Accuracy of transient elastography-FibroScan (R), acoustic radiation force impulse (ARFI) imaging, the enhanced liver fibrosis (ELF) test, APRI, and the FIB-4 index compared with liver biopsy in patients with chronic hepatitis C

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorRAGAZZO, Taisa Grotta
dc.contributor.authorPARANAGUA-VEZOZZO, Denise
dc.contributor.authorLIMA, Fabiana Roberto
dc.contributor.authorMAZO, Daniel Ferraz de Campos
dc.contributor.authorPESSOA, Mario Guimaraes
dc.contributor.authorOLIVEIRA, Claudia Pinto
dc.contributor.authorALVES, Venancio Avancini Ferreira
dc.contributor.authorCARRILHO, Flair Jose
dc.date.accessioned2017-12-12T13:16:48Z
dc.date.available2017-12-12T13:16:48Z
dc.date.issued2017
dc.description.abstractOBJECTIVES: Although liver biopsy is the gold standard for determining the degree of liver fibrosis, issues regarding its invasiveness and the small amount of liver tissue evaluated can limit its applicability and interpretation in clinical practice. Non-invasive evaluation methods for liver fibrosis can address some of these limitations. The aim of this study was to evaluate the accuracy of transient elastography-FibroScan (R), acoustic radiation force impulse (ARFI), enhanced liver fibrosis (ELF), the aspartate aminotransferase-to-platelet ratio index (APRI), and the FIB-4 index compared with liver biopsy in hepatitis C. METHODS: We evaluated chronic hepatitis C patients who were followed at the Division of Clinical Gastroenterology and Hepatology, Hospital das Clinicas, Department of Gastroenterology of University of Sao Paulo School of Medicine, Sao Paulo, Brazil, and who underwent liver biopsy. The accuracy of each method was determined by a receiver operating characteristic (ROC) curve analysis, and fibrosis was classified as significant fibrosis (>= F2), advanced fibrosis (>= F3), or cirrhosis (F4). The Obuchowski method was also used to determine the diagnostic accuracy of each method at the various stages of fibrosis. In total, 107 FibroScan (R), 51 ARFI, 68 ELF, 106 APRI, and 106 FIB-4 analyses were performed. RESULTS: A total of 107 patients were included in the study. The areas under the ROC curve (AUROCs) according to fibrosis degree were as follows: significant fibrosis (>= F2): FibroScan (R) : 0.83, FIB-4: 0.76, ELF: 0.70, APRI: 0.69, and ARFI: 0.67; advanced fibrosis (>= F3): FibroScan (R) : 0.85, ELF: 0.82, FIB-4: 0.77, ARFI: 0.74, and APRI: 0.71; and cirrhosis (F4): APRI: 1, FIB-4: 1, FibroScan (R) : 0.99, ARFI: 0.96, and ELF: 0.94. The accuracies of transient elastography, ARFI, ELF, APRI and FIB-4 determined by the Obuchowski method were F0-F1: 0.81, 0.78, 0.44, 0.72 and 0.67, respectively; F1-F2: 0.73, 0.53, 0.62, 0.60, and 0.68, respectively; F2-F3: 0.70, 0.64, 0.77, 0.60, and 0.67, respectively; and F3-F4: 0.98, 0.96, 0.82, 1, and 1, respectively. CONCLUSION: Transient elastography remained the most effective method for evaluating all degrees of fibrosis. The accuracy of all methodologies was best at F4.
dc.description.indexMEDLINE
dc.identifier.citationCLINICS, v.72, n.9, p.516-525, 2017
dc.identifier.doi10.6061/clinics/2017(09)01
dc.identifier.eissn1980-5322
dc.identifier.issn1807-5932
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/24277
dc.language.isoeng
dc.publisherHOSPITAL CLINICAS, UNIV SAO PAULO
dc.relation.ispartofClinics
dc.rightsopenAccess
dc.rights.holderCopyright HOSPITAL CLINICAS, UNIV SAO PAULO
dc.subjectHepatitis C Chronic
dc.subjectLiver Cirrhosis
dc.subjectElastography
dc.subjectBiomarkers/Blood
dc.subjectDisease Progression
dc.subjectData Accuracy
dc.subject.otherplatelet ratio index
dc.subject.otheraspartate-aminotransferase
dc.subject.otherelastography fibroscan
dc.subject.otherrisk-factors
dc.subject.otherstiffness
dc.subject.othercirrhosis
dc.subject.othermetaanalysis
dc.subject.othercohort
dc.subject.otherdiscordance
dc.subject.otherscore
dc.subject.wosMedicine, General & Internal
dc.titleAccuracy of transient elastography-FibroScan (R), acoustic radiation force impulse (ARFI) imaging, the enhanced liver fibrosis (ELF) test, APRI, and the FIB-4 index compared with liver biopsy in patients with chronic hepatitis C
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalLIMA, Fabiana Roberto:Univ Estadual Campinas, Div Gastroenterol, Fac Ciencias Med, Campinas, SP, Brazil
hcfmusp.citation.scopus42
hcfmusp.contributor.author-fmusphcTAISA GROTTA RAGAZZO
hcfmusp.contributor.author-fmusphcDENISE CERQUEIRA PARANAGUA VEZOZZO
hcfmusp.contributor.author-fmusphcDANIEL FERRAZ DE CAMPOS MAZO
hcfmusp.contributor.author-fmusphcMARIO GUIMARAES PESSOA
hcfmusp.contributor.author-fmusphcCLAUDIA PINTO MARQUES SOUZA DE OLIVEIRA
hcfmusp.contributor.author-fmusphcVENANCIO AVANCINI FERREIRA ALVES
hcfmusp.contributor.author-fmusphcFLAIR JOSE CARRILHO
hcfmusp.description.beginpage516
hcfmusp.description.endpage525
hcfmusp.description.issue9
hcfmusp.description.volume72
hcfmusp.origemWOS
hcfmusp.origem.pubmed29069254
hcfmusp.origem.scieloSCIELO:S1807-59322017000900516
hcfmusp.origem.scopus2-s2.0-85032462706
hcfmusp.origem.wosWOS:000413649800001
hcfmusp.publisher.citySAO PAULO
hcfmusp.publisher.countryBRAZIL
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