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Improving transient elastography performance for detecting hepatitis B cirrhosis.
MedLine Citation:
PMID:  21907650     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Transient elastography is a well-established method for detecting cirrhosis. AIM: To improve the performance of transient elastography in detecting hepatitis B cirrhosis by alanine aminotransferase (ALT)-stratified cutoffs, bilirubin normalization and transient elastography-based algorithms. METHODS: A total of 315 compensated patients were analysed following liver biopsies, transient elastography, ultrasonography and blood tests. RESULTS: The area under the receiver operating characteristics (ROC) curve of transient elastography for predicting cirrhosis was 0.88 (95% confidence interval 0.84-0.92). The cutoffs to exclude and confirm cirrhosis were 10.4kPa and 17.3kPa in patients with ALT <5×upper limit of normal range, 13.7kPa and 25.0kPa in ALT ≥5×upper limit of normal range, respectively. With ALT-stratified cutoffs, 68.6% of patients did not require liver biopsies. Areas under the ROC curve in patients with normal or abnormal bilirubin was 0.90(0.85-0.95) and 0.84(0.77-0.92), respectively. In patients with normal bilirubin, the cutoffs for excluding and confirming cirrhosis were 10.6kPa and 16.9kPa, respectively. By transient elastography screening, 78.3% of patients with normal bilirubin would not need a liver biopsy. Areas under the ROC curves between transient elastography and transient elastography-based algorithm including transient elastography-splenomegaly-platelet index [0.90(0.86-0.94)] and ultrasonic score-transient elastography index [0.91(0.86-0.96)] were not significantly different. CONCLUSIONS: Amongst ALT-stratified cutoffs, bilirubin normalization and transient elastography-based algorithm, bilirubin normalization was especially important for improving performance of transient elastography for compensated hepatitis B cirrhosis detection.
Authors:
Yong Peng Chen; Xie Er Liang; Lin Dai; Qi Zhang; Jie Peng; You Fu Zhu; Wei Qun Wen; Henry Lik-Yuen Chan; Jin Lin Hou
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-8
Journal Detail:
Title:  Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver     Volume:  -     ISSN:  1878-3562     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100958385     Medline TA:  Dig Liver Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Infectious Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China; Institute for Hepatology Research, Southern Medical University, Guangzhou, China.
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