title: Real-time elastography for noninvasive assessment of liver fibrosis in chronic viral hepatitis.
abstract: OBJECTIVE
  Recently, transient elastography (FibroScan) has been introduced for noninvasive staging of liver fibrosis. Here, we investigated a novel approach for noninvasive assessment of liver fibrosis using sonography-based real-time elastography, which can be performed with conventional ultrasound probes during a routine sonography examination.
  
  
  METHODS
  Real-time elastography was performed in 79 patients with chronic viral hepatitis and known fibrosis stage and in 20 healthy volunteers. A specially developed program was used for quantification of tissue elasticity. Stepwise logistic regression analysis was performed to define an elasticity score using variables with high reproducibility in a preceding analysis of data from 16 different patients. In addition, aspartate transaminase-to-platelet ratio index (APRI) and routine laboratory values were included in the analysis.
  
  
  RESULTS
  The Spearman's correlation coefficient between the elasticity scores obtained using real-time elastography and the histologic fibrosis stage was 0.48, which is highly significant (p < 0.001). The diagnostic accuracy expressed as areas under receiver operating characteristic (ROC) curves were 0.75 for the diagnosis of significant fibrosis (fibrosis stage according to METAVIR scoring system [F] > or = F2), 0.73 for severe fibrosis (F > or = F3), and 0.69 for cirrhosis. For a combined elasticity-laboratory score, the areas under the ROC curves were 0.93, 0.95, and 0.91, respectively.
  
  
  CONCLUSIONS
  Real-time elastography is a new and promising sonography-based noninvasive method for the assessment of liver fibrosis in patients with chronic viral hepatitis.
authors.affiliation: Department of Internal Medicine II, Saarland University Hospital, Kirrbergerstrasse, Bldg. 41, Homburg/Saar 66421, Germany. mireen.friedrich.rust@uniklinikum-saarland.de
authors.forename: Mireen
authors.initials: M
authors.lastname: Friedrich-Rust
authors.forename: Mei-Fang
authors.initials: MF
authors.lastname: Ong
authors.forename: Eva
authors.initials: E
authors.lastname: Herrmann
authors.forename: Volker
authors.initials: V
authors.lastname: Dries
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Samaras
authors.forename: Stefan
authors.initials: S
authors.lastname: Zeuzem
authors.forename: Christoph
authors.initials: C
authors.lastname: Sarrazin
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003199:Computer Systems; D005260:Female; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*