Real-time tissue elastography versus FibroScan for noninvasive assessment of liver fibrosis in chronic liver disease.

Friedrich-Rust M, Schwarz A, Ong M, Dries V, Schirmacher P

Abstract

Purpose

Transient elastography (FibroScan, [TE]) and serum fibrosis markers such as the FibroTest (FT) are established methods for the noninvasive staging of liver fibrosis. A study using real-time elastography (HI-RTE), which is integrated in a conventional ultrasound system, was recently published with comparable results to transient elastography. The aim of the present study was to validate real-time elastography using the formulas calculated in previous studies and to compare the results to transient elastography and FibroTest for the noninvasive assessment of liver fibrosis.

Materials And Methods

One hundred and thirty-four patients with chronic liver disease and either histological assessment of liver fibrosis (n = 112) or proven liver cirrhosis (n = 22) were included in the study. All patients received TE, HI-RTE, and biochemical evaluation on the same day as presentation. The calculation of the elasticity score of real-time elastography was performed in accordance with the two previously published studies.

Results

The Spearman correlation coefficient between transient elastography, real-time elastography and FibroTest with the histological Chevallier score was statistically significant with 0.78, 0.34, and 0.67, respectively (p < 0.01). The diagnostic accuracy expressed as areas under ROC curves was 0.84, 0.69 and 0.85 for the diagnosis of significant fibrosis (F > or = 2), and 0.97, 0.65, and 0.83 for the diagnosis of cirrhosis, respectively.

Conclusion

Real-time elastography in its present form cannot replace transient elastography for noninvasive assessment of liver fibrosis.

MeSH — NLM indexing Alanine Transaminase / blood Aspartate Aminotransferases / blood Biopsy Chronic Disease Elasticity Imaging Techniques / methods Humans Liver Cirrhosis / blood Liver Cirrhosis / diagnostic imaging Liver Cirrhosis / pathology Liver Diseases / blood Liver Diseases / diagnostic imaging Liver Diseases / pathology