title: Prospective comparison of real-time tissue elastography and serum fibrosis markers for the estimation of liver fibrosis in chronic hepatitis C patients.
abstract: OBJECTIVE
  Real-time tissue elastography (RTE) is a non-invasive method for the measurement of tissue elasticity using ultrasonography. Liver fibrosis (LF) index is a quantitative method for evaluation of liver fibrosis calculated by RTE image features. This study aimed to investigate the significance of LF index for predicting liver fibrosis in chronic hepatitis C patients.
  
  
  METHODS
  In this prospective study, 115 patients with chronic hepatitis C who underwent liver biopsy were included, and the diagnostic accuracy of LF index and serum fibrosis markers was evaluated.
  
  
  RESULTS
  RTE imaging was successfully performed on all patients. Median LF index in patients with F0-1, F2, F3 and F4 were 2.61, 3.07, 3.54 and 4.25, respectively, demonstrating a stepwise increase with liver fibrosis progression (P < 0.001). LF index (odds ratio [OR] = 5.3, 95% confidence interval [CI] = 2.2-13.0) and platelet count (OR = 0.78, 95% CI = 0.68-0.89) were independently associated with the presence of advanced fibrosis (F3-4). Further, LF index was independently associated with the presence of minimal fibrosis (F0-1) (OR = 0.25, 95% CI = 0.11-0.55). The area under the receiver-operator curve (AUROC) of LF index for predicting advanced fibrosis (0.84) was superior to platelets (0.82), FIB-4 index (0.80) and aspartate aminotransferase/platelet ratio index (APRI) (0.76). AUROC of LF index (0.81) was superior to platelets (0.73), FIB-4 index (0.79) and APRI (0.78) in predicting minimal fibrosis.
  
  
  CONCLUSIONS
  LF index calculated by RTE is useful for predicting liver fibrosis, and diagnostic accuracy of LF index is superior to serum fibrosis markers.
authors.affiliation: Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.
authors.forename: Nobuharu
authors.initials: N
authors.lastname: Tamaki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kurosaki
authors.forename: Shuya
authors.initials: S
authors.lastname: Matsuda
authors.forename: Toru
authors.initials: T
authors.lastname: Nakata
authors.forename: Masaru
authors.initials: M
authors.lastname: Muraoka
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Shoko
authors.initials: S
authors.lastname: Suzuki
authors.forename: Takanori
authors.initials: T
authors.lastname: Hosokawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Nishimura
authors.forename: Ken
authors.initials: K
authors.lastname: Ueda
authors.forename: Kaoru
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakanishi
authors.forename: Jun
authors.initials: J
authors.lastname: Itakura
authors.forename: Yuka
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Kotaro
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Taki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Asahina
authors.forename: Namiki
authors.initials: N
authors.lastname: Izumi
keywords: chronic hepatitis C; fibrosis; liver fibrosis index; real-time tissue elastography