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 28 May 2018

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News

Diagnosing steatosis in bariatric surgery candidates with suspected NAFLD

The most recent issue of the European Journal of Gastroenterology & Hepatology examines controlled attenuation parameter for diagnosing steatosis in bariatric surgery candidates with suspected nonalcoholic fatty liver disease.

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Steatosis in patients with nonalcoholic fatty liver disease (NAFLD) is often benign, but may progress to fibrosis.

The accurate diagnosis of hepatic steatosis is therefore important for clinical decision-making and prognostic assessments.

The controlled attenuation parameter, a noninvasive measurement obtained with Fibro-Scan, has been developed for liver steatosis assessment.

Controlled attenuation parameter performs poorly in patients with high BMI.

The XL probe was initially developed for measuring liver stiffness in overweight patients.

Dr Sylviea Naveau and colleagues assessed the diagnostic value of controlled attenuation parameter in candidates for bariatric surgery with suspected NAFLD examined with the XL probe.

The Obuchowski measure demonstrated a very good discriminatory performance
European Journal of Gastroenterology & Hepatology

For the retrospective group, the team found that raw ultrasonic radiofrequency signals were stored prospectively in the Fibro-Scan examination file for offline controlled attenuation parameter calculation in 194 consecutive obese patients undergoing liver stiffness measurement in the 15 days before liver biopsy.

For the prospective group, controlled attenuation parameter was calculated automatically and prospectively from the XL probe in 123 obese patients.

The research team found that in the retrospective group, the diagnostic accuracy of controlled attenuation parameter was satisfactory for differentiating S3 from S0–S1–S2, and S3 from S0.

The team noted that the Obuchowski measure demonstrated a very good discriminatory performance, at 0.8 in the retrospective group, and 0.9 in the prospective group.

Dr Naveau's team concludes, "Controlled attenuation parameter calculations from XL probe measurements efficiently detected severe steatosis in morbidly obese patients with suspected NAFLD."

"However, the cutoff values should now be confirmed in a larger prospective cohort."

Eur J Gastroenterol Hepatol 2017: 29(9): 1022–1030
24 August 2017

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