Liver fibrosis is the main predictor of the progression of chronic hepatitis C, and its assessment by liver biopsy can help determine therapy.
However, biopsy is an invasive procedure with several limitations.
A new, noninvasive medical device based on transient elastography has been designed to measure liver stiffness.
Dr Beaugrand and colleagues from France undertook a study in order to investigate the use of liver stiffness measurement (LSM) in the evaluation of liver fibrosis in patients with chronic hepatitis C.
The researchers enrolled 327 patients with chronic hepatitis C prospectively in a multicenter study.
Patients underwent liver biopsy and LSM. 2 pathologists then assessed METAVIR liver fibrosis stages on biopsy specimens.
| Liver stiffness measurement was well correlated with fibrosis stage|
LSM was performed by transient elastography.
The research team determined the efficiency of LSM and optimal cutoff values for fibrosis stage assessment using a receiver-operating characteristics (ROC) curve analysis and cross-validated by the jack-knife method.
The researchers found that liver stiffness measurement was well correlated with fibrosis stage.
The research team noted that the areas under ROC curves were 0.79 for F=2, 0.91 for F=3, and 0.97 for F = 4; for larger biopsies, these values were, respectively, 0.81, 0.95, and 0.99.
Optimal stiffness cutoff values of 8.7 and 14.5 kPa showed F=2 and F = 4, respectively.
Dr Beaugrand concluded, "Noninvasive assessment of liver stiffness with transient elastography appears as a reliable tool to detect significant fibrosis or cirrhosis in patients with chronic hepatitis C."