcontrib><creatorcontrib>Liu, Jing</creatorcontrib><creatorcontrib>Yao, Simin</creatorcontrib><creatorcontrib>Li, Han ying</creatorcontrib><creatorcontrib>Yuan, Jing</creatorcontrib><creatorcontrib>Li, Shaxi</creatorcontrib><creatorcontrib>Le, Xiaohua</creatorcontrib><creatorcontrib>Lin, Yimin</creatorcontrib><creatorcontrib>Zeng, Wen</creatorcontrib><creatorcontrib>Lin, Haoming</creatorcontrib><creatorcontrib>Zhang, Xinyu</creatorcontrib><creatorcontrib>Chen, Xin</creatorcontrib><title>Optimal linear combination of ARFI, transient elastography and APRI for the assessment of fibrosis in chronic hepatitis B</title><title>Liver international</title><addtitle>Liver Int</addtitle><description>Background & Aims
Accurate assessment of liver fibrosis in patients with chronic hepatitis B (CHB) is necessary not only to predict the long‐term clinical course but also to determine an appropriate antiviral therapy scheme. Several noninvasive approaches – serum markers and elastography – have been proposed as alternatives for the histopathological analysis of liver biopsies. The aim of this study was to evaluate two ultrasound elastography methods (ARFI and TE) and one biochemical test (APRI), as well as their optimal linear combination, in the assessment of liver fibrosis in CHB.
Methods
Ninety five patients with CHB and 16 volunteers underwent ARFI, TE and APRI; and liver fibrosis was staged in the patients by a liver biopsy. An optimal linear combination of the three methods was developed, and its diagnostic performance was evaluated by a 10‐fold cross‐validation.
Results
The accuracy of the linear combination was 83.86% and 91.88% for significant fibrosis (≥F2) and cirrhosis (F4), respectively, higher than those obtained for ARFI (83.50%, 88.76%), TE (75.27%, 87.61%) and APRI (73.29% and 81.67%). The combination also increased the sensitivity and the negative predictive values for the diagnosis of significant fibrosis and cirrhosis.
Conclusions
The optimal linear combination algorithm is effective for noninvasive staging of liver fibrosis in CHB. However, linear combination has its own limitations; nonlinear methods may eventually reveal even clearer diagnostic results.</description><subject>acoustic radiation force impulse</subject><subject>Adult</subject><subject>Aged</subject><subject>aspartate aminotransferase-to-platelet ratio index</subject><subject>Biomarkers - blood</subject><subject>Biopsy</subject><subject>chronic hepatitis B</subject><subject>Elasticity Imaging Techniques - methods</subject><subject>Female</subject><subject>Hepatitis B, Chronic - complications</subject><subject>Humans</subject><subject>Liver - pathology</subject><subject>Liver Cirrhosis - diagnosis</subject><subject>liver fibrosis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>ROC Curve</subject><subject>Severity of Illness Index</subject><subject>transient elastography</subject><subject>Young Adult</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1OGzEUhS3UCijtgheovCxSB8Z_87MMUYFIUUGohYiN5fHcaQwz9mA7bfP2GALZYS9sWd_5dH0QOiT5MUnrpDd_jwkVBd9B-4SXVcYoIx-2d8r20KcQ7vOc1LUgu2iP8lIQWtX7aH05RjOoHvfGgvJYu6ExVkXjLHYdnlyfzb7j6JUNBmzE0KsQ3R-vxuUaK9viydX1DHfO47gErEKAEIZnMGU703gXTMDGYr30zhqNlzAmd0yPp5_Rx071Ab68ngfo99mPX9OLbH55PptO5pnmjPGsagVv27bOFa9pkzawAjgtG10JSmvgmrKKCgoFYVWVvsdqzaHKhSKUqBzYAfq28Y7ePa4gRDmYoKHvlQW3CpIUQiQTLeqEHm1QnQYPHjo5-lSOX0uSy-emZWpavjSd2K-v2lUzQLsl36pNwMkG-Gd6WL9vkvPZzZsy2yRMiPB_m1D-QRYlK4W8_XkuF4u74uLmdiGn7AkCLpcA</recordid><startdate>201503</startdate><enddate>201503</enddate><creator>Liu, Yingxia</creator><creator>Dong, Chang feng</creator><creator>Yang, Guilin</creator><creator>Liu, Jing</creator><creator>Yao, Simin</creator><creator>Li, Han ying</creator><creator>Yuan, Jing</creator><creator>Li, Shaxi</creator><creator>Le, Xiaohua</creator><creator>Lin, Yimin</creator><creator>Zeng, Wen</creator><creator>Lin, Haoming</creator><creator>Zhang, Xinyu</creator><creator>Chen, Xin</creator><general>Blackwell Publishing Ltd</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>7X8</scope></search><sort><creationdate>201503</creationdate><title>Optimal linear combination of ARFI, transient elastography and APRI for the assessment of fibrosis in chronic hepatitis B</title><author>Liu, Yingxia ; Dong, Chang feng ; Yang, Guilin ; Liu, Jing ; Yao, Simin ; Li, Han ying ; Yuan, Jing ; Li, Shaxi ; Le, Xiaohua ; Lin, Yimin ; Zeng, Wen ; Lin, Haoming ; Zhang, Xinyu ; Chen, Xin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4334-8d54ddd90a492b2b2e36e427bc85229e4c238252e6138895139c4e805a121a0e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>acoustic