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Non-invasive algorithm of liver fibrosis with transient elastography in Hepatitis B

Published ahead of print, a study in the Alilmentary Pharmacology & Therapeutics developed a non-invasive algorithm of enhanced liver fibrosis and liver stiffness measurement with transient elastography for advanced liver fibrosis in chronic hepatitis B.

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The accuracy of Enhanced Liver Fibrosis (ELF; ADVIA Centaur, Siemens Healthcare Diagnostics, Tarrytown, NY, USA) in assessing liver fibrosis in chronic hepatitis B (CHB) is to be determined.

Dr Vincent Wong and colleagues from China derived and validated a combined ELF-liver stiffness measurement (LSM) algorithm to predict advanced fibrosis in CHB patients.

Using the data of a previously reported cohort of 238 CHB patients, an ALT-based LSM algorithm for liver fibrosis was used as a training cohort to evaluate the performance of ELF against liver histology.

The best combined ELF-LSM algorithm was then validated in new cohort of 85 CHB patients not previously reported.

Low ELF or low LSM could be used to exclude advanced fibrosis
Alimentary Pharmacology & Therapeutics

The team observed that in the training cohort, LSM has better performance of diagnosing advanced fibrosis than ELF.

The research team found that the optimal cut-off values of ELF were 8.4 to exclude advanced fibrosis, and 10.8 to confirm advanced fibrosis.

In the training cohort, the researchers noted that an ELF of 8.4 or less had a sensitivity of 95% to exclude advanced fibrosis, and an ELF of more than 10.8 had a specificity of 92% to confirm advanced fibrosis.

In the combined algorithm, low ELF or low LSM could be used to exclude advanced fibrosis as both of them had high sensitivity.

To confirm advanced fibrosis, the team found that agreement between high ELF and high LSM could improve the negative predictive value specificity.

Dr Wong's team concludes, "An Enhanced Liver Fibrosis - liver stiffness measurement algorithm could improve the accuracy of prediction of either ELF or LSM alone."

"Liver biopsy could be correctly avoided in approximately 60% of patients."

Aliment Pharmacol Ther 2013: DOI: 10.1111/apt.12559
02 December 2013

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