title: Elastography for hepatic fibrosis severity in chronic hepatitis B or C.
abstract: OBJECTIVE
  To assess the value of transient elastography for predicting significant fibrosis or cirrhosis in chronic hepatitis B or C (CHB or CHC) patients.
  
  
  METHODS
  75 patients (CHB: 45, CHC: 32) were included. All underwent elastography and liver biopsy concurrently. Biopsies were evaluated using Ishak's classification. Fibrosis was mild, moderate or severe/cirrhosis when scores were 0-1 (n = 30), 2-3 (n = 20), 4-6 (n = 25), respectively.
  
  
  RESULTS
  Median liver stiffness values were higher in patients with severe fibrosis or cirrhosis than in those with moderate or mild fibrosis (14.8 vs. 6.4 vs. 5.3 kPa, p < 0.001). The diagnostic accuracy of elastography for severe fibrosis and cirrhosis was excellent [area under the receiver operating characteristic (AUROC) curve 0.938 vs. 0.948], but it was not optimal for mild fibrosis (AUROC 0.78). Values of 7.5, 9.0 and 12 kPa had a sensitivity and specificity for severe fibrosis/cirrhosis of 96, 84 and 60%, and 76, 90 and 94%, respectively. The median stiffness value in cirrhotic patients (score 5-6) was 16.6 kPa (7.7-48). No differences in accuracy of elastography between CHB or CHC patients were found. Cutoff was 12.5 kPa for cirrhosis; 10/75 patients (13%) were misclassified.
  
  
  CONCLUSIONS
  Transient elastography has an excellent diagnostic accuracy for severe fibrosis and cirrhosis in CHB and CHC, but the cutoffs need further evaluation.
authors.affiliation: 2nd Department of Internal Medicine, Medical School of Athens University, Athens, Greece.
authors.forename: Maria-Vasiliki
authors.initials: MV
authors.lastname: Papageorgiou
authors.forename: George V
authors.initials: GV
authors.lastname: Papatheodoridis
authors.forename: Spilios
authors.initials: S
authors.lastname: Manolakopoulos
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Tsochatzis
authors.forename: Hariklia
authors.initials: H
authors.lastname: Kranidioti
authors.forename: Georgia
authors.initials: G
authors.lastname: Kafiri
authors.forename: Athanasios I
authors.initials: AI
authors.lastname: Archimandritis