title: Applicability and variability of liver stiffness measurements according to probe position.
abstract: OBJECTIVE
  To investigate the liver stiffness measurement (LSM) applicability and variability with reference to three probe positions according to the region of liver biopsy.
  
  
  METHODS
  The applicability for LSM was defined as at least 10 valid measurements with a success rate greater than 60% and an interquartile range/median LSM < 30%. The LSM variability compared the inter-position concordance and the concordance with FibroTest.
  
  
  RESULTS
  Four hundred and forty two consecutive patients were included. The applicability of the anterior position (81%) was significantly higher than that of the reference (69%) and lower positions (68%), (both P = 0.0001). There was a significant difference (0.5 kPa, 95% CI 0.13-0.89; P < 0.0001) between mean LSM estimated at the reference position (9.3 kPa) vs the anterior position (8.8 kPa). Discordance between positions was associated with thoracic fold (P = 0.008). The discordance rate between the reference position result and FibroTest was higher when the 7.1 kPa cutoff was used to define advanced fibrosis instead of 8.8 kPa (33.6% vs 23.5%, P = 0.03).
  
  
  CONCLUSIONS
  The anterior position of the probe should be the first choice for LSM using Fibroscan, as it has a higher applicability without higher variability compared to the usual liver biopsy position.
authors.affiliation: AP-HP Hospital Group Pitié-Salpêtrière, Hepatology Department, Cedex 13, Paris 75651, France. p_ingiliz@web.de
authors.forename: Patrick
authors.initials: P
authors.lastname: Ingiliz
authors.forename: Kim Pav
authors.initials: KP
authors.lastname: Chhay
authors.forename: Mona
authors.initials: M
authors.lastname: Munteanu
authors.forename: Pascal
authors.initials: P
authors.lastname: Lebray
authors.forename: Yen
authors.initials: Y
authors.lastname: Ngo
authors.forename: Dominique
authors.initials: D
authors.lastname: Roulot
authors.forename: Yves
authors.initials: Y
authors.lastname: Benhamou
authors.forename: Dominique
authors.initials: D
authors.lastname: Thabut
authors.forename: Vlad
authors.initials: V
authors.lastname: Ratziu
authors.forename: Thierry
authors.initials: T
authors.lastname: Poynard
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005355:Fibrosis / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008099:Liver / Q000033:anatomy & histology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011187:Posture; D015203:Reproducibility of Results
chemical_list: D015415:Biomarkers