Dataset Information

Ultrasound score combined with liver stiffness measurement by sound touch elastography for staging liver fibrosis in patients with chronic hepatitis B: a clinical prospective study.

ABSTRACT:

Background

A noninvasive and precise diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB) is crucial for establishing the optimal time and strategy of therapy and for predicting treatment response. This study aimed to assess the diagnostic performance of ultrasound (US) score and liver stiffness measurement (LSM) of sound touch elastography (STE) in diagnosing liver fibrosis stages and to investigate whether combining these methods would improve liver fibrosis staging.

Methods

US and STE examinations were performed in CHB patients included. Liver biopsy was used as a reference standard. A diagnostic marker with the optimal linear combination (LC) of US score and LSM of STE, namely LC marker, was established for noninvasive assessment of liver fibrosis stages. The diagnostic performance of the LC marker was evaluated by using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC).

Results

A total of 291 subjects, including 242 patients with CHB and 49 healthy volunteers, were included. Correlation analysis showed that the correlation of liver fibrosis stages to the LC marker (Spearman's r=0.846, P<0.001) was higher than that of LSM (r=0.771, P<0.001) or US score (r=0.825, P<0.001) alone. The results showed that the overall diagnostic performance of the LC marker in predicting a fibrosis stage of ≥F1, ≥F2, ≥F3, and =F4 {AUCs: 0.943 [95% confidence interval (CI): 0.917-0.948], 0.906 (0.871-0.915), 0.953 (0.923-0.969), and 0.961 (0.922-0.973), respectively} were better than those of the US score [AUCs: 0.916 (0.883-0.948, P=0.014), 0.875 (0.835-0.915, P<0.001), 0.934 (0.898-0.969, P=0.001), and 0.918 (0.864-0.973, P<0.001), respectively] or LSM [AUCs: 0.858 (0.812-0.948, P<0.001), 0.867 (0.826-0.915, P=0.006), 0.930 (0.894-0.969, P<0.023), and 0.958 (0.918-0.973, P=0.778), respectively].

Conclusions

The LC marker with the optimal combination of LSM and US score may be considered as a promising diagnostic model for noninvasive staging of liver fibrosis.

SUBMITTER: Huang K

PROVIDER: S-EPMC9011233 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Publications

Ultrasound score combined with liver stiffness measurement by sound touch elastography for staging liver fibrosis in patients with chronic hepatitis B: a clinical prospective study.

Huang Kun K Li Qinyuan Q Zeng Weimei W Chen Xin X Liu Li L Wan Xiang X Feng Cheng C Li Zhiyan Z Liu Zhong Z Dong Changfeng C

Annals of translational medicine 20220301 6

<h4>Background</h4>A noninvasive and precise diagnosis of liver fibrosis in patients with chronic hepatitis B (CHB) is crucial for establishing the optimal time and strategy of therapy and for predicting treatment response. This study aimed to assess the diagnostic performance of ultrasound (US) score and liver stiffness measurement (LSM) of sound touch elastography (STE) in diagnosing liver fibrosis stages and to investigate whether combining these methods would improve liver fibrosis staging.< ...[more]

PMID: 35434021

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Project description:BackgroundPediatric patients with liver disease require noninvasive monitoring to evaluate the risk of fibrosis progression. This study aimed to identify the significant factors affecting liver stiffness values using two-dimensional shear-wave elastography (2D-SWE), and determine whether liver stiffness can predict the fibrosis stage of various childhood liver diseases.MethodsThis study included 30 children (22 boys and 8 girls; mean age, 5.1 ± 6.1 years; range, 7 days-17.9 years) who had undergone biochemical evaluation, 2D-SWE examination, histopathologic analysis of fibrosis grade (F0 to F3), assessment of necroinflammatory activity, and steatosis grading between August 2016 and March 2020. The liver stiffness from 2D-SWE was compared between fibrosis stages using Kruskal-Wallis analysis. Factors that significantly affected liver stiffness were evaluated using univariate and multivariate linear regression analyses. The diagnostic performance was determined from the area under the receiver operating curve (AUC) values of 2D-SWE liver stiffness.ResultsLiver stiffness at the F0-1, F2, and F3 stages were 7.9, 13.2, and 21.7 kPa, respectively (P < 0.001). Both fibrosis stage and necroinflammatory grade were significantly associated with liver stiffness (P < 0.001 and P = 0.021, respectively). However, in patients with alanine aminotransferase (ALT) levels below 200 IU/L, the only factor affecting liver stiffness was fibrosis stage (P = 0.030). The liver stiffness value could distinguish significant fibrosis (≥ F2) with an AUC of 0.950 (cutoff value, 11.3 kPa) and severe fibrosis (F3 stage) with an AUC of 0.924 (cutoff value, 18.1 kPa). The 2D-SWE values for differentiating significant fibrosis were 10.5 kPa (≥ F2) and 18.1 kPa (F3) in patients with ALT levels below 200 IU/L.ConclusionThe liver stiffness values on 2D-SWE can be affected by both fibrosis and necroinflammatory grade and can provide excellent diagnostic performance in evaluating the fibrosis stage in various pediatric liver diseases. However, clinicians should be mindful of potential confounders, such as necroinflammatory activity or transaminase level, when performing 2D-SWE measurements for liver fibrosis staging.

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Dataset Information

Ultrasound score combined with liver stiffness measurement by sound touch elastography for staging liver fibrosis in patients with chronic hepatitis B: a clinical prospective study.

Background

Methods

Results

Conclusions

Publications

Ultrasound score combined with liver stiffness measurement by sound touch elastography for staging liver fibrosis in patients with chronic hepatitis B: a clinical prospective study.

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