EFSUMB EUROPEAN FEDERATION OF SOCIETIES FOR ULTRASOUND IN MEDICINE AND BIOLOGY ‘Building a European Ultrasound Community’ Young Investigator’s Award EUROSON 2016 Leipzig, Germany 28 October 14.00 – 15.30
7 minutes each for presentation plus 2 minutes discussion
The Value of Elastpq for the Evaluation of Liver Fibrosis in Patients with B and C Chronic Hepatopathies
Ruxandra Mare, Ioan Sporea, Alina Popescu, Roxana Sirli, Mirela Danila, Ana-Maria Stepan, Raluca Lupusoru, Felix Bende Department of Gastroenterology and Hepatology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Romania
ABSTRACT Purpose The aim of this study was to evaluate the diagnostic performance of a point shear wave elastography using ARFI technique- ElastPQ, in patients with B and C chronic hepatopathies, using Transient Elastography (TE) as the reference method, since it is a validated method for liver fibrosis assessment. Methods The study included 193 consecutive subjects with chronic hepatopathies (32.6% HBV, 67.4% HCV) from whom 42.5% had liver cirrhosis. Liver stiffness (LS) was evaluated in the same session by means of 2 elastographic methods: TE (Fibroscan, Echosens) and ElastPQ (Philips, Affinity) techniques. Reliable LS measurements were defined as follows: for TE – the median value of 10 LS measurements with a success rate≥60% and an interquartile range<30%. For ElastPQ- the median value of 10 LS measurements in the liver parenchyma, at least 1 cm below the capsule, avoiding large vessels. For TE M and XL probes were used. For differentiating between stages of liver fibrosis we used the following cut-off values for TE – mild fibrosis (F1)-6.1 kPa, moderate fibrosis (F2)- 7.2 kPa , severe fibrosis (F3)9.6 kPa and for liver cirrhosis (F4) -14.5kPa (1). Results
Reliable liver stiffness measurements were obtained in 93.8% (181/193) by means of TE and in 98.4% (190/193) with ElastPQ. In our cohort the ElastPQ values ranged from 2.32 to 44.07 kPa (median= 8.37 kPa). Based on TE cut-off values we divided our cohort into 4 groups: F1: 69/181 (38.1%); F2: 10/181 (5.5%) F3: 29/181(16.1%); F=4: 73/181 (40.3%). The areas under the receiver operating characteristic curve were: 0.89 ± 0.02 for patients with mild fibrosis (F1), 0.93 ±0.02 for moderate fibrosis (F2), 0.95±0.01 for severe fibrosis (F3) and 0.95±0.01 for cirrhosis. The best cut-off values for discriminating mild, moderate, severe fibrosis and cirrhosis were 6.5, 7.2, 8.6 and 9.9 kPa respectively.
Conclusion
ElastPQ is a method that seems to be good for the diagnosis of all stages of liver fibrosis with good diagnostic accuracy. References 1. Tsochatzis et al. Elastography for the diagnosis of severity of fibrosis in chronic liver disease: a metaanalysis of diagnostic accuracy. J Hepatol. 2011 Apr;54(4):650-9.