Accuracy of transient elastography in assessing liver fibrosis in chronic viral hepatitis: A multicentre, retrospective study
Yeon Seok Seo
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, South Korea
Both authors contributed equally to this work as joint first authors.Search for more papers by this authorMoon Young Kim
Yonsei University, Wonju College of Medicine, Department of Internal Medicine, Wonju, South Korea
Both authors contributed equally to this work as joint first authors.Search for more papers by this authorCorresponding Author
Seung Up Kim
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
Both authors contributed equally to this work as co-corresponding authors.Correspondence
Young Seok Kim, MD, PhD, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 1174 Jung-dong, Wonmi-gu, Bucheon 420-767, South Korea
Tel: +82 32 621 5085
Fax: +82 32 621 5018
e-mail: [email protected]
Search for more papers by this authorBae Si Hyun
Division of Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
Search for more papers by this authorJae Young Jang
Institute for Digestive Research, Digestive Disease Center, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, South Korea
Search for more papers by this authorJin Woo Lee
Department of Internal Medicine, Division of Hepatology, Inha University School of Medicine, Incheon, South Korea
Search for more papers by this authorJung Il Lee
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
Search for more papers by this authorSang Jun Suh
Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
Search for more papers by this authorSoo Young Park
Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, South Korea
Search for more papers by this authorHana Park
Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Bundang, South Korea
Search for more papers by this authorEun Uk Jung
Departments of Internal Medicine and Preventive Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
Search for more papers by this authorByung Seok Kim
Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
Search for more papers by this authorIn Hee Kim
Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Seoul, South Korea
Search for more papers by this authorTae Hee Lee
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University School of Medicine, Daejeon, South Korea
Search for more papers by this authorSoon Ho Um
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, South Korea
Search for more papers by this authorKwang-Hyub Han
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
Search for more papers by this authorSang Gyune Kim
Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
Search for more papers by this authorSoon Koo Paik
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
Search for more papers by this authorJong Young Choi
Division of Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
Search for more papers by this authorSoung Won Jeong
Institute for Digestive Research, Digestive Disease Center, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, South Korea
Search for more papers by this authorYoung Joo Jin
Department of Internal Medicine, Division of Hepatology, Inha University School of Medicine, Incheon, South Korea
Search for more papers by this authorKwan Sik Lee
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
Search for more papers by this authorHyung Joon Yim
Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
Search for more papers by this authorWon Young Tak
Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, South Korea
Search for more papers by this authorSeong Gyu Hwang
Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Bundang, South Korea
Search for more papers by this authorYoun Jae Lee
Departments of Internal Medicine and Preventive Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
Search for more papers by this authorChang Hyeong Lee
Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
Search for more papers by this authorDae-Ghon Kim
Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Seoul, South Korea
Search for more papers by this authorYoung Woo Kang
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University School of Medicine, Daejeon, South Korea
Search for more papers by this authorCorresponding Author
Young Seok Kim
Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
Both authors contributed equally to this work as co-corresponding authors.Correspondence
Young Seok Kim, MD, PhD, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 1174 Jung-dong, Wonmi-gu, Bucheon 420-767, South Korea
Tel: +82 32 621 5085
Fax: +82 32 621 5018
e-mail: [email protected]
Search for more papers by this authorThe Korean Transient Elastography Study Group
Search for more papers by this authorYeon Seok Seo
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, South Korea
Both authors contributed equally to this work as joint first authors.Search for more papers by this authorMoon Young Kim
Yonsei University, Wonju College of Medicine, Department of Internal Medicine, Wonju, South Korea
Both authors contributed equally to this work as joint first authors.Search for more papers by this authorCorresponding Author
Seung Up Kim
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
Both authors contributed equally to this work as co-corresponding authors.Correspondence
Young Seok Kim, MD, PhD, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 1174 Jung-dong, Wonmi-gu, Bucheon 420-767, South Korea
Tel: +82 32 621 5085
Fax: +82 32 621 5018
e-mail: [email protected]
Search for more papers by this authorBae Si Hyun
Division of Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
Search for more papers by this authorJae Young Jang
