Transient elastography is gaining popularity as a non-invasive method for predicting liver fibrosis.
However, intraobserver and interobserver agreement and factors influencing transient elastography reproducibility have not been adequately assessed.
Dr Mirella Fraquelli and colleagues from Italy investigated these aspects.
The team assessed 200 patients with chronic liver disease with varying etiology, over a 4-month period.
The patients consecutively underwent transient elastography and liver biopsy.
Transient elastography was performed twice by 2 different operators either concomitantly or within 3 days of the bioptic procedure.
Intraobserver and interobserver agreement were analyzed using the intraclass correlation coefficient.
|Transient elastography reproducibility is reduced with steatosis|
The team correlated the data with different patient-related and liver disease-related covariates.
The researchers performed 800 transient elastography examinations, with an indeterminate result rate of 2%.
The overall interobserver agreement intraclass correlation coefficient was 0.98.
The team found that increased body mass index, steatosis, and low staging grade were associated with reduced intraclass correlation coefficient.
Intraobserver agreement intraclass correlation coefficient was 0.98 for both raters.
The team identified 3 diagnostic transient elastography thresholds.
The research team noted that the transient elastography threshold for F2 was above 8 kPa, more than 10 for F3, and more than 12 for F4.
Transient elastography values assessed by the 2 raters fell within the same cut-off of fibrosis in 88% of the cases for F2, in 92% for F3, and 91% for F4.
Dr Fraquelli's team concluded, "Transient elastography is a highly reproducible and user-friendly technique for assessing liver fibrosis in patients with chronic liver disease."
"However, because transient elastography reproducibility is significantly reduced in patients with steatosis, increased body mass index and lower degrees of hepatic fibrosis, caution is warranted in the clinical use of transient elastography as a surrogate for liver biopsy."