radiation force impulse</topic><topic>Adult</topic><topic>Aged</topic><topic>aspartate aminotransferase-to-platelet ratio index</topic><topic>Biomarkers - blood</topic><topic>Biopsy</topic><topic>chronic hepatitis B</topic><topic>Elasticity Imaging Techniques - methods</topic><topic>Female</topic><topic>Hepatitis B, Chronic - complications</topic><topic>Humans</topic><topic>Liver - pathology</topic><topic>Liver Cirrhosis - diagnosis</topic><topic>liver fibrosis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>ROC Curve</topic><topic>Severity of Illness Index</topic><topic>transient elastography</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Yingxia</creatorcontrib><creatorcontrib>Dong, Chang feng</creatorcontrib><creatorcontrib>Yang, Guilin</creatorcontrib><creatorcontrib>Liu, Jing</creatorcontrib><creatorcontrib>Yao, Simin</creatorcontrib><creatorcontrib>Li, Han ying</creatorcontrib><creatorcontrib>Yuan, Jing</creatorcontrib><creatorcontrib>Li, Shaxi</creatorcontrib><creatorcontrib>Le, Xiaohua</creatorcontrib><creatorcontrib>Lin, Yimin</creatorcontrib><creatorcontrib>Zeng, Wen</creatorcontrib><creatorcontrib>Lin, Haoming</creatorcontrib><creatorcontrib>Zhang, Xinyu</creatorcontrib><creatorcontrib>Chen, Xin</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>MEDLINE - Academic</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Yingxia</au><au>Dong, Chang feng</au><au>Yang, Guilin</au><au>Liu, Jing</au><au>Yao, Simin</au><au>Li, Han ying</au><au>Yuan, Jing</au><au>Li, Shaxi</au><au>Le, Xiaohua</au><au>Lin, Yimin</au><au>Zeng, Wen</au><au>Lin, Haoming</au><au>Zhang, Xinyu</au><au>Chen, Xin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal linear combination of ARFI, transient elastography and APRI for the assessment of fibrosis in chronic hepatitis B</atitle><jtitle>Liver international</jtitle><addtitle>Liver Int</addtitle><date>2015-03</date><risdate>2015</risdate><volume>35</volume><issue>3</issue><spage>816</spage><epage>825</epage><pages>816-825</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract>Background & Aims
Accurate assessment of liver fibrosis in patients with chronic hepatitis B (CHB) is necessary not only to predict the long‐term clinical course but also to determine an appropriate antiviral therapy scheme. Several noninvasive approaches – serum markers and elastography – have been proposed as alternatives for the histopathological analysis of liver biopsies. The aim of this study was to evaluate two ultrasound elastography methods (ARFI and TE) and one biochemical test (APRI), as well as their optimal linear combination, in the assessment of liver fibrosis in CHB.
Methods
Ninety five patients with CHB and 16 volunteers underwent ARFI, TE and APRI; and liver fibrosis was staged in the patients by a liver biopsy. An optimal linear combination of the three methods was developed, and its diagnostic performance was evaluated by a 10‐fold cross‐validation.
Results
The accuracy of the linear combination was 83.86% and 91.88% for significant fibrosis (≥F2) and cirrhosis (F4), respectively, higher than those obtained for ARFI (83.50%, 88.76%), TE (75.27%, 87.61%) and APRI (73.29% and 81.67%). The combination also increased the sensitivity and the negative predictive values for the diagnosis of significant fibrosis and cirrhosis.
Conclusions
The optimal linear combination algorithm is effective for noninvasive staging of liver fibrosis in CHB. However, linear combination has its own limitations; nonlinear methods may eventually reveal even clearer diagnostic results.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>24751289</pmid><doi>10.1111/liv.12564</doi><tpages>10</tpages></addata></record> |
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| ispartof | Liver international, 2015-03, Vol.35 (3), p.816-825 |
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| subjects | acoustic radiation force impulse Adult Aged aspartate aminotransferase-to-platelet ratio index Biomarkers - blood Biopsy chronic hepatitis B Elasticity Imaging Techniques - methods Female Hepatitis B, Chronic - complications Humans Liver - pathology Liver Cirrhosis - diagnosis liver fibrosis Male Middle Aged ROC Curve Severity of Illness Index transient elastography Young Adult |
| title | Optimal linear combination of ARFI, transient elastography and APRI for the assessment of fibrosis in chronic hepatitis B |
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