TY - JOUR
T1 - Discordance in fibrosis staging between liver biopsy and transient elastography using the FibroScan XL probe
AU - Myers, Robert P.
AU - Pomier-Layrargues, Gilles
AU - Kirsch, Richard
AU - Pollett, Aaron
AU - Beaton, Melanie
AU - Levstik, Mark
AU - Duarte-Rojo, Andres
AU - Wong, David
AU - Crotty, Pam
AU - Elkashab, Magdy
N1 - Funding Information:
This study was funded by Echosens (Paris, France). Dr. Myers is supported by a New Investigator Award from the Canadian Institutes of Health Research and Clinical Investigator Award from the Alberta Heritage Foundation for Medical Research (now Alberta Innovates – Health Solutions).
PY - 2012/3
Y1 - 2012/3
N2 - Background & Aims: The FibroScan XL probe facilitates liver stiffness measurement (LSM) by transient elastography (TE) in obese patients, yet factors affecting its accuracy have not been described. Our objectives were to examine the prevalence, risk factors, and causes of discordance between fibrosis estimated by the FibroScan XL probe and biopsy. Methods: Two hundred and ten patients with chronic liver disease (45% viral hepatitis, 55% nonalcoholic fatty liver disease (NAFLD) and a body mass index (BMI) ≥28 kg/m 2) underwent liver biopsy and TE with the FibroScan XL probe. Predictors of discordance ≥2 fibrosis stages between measures, which occurred in 11% of patients (n = 24), were identified by comparing patient, TE, and biopsy characteristics of discordant and non-discordant cases. Results: Fibrosis estimated by the FibroScan XL probe was greater than biopsy in 75% (18/24) of discordant cases. Although biopsy quality was not associated with discordance, discordant cases were less likely to have ≥10 valid shots (75% vs. 97%; p = 0.001), a success rate ≥60% (67% vs. 95%; p <0.0005), and an interquartile range over median liver stiffness (IQR/M) <21% (37% vs. 57%; p = 0.07) than non-discordant cases. However, only increased BMI (odds ratio [OR] 1.09 per kg/m 2; 95% confidence interval [CI] 1.01-1.18; p = 0.04) was independently associated with discordance; liver stiffness was of borderline significance (OR 1.73 per log 10-transformed value; 95% CI 0.95-3.18; p = 0.08). Discordance was 4- to 5-fold more frequent among patients with severe obesity (BMI ≥40 kg/m 2: 32% vs. 8%) and liver stiffness above the median of 7.0 kPa (20% vs. 4%; both p <0.0005). Conclusions: Discordance between liver fibrosis estimated by biopsy and TE using the FibroScan XL probe was infrequent in this obese population. Patients with severe obesity and elevated liver stiffness have the greatest risk of discordance.
AB - Background & Aims: The FibroScan XL probe facilitates liver stiffness measurement (LSM) by transient elastography (TE) in obese patients, yet factors affecting its accuracy have not been described. Our objectives were to examine the prevalence, risk factors, and causes of discordance between fibrosis estimated by the FibroScan XL probe and biopsy. Methods: Two hundred and ten patients with chronic liver disease (45% viral hepatitis, 55% nonalcoholic fatty liver disease (NAFLD) and a body mass index (BMI) ≥28 kg/m 2) underwent liver biopsy and TE with the FibroScan XL probe. Predictors of discordance ≥2 fibrosis stages between measures, which occurred in 11% of patients (n = 24), were identified by comparing patient, TE, and biopsy characteristics of discordant and non-discordant cases. Results: Fibrosis estimated by the FibroScan XL probe was greater than biopsy in 75% (18/24) of discordant cases. Although biopsy quality was not associated with discordance, discordant cases were less likely to have ≥10 valid shots (75% vs. 97%; p = 0.001), a success rate ≥60% (67% vs. 95%; p <0.0005), and an interquartile range over median liver stiffness (IQR/M) <21% (37% vs. 57%; p = 0.07) than non-discordant cases. However, only increased BMI (odds ratio [OR] 1.09 per kg/m 2; 95% confidence interval [CI] 1.01-1.18; p = 0.04) was independently associated with discordance; liver stiffness was of borderline significance (OR 1.73 per log 10-transformed value; 95% CI 0.95-3.18; p = 0.08). Discordance was 4- to 5-fold more frequent among patients with severe obesity (BMI ≥40 kg/m 2: 32% vs. 8%) and liver stiffness above the median of 7.0 kPa (20% vs. 4%; both p <0.0005). Conclusions: Discordance between liver fibrosis estimated by biopsy and TE using the FibroScan XL probe was infrequent in this obese population. Patients with severe obesity and elevated liver stiffness have the greatest risk of discordance.
KW - Biomarker
KW - Biopsy
KW - Fibrosis
KW - Stiffness
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U2 - 10.1016/j.jhep.2011.10.007
DO - 10.1016/j.jhep.2011.10.007
M3 - Article
C2 - 22027584
AN - SCOPUS:84857369747
SN - 0168-8278
VL - 56
SP - 564
EP - 570
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 3
ER -
