Liver stiffness in nonalcoholic fatty liver disease: A... : Hepatology (original) (raw)

Steatohepatitis/Metabolic Liver Disease

Liver stiffness in nonalcoholic fatty liver disease: A comparison of supersonic shear imaging, FibroScan, and ARFI with liver biopsy

Cassinotto, Christophe*,1,2; Boursier, Jérome3,4; de Lédinghen, Victor2,5; Lebigot, Jérome4,6; Lapuyade, Bruno1; Cales, Paul3,4; Hiriart, Jean‐Baptiste5; Michalak, Sophie4,7; Bail, Brigitte Le2,8; Cartier, Victoire4,6; Mouries, Amaury1; Oberti, Frédéric3,4; Fouchard‐Hubert, Isabelle3; Vergniol, Julien5; Aubé, Christophe4,6

1Department of Diagnostic and Interventional Imaging, Hôpital Haut‐LévêqueUniversity Hospital of BordeauxPessacFrance

2INSERM U1053University of BordeauxBordeauxFrance

3Department of HepatologyUniversity Hospital of AngersFrance

4Laboratory HIFIH, UPRES 3859LUNAM UniversityAngersFrance

5Centre d'Investigation de la Fibrose Hépatique, Hôpital Haut‐LévêqueUniversity Hospital of BordeauxPessacFrance

6Department of RadiologyUniversity Hospital of AngersFrance

7Department of PathologyUniversity Hospital of AngersFrance

8Department of Pathology, Hôpital PellegrinUniversity Hospital of BordeauxBordeauxFrance

*ADDRESS CORRESPONDENCE AND REPRINT REQUESTS TO:
Christophe Cassinotto, M.D.
Unité d'Imagerie Abdominale, Digestive et Interventionnelle
Service de Radiologie Diagnostique et Interventionnelle
Hôpital Haut‐Lévêque
Centre Hospitalier Universitaire de Bordeaux
1, Avenue de Magellan, 33604 Pessac, France
E‐mail: [email protected]
Fax: +33‐557656472

Abstract

Nonalcoholic fatty liver disease (NAFLD) has become a major public health issue. The goal of this study was to assess the clinical use of liver stiffness measurement (LSM) evaluated by supersonic shear imaging (SSI), FibroScan, and acoustic radiation force impulse (ARFI) in a cohort of NAFLD patients who underwent liver biopsy. A total of 291 NAFLD patients were prospectively enrolled from November 2011 to February 2015 at 2 French university hospitals. LSM was assessed by SSI, FibroScan (M probe), and ARFI within two weeks prior to liver biopsy. Calculations of the area under the receiver operating curve (AUROC) were performed and compared for the staging of liver fibrosis. AUROC for SSI, FibroScan, and ARFI were 0.86, 0.82, and 0.77 for diagnoses of ≥F2; 0.89, 0.86, and 0.84 for ≥F3; and 0.88, 0.87, and 0.84 for F4, respectively. SSI had a higher accuracy than ARFI for diagnoses of significant fibrosis (≥F2) (P = 0.004). Clinical factors related to obesity such as body mass index ≥ 30 kg/m2, waist circumference ≥102 cm or increased parietal wall thickness were associated with LSM failures when using SSI or FibroScan and with unreliable results when using ARFI. In univariate analysis, FibroScan values were slightly correlated with NAFLD activity score and steatosis (R = 0.28 and 0.22, respectively), whereas SSI and ARFI were not; however, these components of NAFLD did not affect LSM results in multivariate analysis. The cutoff values for SSI and FibroScan for staging fibrosis with a sensitivity ≥90% were very close: 6.3/6.2 kPa for ≥F2, 8.3/8.2 kPa for ≥F3, and 10.5/9.5 kPa for F4. Conclusion: Although obesity is associated with an increase in LSM failure, the studied techniques and especially SSI provide high value for the diagnosis of liver fibrosis in NAFLD patients. (Hepatology 2016;63:1817‐1827)