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How can we enhance the performance of liver stiffness measurement using FibroScan in diagnosing liver cirrhosis in patients with chronic hepatitis B?

Authors
 Seung Up Kim  ;  Do Young Kim  ;  Jun Yong Park  ;  Jin Ha Lee  ;  Sang Hoon Ahn  ;  Ja Kyung Kim  ;  Yong Han Paik  ;  Kwan Sik Lee  ;  Chae Yoon Chon  ;  Eun Hee Choi  ;  Ki Jun Song  ;  Young Nyun Park  ;  Kwang-Hyub Han 
Citation
 JOURNAL OF CLINICAL GASTROENTEROLOGY, Vol.44(1) : 66-71, 2010 
Journal Title
 JOURNAL OF CLINICAL GASTROENTEROLOGY 
ISSN
 0192-0790 
Issue Date
2010
MeSH
Adult ; Age Factors ; Alanine Transaminase/blood ; Elasticity Imaging Techniques/methods* ; Female ; Hepatitis B, Chronic/complications* ; Humans ; Liver/pathology ; Liver Cirrhosis/diagnosis* ; Liver Cirrhosis/pathology ; Liver Cirrhosis/virology ; Male ; Middle Aged ; Organ Size ; Platelet Count ; Predictive Value of Tests ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Spleen/metabolism
Keywords
stiffness measurement ; transient elastography ; aminotransferase ; chronic hepatitis B ; cirrhosis
Abstract
GOAL: This study aimed to enhance the diagnostic accuracy by defining different cutoff liver stiffness measurement (LSM) values according to alanine aminotransferase (ALT) level and combining LSM with noninvasive models in patients with chronic hepatitis B (CHB). BACKGROUND: Several studies have indicated that ALT influences LSM using FibroScan. STUDY: The study prospectively enrolled 200 patients (143 men, mean age 45.4 y) between June 2007 and November 2008 who had been diagnosed with CHB and underwent both liver biopsy and LSM on the same day. RESULTS: The area under the receiver operating characteristic curves (AUROC) of LSM for predicting cirrhosis in patients with ALT < or = upper limit of normal (ULN) was higher than that of all patients or those with ALT >ULN and < or = 2x ULN (AUROC=0.884 vs. 0.849 and 0.867). The cutoff LSM values for > or = F2, > or = F3, and F4 were 6.0, 7.5, and 10.1 kPa, respectively, in patients with ALT < or = ULN, whereas they were 8.9, 11.0, and 15.5 kPa, respectively, in those with ALT >ULN and < or = 2x ULN. The combination of LSM and the age-spleen-platelet ratio index performed the best at predicting cirrhosis, regardless of ALT level (AUROC=0.917 in patients with ALT < or = ULN, 0.909 in those with ALT < or = 2x ULN, and 0.894 in all patients). CONCLUSIONS: Different cutoff LSM values according to ALT level and combination with age-spleen-platelet ratio index can enhance the performance of LSM in CHB, regardless of ALT level.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00004836-201001000-00019&LSLINK=80&D=ovft
DOI
10.1097/MCG.0b013e3181a95c7f
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
7. Others (기타) > Dept. of Health Promotion (건강의학과) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Kim, Ja Kyung(김자경) ORCID logo https://orcid.org/0000-0001-5025-6846
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Paik, Yong Han(백용한)
Song, Ki Jun(송기준) ORCID logo https://orcid.org/0000-0003-2505-4112
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Kwan Sik(이관식) ORCID logo https://orcid.org/0000-0002-3672-1198
Lee, Jin Ha(이진하)
Chon, Chae Yoon(전재윤)
Choi, Eun Hee(최은희)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101802
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