Liver fibrosis: noninvasive assessment using supersonic shear imaging and FIB4 index in patients with non-alcoholic fatty liver disease

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  • TAKEUCHI Hirohito
    Department of Gastroenterology and Hepatology, Tokyo Medical University
  • SUGIMOTO Katsutoshi
    Department of Gastroenterology and Hepatology, Tokyo Medical University
  • OSHIRO Hisashi
    Department of Pathology, Jichi Medical University
  • IWATSUKA Kunio
    Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine
  • KONO Shin
    Department of Gastroenterology and Hepatology, Tokyo Medical University
  • YOSHIMASU Yu
    Department of Gastroenterology and Hepatology, Tokyo Medical University
  • KASAI Yoshitaka
    Department of Gastroenterology and Hepatology, Tokyo Medical University
  • FURUICHI Yoshihiro
    Department of Gastroenterology and Hepatology, Tokyo Medical University
  • SAKAMAKI Kentaro
    Department of Biostatistics and Bioinformatics, Graduate School of Medicine, University of Tokyo
  • ITOI Takao
    Department of Gastroenterology and Hepatology, Tokyo Medical University

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Other Title
  • 非アルコール性脂肪性肝疾患におけるShear wave elastographyとFIB4 indexを用いた非侵襲的評価法の検討

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Abstract

<p>Purpose: Shear wave elastography (SWE) has been validated in chronic hepatitis C and B; however, limited data are available in non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the accuracy of SWE and FIB4 index for the diagnosis of fibrosis in a cohort of consecutive patients with biopsy-proven NAFLD, and to evaluate the effects of other histologic parameters on SWE measurement. Methods: Written informed consent was obtained from all patients, and this study was approved by our internal review board and ethics committee. Seventy-one patients with histologically proven NAFLD (mean age 50.8 years ± 15.7) were examined. All patients underwent SWE (Aixplorer; SuperSonic Imagine) and FIB4 index (based on age, aspartate aminotransferase and alanine aminotransferase levels, and platelet counts) measurements. SWE measurements were compared with the histologic features based on the NAFLD activity score and FIB4 index. Results: The area under the ROC curve for the diagnosis of hepatic fibrosis stage 3 or higher was 0.821 (optimal cut-off value 13.1 kPa, sensitivity 62.5%, specificity 57.4%) for SWE and 0.822 (optimal cut-off value 1.41, sensitivity 71.9%, specificity 53.9%) for FIB4 index. The median liver stiffness values measured using SWE showed a stepwise increase with increasing hepatic fibrosis stage (P < 0.001), inflammation score (P = 0.018), and ballooning score (P < 0.001), and showed a stepwise decrease with increasing hepatic steatosis stage (P = 0.046). Conclusions: SWE and FIB4 index are useful noninvasive tools for estimating the severity of fibrosis in NAFLD patients. However, the presence of severe steatosis may affect the liver stiffness measurement, resulting in underestimations of liver fibrosis.</p>

Journal

  • Choonpa Igaku

    Choonpa Igaku 47 (6), 241-248, 2020

    The Japan Society of Ultrasonics in Medicine

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