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Reliability of liver stiffness measurement in non-alcoholic fatty liver disease: the effects of body mass index.
MedLine Citation:
PMID:  21517924     Owner:  NLM     Status:  Publisher    
Background  Liver stiffness measurement (LSM) using transient elastography (TE) is used to stage fibrosis in patients with liver disease, diagnostic reliability and the factors affecting its performance in patients with non-alcoholic fatty liver disease (NAFLD) are incompletely understood. Aim  To assess LSM. Methods  Consecutive NAFLD patients (n = 169), assessed by liver biopsy (Kleiner score), anthropometrical, biochemical and metabolic features, underwent LSM using TE with standard M probe. Results  Liver stiffness measurement was not reliable in 23 patients (14%) due to obesity. Among patients with a reliable TE, a LSM value >7.25 kPa was the best cut-off for predicting significant fibrosis at biopsy (AUC 0.794); however, this cut-off still failed to rule out F2-F4 fibrosis in 31% (false-negative rate) or rule in F3-F4 in 29% (false-positive rate). Similarly a LSM value >8.75 kPa was the best cut-off for severe fibrosis (F3-F4) (AUC 0.870), with a rate of false-negatives 24% and of false-positives 2%. Body mass index was the major determinant of these diagnostic errors in predicting significant and severe fibrosis both by overestimating or underestimating the stage of fibrosis. Conclusions  In NAFLD patients, even when liver stiffness measurement is feasible, high BMI values negatively affect the diagnostic reliability. Improved performance of transient elastography could be obtained using specifically designed probes.
S Petta; V Di Marco; C Cammà; G Butera; D Cabibi; A Craxì
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-25
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  -     ISSN:  1365-2036     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Sezione di Gastroenterologia, Di.Bi.M.I.S., University of Palermo, Palermo, Italy. Cattedra di Anatomia Patologica, University of Palermo, Palermo, Italy.
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