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dc.contributor.authorEddowes, PJen
dc.contributor.authorSasso, Men
dc.contributor.authorAllison, Men
dc.contributor.authorTsochatzis, Een
dc.contributor.authorAnstee, QMen
dc.contributor.authorSheridan, Den
dc.contributor.authorGuha, INen
dc.contributor.authorCobbold, JFen
dc.contributor.authorDeeks, JJen
dc.contributor.authorParadis, Ven
dc.contributor.authorBedossa, Pen
dc.contributor.authorNewsome, PNen
dc.date.accessioned2019-02-08T13:19:06Z
dc.date.issued2019-01-25en
dc.identifier.issn0016-5085en
dc.identifier.urihttp://hdl.handle.net/10026.1/13286
dc.description.abstract

BACKGROUND & AIMS: We estimated the accuracy of FibroScan vibration-controlled transient elastography controlled attenuation parameter (CAP) and liver stiffness measurements (LSMs) in assessing steatosis and fibrosis in patients with suspected NAFLD. METHODS: We collected data from 450 consecutive adults who underwent liver biopsy analysis for suspected NAFLD at 7 centers in the United Kingdom from March 2014 through January 2017. FibroScan examinations with M or XL probe were completed within the 2 weeks of the biopsy analysis (404 had a valid examination). The biopsies were scored by 2 blinded expert pathologists according to non-alcoholic steatohepatitis clinical research network criteria. Diagnostic accuracy was estimated using the area under the receiver operating characteristic curves (AUROC) for the categories of steatosis and fibrosis. We assessed effects of disease prevalence on positive and negative predictive values. For LSMs, the effects of histological parameters and probe type were appraised using multivariable analysis. RESULTS: Using biopsy analysis as the reference standard, we found that CAP identified patients with steatosis with an AUROCs of 0.87 (95% CI, 0.82-0.92) for S≥S1, 0.77 (95% CI, 0.71-0.82) for S≥S2, and 0.70 (95% CI, 0.64-0.75) for S=S3. Youden cut-off values for S≥S1, S≥S2 and S≥S3 were 302 dB/m, 331 dB/m, and 337 dB/m respectively. LSM identified patients with fibrosis with AUROCs of 0.77 (95% CI, 0.72-0.82) for F≥F2, 0.80 (95% CI, 0.75-0.84) for F≥F3, and 0.89 (95% CI, 0.84-0.93) for F=F4. Youden cut-off values for F≥F2, F≥F3 and F=F4 were 8.2 kPa, 9.7 kPa, and 13.6 kPa respectively. Applying the optimal cut-off values, determined from this cohort, to populations of lower fibrosis prevalence increased negative predictive values and reduced positive predictive values. Multivariable analysis found that the only parameter that significantly affect LSMs was fibrosis stage (P<10-16); we found no association with steatosis or probe type. CONCLUSIONS: In a prospective analysis of patients with NAFLD, we found CAP and LSMs by FibroScan to assess liver steatosis and fibrosis, respectively, with AUROC values ranging from 0.7 to 0.89. Probe type and steatosis did not affect LSMs.

en
dc.language.isoenen
dc.publisherElsevieren
dc.subjectNASHen
dc.subjectVCTEen
dc.subjectbiomarkeren
dc.subjectnon-invasiveen
dc.titleAccuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Non-alcoholic Fatty Liver Disease.en
dc.typeJournal Article
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/30689971en
plymouth.journalGastroenterologyen
dc.identifier.doi10.1053/j.gastro.2019.01.042en
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/00 Groups by role
plymouth.organisational-group/Plymouth/00 Groups by role/Academics
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry/Biomedical Research Group
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry/Biomedical Research Group/RC Reporting Group BRG
plymouth.organisational-group/Plymouth/Faculty of Medicine and Dentistry/Collaboration for the Advancement of Medical Education Research Assessment
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine
dcterms.dateAccepted2019-01-15en
dc.rights.embargodate2020-01-25en
dc.identifier.eissn1528-0012en
dc.rights.embargoperiodNot knownen
rioxxterms.versionofrecord10.1053/j.gastro.2019.01.042en
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2019-01-25en
rioxxterms.typeJournal Article/Reviewen


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