Real-Time Shear Wave versus Transient Elastography for Predicting Fibrosis: Applicability, and Impact of Inflammation and Steatosis. A Non-Invasive ComparisonReportar como inadecuado




Real-Time Shear Wave versus Transient Elastography for Predicting Fibrosis: Applicability, and Impact of Inflammation and Steatosis. A Non-Invasive Comparison - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background and Aims

Real-time shear wave elastography 2D-SWE is a two-dimensional transient elastography and a competitor as a biomarker of liver fibrosis in comparison with the standard reference transient elastography by M probe TE-M. The aims were to compare several criteria of applicability, and to assess inflammation and steatosis impact on elasticity values, two unmet needs.

Methods

We took FibroTest as the fibrosis reference and ActiTest and SteatoTest as quantitative estimates of inflammation and steatosis. After standardization of estimates, analyses used curve fitting, quantitative Lin concordance coefficient LCC, and multivariate logistic regression.

Results

A total of 2,251 consecutive patients were included. We validated the predetermined 0.2 kPa cut-off as a too low minimal elasticity value identifying not-reliable 2D-SWE results LCC with FibroTest = 0.0281-0.119;0.175. Other criteria, elasticity CV, body mass index and depth of measures were not sufficiently discriminant. The applicability of 2D-SWE 95%CI 89.6%88.2–90.8, was significantly higher than that of TE, 85.6%84.0–87.0; P<0.0001. In patients with non-advanced fibrosis METAVIR F0F1F2, elasticity values estimated by 2D-SWE was less impacted by inflammation and steatosis than elasticity value estimated by TE-M: LCC 95%CI 0.039 0.021;0.058 vs 0.090 0.068;0.112;P<0.01 and 0.105 0.068;0.141 vs 0.192 0.153;0.230; P<0.01 respectively. The three analyses methods gave similar results.

Conclusions

Elasticity results including very low minimal signal in the region of interest should be considered not reliable. 2D-SWE had a higher applicability than TE, the reference elastography, with less impact of inflammation and steatosis especially in patients with non-advanced fibrosis, as presumed by blood tests.

Trial Registration

ClinicalTrials.gov NCT01927133



Autor: Thierry Poynard , Tam Pham, Hugo Perazzo, Mona Munteanu, Elena Luckina, Djamel Elaribi, Yen Ngo, Luminita Bonyhay, Noemie Seurat,

Fuente: http://plos.srce.hr/



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