Institute for Digestive Research, Digestive Disease Center, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, South Korea
Search for more papers by this authorJin Woo Lee
Department of Internal Medicine, Division of Hepatology, Inha University School of Medicine, Incheon, South Korea
Search for more papers by this authorJung Il Lee
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
Search for more papers by this authorSang Jun Suh
Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
Search for more papers by this authorSoo Young Park
Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, South Korea
Search for more papers by this authorHana Park
Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Bundang, South Korea
Search for more papers by this authorEun Uk Jung
Departments of Internal Medicine and Preventive Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
Search for more papers by this authorByung Seok Kim
Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
Search for more papers by this authorIn Hee Kim
Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Seoul, South Korea
Search for more papers by this authorTae Hee Lee
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University School of Medicine, Daejeon, South Korea
Search for more papers by this authorSoon Ho Um
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, South Korea
Search for more papers by this authorKwang-Hyub Han
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
Search for more papers by this authorSang Gyune Kim
Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
Search for more papers by this authorSoon Koo Paik
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
Search for more papers by this authorJong Young Choi
Division of Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
Search for more papers by this authorSoung Won Jeong
Institute for Digestive Research, Digestive Disease Center, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, South Korea
Search for more papers by this authorYoung Joo Jin
Department of Internal Medicine, Division of Hepatology, Inha University School of Medicine, Incheon, South Korea
Search for more papers by this authorKwan Sik Lee
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea
Search for more papers by this authorHyung Joon Yim
Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea
Search for more papers by this authorWon Young Tak
Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, South Korea
Search for more papers by this authorSeong Gyu Hwang
Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Bundang, South Korea
Search for more papers by this authorYoun Jae Lee
Departments of Internal Medicine and Preventive Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
Search for more papers by this authorChang Hyeong Lee
Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
Search for more papers by this authorDae-Ghon Kim
Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Seoul, South Korea
Search for more papers by this authorYoung Woo Kang
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University School of Medicine, Daejeon, South Korea
Search for more papers by this authorCorresponding Author
Young Seok Kim
Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
Both authors contributed equally to this work as co-corresponding authors.Correspondence
Young Seok Kim, MD, PhD, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 1174 Jung-dong, Wonmi-gu, Bucheon 420-767, South Korea
Tel: +82 32 621 5085
Fax: +82 32 621 5018
e-mail: [email protected]
Search for more papers by this authorThe Korean Transient Elastography Study Group
Search for more papers by this authorAbstract
Background/Aims
Transient elastography (TE) has become an alternative to liver biopsy (LB). This study investigated the diagnostic performance of liver stiffness (LS) measurement using TE in Korean patients with chronic hepatitis B and C (CHB and CHC).
Methods
From April 2006 to June 2014, 916 patients (567 CHB and 349 CHC) who underwent LB and TE at 15 centres were analyzed. The Batts and Ludwig scoring system was used for histologic assessment. Aspartate aminotransferase (AST)–to–platelet ratio indexes (APRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used.
Results
The median age, LS value, and APRI score were 45 years, 8.8 kPa, and 0.61, respectively, in CHB patients vs. 51 years, 6.8 kPa and 0.55, respectively, in CHC patients. TE was significantly superior to APRI in CHB patients (AUROC 0.774 vs. 0.72 for ≥F2, 0.849 vs. 0.812 for ≥F3, and 0.902 vs. 0.707 for F4, respectively; all P < 0.05). Furthermore, TE was significantly superior for predicting ≥ F3 stage (AUROC 0.865 vs. 0.840, P = 0.009) whereas it was similar for predicting ≥ F2 and F4 stage (AUROC 0.822 vs. 0.796; 0.910 vs. 0.884; all P > 0.05) in CHC patients. In CHB patients, optimal cut-off LS values were 7.8 kPa for ≥F2, 8.2 kPa for ≥ F3, and 11.6 kPa for F4, vs. 6.8 kPa, 8.6 kPa, and 14.5 kPa, respectively, in CHC patients.
Conclusions
TE can accurately assess the degree of liver fibrosis in Korean patients with CVH. TE was superior to APRI for predicting each fibrosis stage.
Supporting Information
| Filename | Description |
|---|---|
| liv12808-sup-0001-supinfo.docWord document, 307 KB | Table S1. Cut-off values for cirrhosis according to ALT level. Fig. S1. Flowchart describing the selection of the study population. Fig. S2. ROC curves of TE and APRI to predict ≥ F2 (A), ≥ F3 (B), and F=4 (C) in CHB patients. Fig. S3. ROC curves of TE and APRI to predict ≥ F2 (A), ≥ F3 (B), and F=4 (C) in CHC patients. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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