Noninvasive test accurately identifies advanced liver disease without biopsy

Sep 01, 2008

Non-invasively measuring liver stiffness with transient elastography accurately diagnoses patients with late-stage liver disease, reports a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.

Liver biopsy has been the gold standard for assessing liver disease. However, it is limited by invasiveness, risk of complications, patient discomfort and the availability of expertise. Liver stiffness measurement (LSM) has been shown to be a reliable tool to detect liver cirrhosis, and transient elastography is a rapid, non-invasive and reproducible new technique being employed to measure liver stiffness.

"Research has shown that LSM has the potential to become a non-invasive way to diagnose severe liver disease," said Henry LY Chan, MD, with Prince of Wales Hospital in Hong Kong. "We wanted to take a closer look at its potential, evaluating its accuracy in relation to traditional biopsy. Comparing the results of transient elastography with biopsy reports enables us to determine just how precise this technique can be."

In the study, Dr. Chan and colleagues evaluated the accuracy of LSM to detect severe liver fibrosis in 133 patients suffering from chronic liver diseases. The research team recruited adult patients with chronic liver diseases who were clinically indicated for liver biopsy examination in a twelve-month window. Chronic drinkers or those with decompensated liver disease, complications of liver cirrhosis, previous liver surgery or liver transplantation were excluded. LSM was performed within four weeks of the liver biopsy examination.

Study results showed that LSM is most accurate when diagnosing liver disease in patients with advanced, or pericellular, fibrosis, revealing a high correlation (r=0.43) between LSM and pericellular disease. In addition, the correlation of LSM and pericellular fibrosis was stronger in patients with severe fibrosis than in those with mild disease. Though not statistically significant, LSM also provided a better prediction of cirrhosis than did bridging fibrosis, which is an earlier stage of liver disease.

"Right now, LSM is a tool to be used in advanced liver fibrosis," said Dr. Chan. "It has a great ability to diagnose bridging fibrosis and cirrhosis but not a milder degree of liver fibrosis. Using different LSM cutoff values, liver cirrhosis can be diagnosed or excluded with high certainty, which may alleviate the need for biopsy in these later stages."

Higher LSM also was associated with higher serum alanine transaminase (ALT) levels, another marker of liver disease. Patients with higher ALT levels tended to have higher LSM than those with lower ALT levels at the same stage of liver fibrosis. This finding lead the research team to conclude that transient elastography may overestimate liver fibrosis when ALT is elevated.

Source: American Gastroenterological Association

Explore further: In US, Ebola fears rise but most confident in response

add to favorites email to friend print save as pdf

Related Stories

The social web of things

28 minutes ago

Research to be published in the International Journal of Web-Based Communities suggests that the familiar interfaces of online social networking sites might be adapted to allow us to interact more efficiently with our ne ...

Amphibian communities collapse in wake of viral outbreak

8 minutes ago

Two closely related viruses that have been introduced to northern Spain in recent years have already led to the collapse of three different species of amphibian—the common midwife toad, the common toad, ...

Are male brains wired to ignore food for sex?

8 minutes ago

Choosing between two good things can be tough. When animals must decide between feeding and mating, it can get even trickier. In a discovery that might ring true even for some humans, researchers have shown that male brains ...

FBI director warns against cellphone encryption

44 minutes ago

(AP)—The FBI director is warning against smartphone encryption. James Comey is talking about tech companies like Apple and Google that say their new operating systems will be encrypted, or protected by coding. Comey says ...

CBS debuts stand-alone streaming service

45 minutes ago

(AP)—CBS is jumping on the cord-cutting bandwagon, launching a stand-alone digital streaming service for $5.99 a month that will offer subscribers access to its current and older shows.

Recommended for you

In US, Ebola fears rise but most confident in response

2 hours ago

After two health care workers in Texas were infected with Ebola while caring for a Liberian patient, a poll Tuesday showed a rattled US public that nevertheless stayed confident in the government's response.

'Humbled' NBC cameraman recovers from Ebola

3 hours ago

A US photojournalist said Tuesday he was grateful to be alive after the hospital treating him declared him now free of Ebola, in a minor victory over the virus that has killed more than 4,500 people.

User comments : 0