title: Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: comparison between M and XL probe of FibroScan®.
abstract: OBJECTIVE
  Unreliable results of liver stiffness measurement are obtained in 16% of cases and are independently associated with body mass index (BMI) greater than 30 kg/m(2). A new FibroScan® probe (XL probe) was designed specifically for obese patients. The aim of this study was to evaluate the accuracy of liver stiffness measurement using M and XL probes of Fibroscan® for the diagnosis of fibrosis and cirrhosis in a large cohort of patients.
  
  
  METHODS
  Consecutive patients undergoing liver biopsies for chronic liver disease were prospectively recruited. Liver stiffness measurement was performed within 1 week before liver biopsy using both M and XL probes of FibroScan®.
  
  
  RESULTS
  A total of 286 patients were evaluated. A reliable liver stiffness measurement using M probe was obtained in 79.7% of cases. In the other 21.3%, liver stiffness measurement using XL probe was obtained in 56.9% of patients. A strong correlation was found between M and XL values, regardless of BMI. In all groups, median liver stiffness measurement using the XL probe was significantly lower than liver stiffness measurement using the M probe. By multivariate analysis, unsuccessful liver stiffness examination with M probe was independently associated with age >50 years and BMI >30 kg/m(2). By univariate analysis, only BMI >30 kg/m(2) was associated with unsuccessful liver stiffness measurement with XL probe. No significant difference was observed between the M and XL probes for the diagnosis of liver fibrosis.
  
  
  CONCLUSIONS
  Liver stiffness measurement with either M or XL probe is possible in 91.2% of patients with comparable diagnostic accuracy. In clinical practice, the M probe could be used as first step for liver stiffness measurement. In case of no valid shot or unreliable measurement, the XL probe could be used. This result could be useful for the assessment of liver fibrosis in NAFLD and/or obese patients.
authors.affiliation: Centre d'Investigation de la Fibrose Hépatique, Centre Hospitalier Universitaire (CHU) de Bordeaux, Hôpital Haut-Lévêque, France. victor.deledinghen@chu-bordeaux.fr
authors.forename: Victor
authors.initials: V
authors.lastname: de Lédinghen
authors.forename: Vincent Wai-Sun
authors.initials: VW
authors.lastname: Wong
authors.forename: Julien
authors.initials: J
authors.lastname: Vergniol
authors.forename: Grace Lai-Hung
authors.initials: GL
authors.lastname: Wong
authors.forename: Juliette
authors.initials: J
authors.lastname: Foucher
authors.forename: Shirley Ho-Ting
authors.initials: SH
authors.lastname: Chu
authors.forename: Brigitte
authors.initials: B
authors.lastname: Le Bail
authors.forename: Paul Cheung-Lung
authors.initials: PC
authors.lastname: Choi
authors.forename: Faiza
authors.initials: F
authors.lastname: Chermak
authors.forename: Karen Kar-Lum
authors.initials: KK
authors.lastname: Yiu
authors.forename: Wassil
authors.initials: W
authors.lastname: Merrouche
authors.forename: Henry Lik-Yuen
authors.initials: HL
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D004548:Elasticity / Q000502:physiology*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005234:Fatty Liver / Q000150:complications; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008099:Liver / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000150:complications; D015203:Reproducibility of Results