Noninvasive ways to assess liver disease( Two new studies examine non-invasive...),Health

Two new studies examine non-invasive ways to determine liver fibrosis and cirrhosis. An enhanced version of the Original European Liver Fibrosis panel was found to have good diagnostic accuracy for fibrosis in patients with non-alcoholic fatty liver disease. Conversely, transient elastography was unreliable for detecting cirrhosis in patients with acute liver damage. The studies are published in the February issue of Hepatology, a journal by John Wiley & Sons on behalf of the American Association for the Study of Liver Diseases (AASLD). The articles are also available online at Wiley Interscience (http://www.interscience.wiley.com/journal/hepatology).

Liver biopsy is the undisputed best way to assess liver fibrosis or cirrhosis; however, it is an invasive procedure that can cause rare, but potentially life threatening complications. Researchers have been seeking less invasive ways to diagnose liver disease, developing and testing clinical tools, like the Original European Liver Fibrosis Panel and transient elastography.

Researchers led by William Rosenberg in the United Kingdom, sought to validate the Original European Liver Fibrosis panel and consider a simplification that removed age as a factor yielding the Enhanced Liver Panel. They also tested the diagnostic performance of the ELF panel with the addition of the following simple markers: age, BMI, presence of diabetes/impaired fasting glucose, AST/ALT ratio, platelets, and albumin.

They recruited 196 patients with non-alcoholic fatty liver disease from two separate centers and tested the diagnostic accuracy of the new panels. They found that the Enhanced Liver Fibrosis panel detected severe fibrosis, moderate fibrosis and no fibrosis at AUCs of .90, .82, and .76 respectively. The diagnostic accuracy of the ELF panel plus simple markers was .98, .93 and .84 respectively. They report that using either panel could
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