title: The usefulness of liver stiffness measurement using FibroScan in chronic hepatitis C in South Korea: a multicenter, prospective study.
abstract: OBJECTIVE
  We investigated the accuracy of liver stiffness measurement (LSM) in chronic hepatitis C (CHC) in a multicenter, prospective study in South Korea.
  
  
  METHODS
  Between June 2005 and July 2009, 91 CHC patients without a previous history of antiviral treatment, clinical evidences of cirrhosis, coinfection with other viruses, and heavy alcohol consumption and with alanine aminotransferase (ALT) ≤5x upper limit of normal, total bilirubin ≤1.5 mg/dL, sufficient liver biopsy quality (≥15 mm and more than six portal tracts), interquartile range to median liver stiffness (LS) value ratio ≤0.21, and more than 10 valid measurements, were recruited. The Batts and Ludwig scoring system was used for histologic assessment. Age-platelet index (API), aspartate aminotransferase (AST)-to-platelet ratio index (APRI), and age-spleen-platelet ratio index (ASPRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used to evaluate the performance of LSM and other noninvasive models.
  
  
  RESULTS
  The mean age was 47.9 years, and the mean LS value was 7.7 kPa (44 men and 47 women). LS value was highly correlated to the fibrosis stages (r=0.835, P<0.001). The AUROCs of LSM were 0.909 for ≥F2, 0.993 for ≥F3, and 0.970 for F=4 and were superior to those of API (0.72, 0.858, and 0.948, respectively), APRI (0.780, 0.887, and 0.904, respectively), and ASPRI (0.713, 0.862, and 0.957, respectively). The optimal cutoff LS values were 6.2 kPa for ≥F2, 7.7 kPa for ≥F3, and 11.0 kPa for F=4.
  
  
  CONCLUSIONS
  Our data suggest that LSM can accurately assess liver fibrosis in patients with CHC and be applied in South Korea.
authors.affiliation: Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Seung Up
authors.initials: SU
authors.lastname: Kim
authors.forename: Hui Won
authors.initials: HW
authors.lastname: Jang
authors.forename: Jae Youn
authors.initials: JY
authors.lastname: Cheong
authors.forename: Ja Kyung
authors.initials: JK
authors.lastname: Kim
authors.forename: Myung Hee
authors.initials: MH
authors.lastname: Lee
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Yang
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Cho
authors.forename: Kwan Sik
authors.initials: KS
authors.lastname: Lee
authors.forename: Eun Hee
authors.initials: EH
authors.lastname: Choi
authors.forename: Young Nyun
authors.initials: YN
authors.lastname: Park
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
mesh_terms: D000328:Adult; D000367:Age Factors; D044466:Asian People; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D016009:Chi-Square Distribution; D054459:Elasticity Imaging Techniques; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging* / Q000208:ethnology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000201:enzymology; D008103:Liver Cirrhosis / Q000097:blood / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000821:virology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D056910:Republic of Korea; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases