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Study confirms accuracy of transient elastography in NAFLD
Date:1/27/2010

The research team evaluated 246 patients from two ethnic groups from two hospitals in France and Hong Kong with valid LSM acquisitions and satisfactory liver biopsy specimens. Men who consumed more than 30 g of alcohol per week and women who consumed more than 20 g of alcohol per week were excluded. Patients with secondary causes of hepatic steatosis (e.g. chronic use of systemic corticosteroids), positive hepatitis B surface antigen or anti-hepatitis C virus antibody, or histologic evidence of other concomitant chronic liver diseases were also excluded. Since the aim of transient elastography was to diagnose significant fibrosis and early cirrhosis, patients with clinical and radiological evidence of cirrhosis were excluded.

Researchers found that successful measurement could be obtained in over 97% of patients with BMI below 30 kg/m2 and 75% of obese patients. LSM was not affected by hepatic steatosis, necroinflammation and obesity. Most discordance between TE and histology occurred in patients with short liver biopsy lengths and mild or no fibrosis. In addition, TE had superior performance to other non-invasive biochemical tests in diagnosing advanced fibrosis and cirrhosis.

"The adoption of transient elastography could potentially spare two-thirds of NAFLD patients from liver biopsies. Since the prevalence of NAFLD is high in many affluent countries, this approach would be cost saving," speculates Dr. de Ldinghen.

Dr. de Ldinghen also cautions that while TE has a high negative predictive value, the positive predictive value of TE and other noninvasive tests to diagnose advanced fibrosis in NAFLD patients remains modest. He states, "The main value of these tests is to exclude advanced fibrosis as screening tests. Based on our data, it is reasonable to consider liver biopsy in patients whose LSM is 7.9 kPa or above."

Leon Adams, associate professor at the University of Western Australian and author of this month's editori
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Contact: Dawn Peters
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Wiley-Blackwell
Source:Eurekalert

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