title: Detection of hepatic steatosis using the controlled attenuation parameter: a comparative study with liver biopsy.
abstract: OBJECTIVE
  Measurements of controlled attenuation parameter (CAP) with transient elastography (FibroScan®; EcoSens SA, Paris, France) may provide an accurate noninvasive assessment of hepatic steatosis. Herein, we prospectively determined the accuracy of liver fat quantification with CAP values in patients with chronic liver diseases and compare the results with those of histological assessment of steatosis as reference standard.
  
  
  METHODS
  We enrolled 50 Turkish patients with various forms of chronic liver diseases. All patients underwent both CAP assessment and ultrasonography-guided liver biopsy.
  
  
  RESULTS
  On liver biopsy, 16 (32%) patients had S0, 12 (24%) had S1, 9 (18%) had S2, and 13 (26%) had S3. The CAP values increased significantly (p<0.001) for each steatosis stage on liver biopsy: S0, 222 dB/m; S1, 250 dB/m; S2, 270 dB/m; and S3, 318 dB/m. A cutoff value of 257 dB/m could distinguish significant steatosis (S2-S3) from S0 (Sn 89%, Sp 83%, positive likelihood ratio 5.33, negative likelihood ratio 0.13, AUROC=0.93). Multivariable analysis indicated that neither liver fibrosis (p=0.58) nor disease etiology (p=0.96) had a significant impact on the association between CAP and the stage of steatosis.
  
  
  CONCLUSIONS
  The determination of CAP using transient elastography can represent an important step forward toward the goal of an "imaging liver biopsy".
authors.affiliation: Department of Gastroenterology, Marmara University, School of Medicine , Istanbul , Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yilmaz
authors.forename: Atakan
authors.initials: A
authors.lastname: Yesil
authors.forename: Fatma
authors.initials: F
authors.lastname: Gerin
authors.forename: Rabia
authors.initials: R
authors.lastname: Ergelen
authors.forename: Hakan
authors.initials: H
authors.lastname: Akin
authors.forename: Çigdem Ataizi
authors.initials: ÇA
authors.lastname: Celikel
authors.forename: Nese
authors.initials: N
authors.lastname: Imeryuz
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001706:Biopsy; D002908:Chronic Disease; D054459:Elasticity Imaging Techniques; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D014421:Turkey; D055815:Young Adult