title: Accuracy of transient elastography in assessing liver fibrosis in chronic viral hepatitis: A multicentre, retrospective study.
abstract: OBJECTIVE
  Transient elastography (TE) has become an alternative to liver biopsy (LB). This study investigated the diagnostic performance of liver stiffness (LS) measurement using TE in Korean patients with chronic hepatitis B and C (CHB and CHC).
  
  
  METHODS
  From April 2006 to June 2014, 916 patients (567 CHB and 349 CHC) who underwent LB and TE at 15 centres were analyzed. The Batts and Ludwig scoring system was used for histologic assessment. Aspartate aminotransferase (AST)-to-platelet ratio indexes (APRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used.
  
  
  RESULTS
  The median age, LS value, and APRI score were 45 years, 8.8 kPa, and 0.61, respectively, in CHB patients vs. 51 years, 6.8 kPa and 0.55, respectively, in CHC patients. TE was significantly superior to APRI in CHB patients (AUROC 0.774 vs. 0.72 for ≥F2, 0.849 vs. 0.812 for ≥F3, and 0.902 vs. 0.707 for F4, respectively; all P < 0.05). Furthermore, TE was significantly superior for predicting ≥ F3 stage (AUROC 0.865 vs. 0.840, P = 0.009) whereas it was similar for predicting ≥ F2 and F4 stage (AUROC 0.822 vs. 0.796; 0.910 vs. 0.884; all P > 0.05) in CHC patients. In CHB patients, optimal cut-off LS values were 7.8 kPa for ≥F2, 8.2 kPa for ≥ F3, and 11.6 kPa for F4, vs. 6.8 kPa, 8.6 kPa, and 14.5 kPa, respectively, in CHC patients.
  
  
  CONCLUSIONS
  TE can accurately assess the degree of liver fibrosis in Korean patients with CVH. TE was superior to APRI for predicting each fibrosis stage.
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, South Korea.
authors: Yeon Seok
authors: YS
authors: Seo
authors: Yonsei University, Wonju College of Medicine, Department of Internal Medicine, Wonju, South Korea.
authors: Moon Young
authors: MY
authors: Kim
authors: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors: Seung Up
authors: SU
authors: Kim
authors: Division of Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
authors: Bae Si
authors: BS
authors: Hyun
authors: Institute for Digestive Research, Digestive Disease Center, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, South Korea.
authors: Jae Young
authors: JY
authors: Jang
authors: Department of Internal Medicine, Division of Hepatology, Inha University School of Medicine, Incheon, South Korea.
authors: Jin Woo
authors: JW
authors: Lee
authors: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors: Jung Il
authors: JI
authors: Lee
authors: Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea.
authors: Sang Jun
authors: SJ
authors: Suh
authors: Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, South Korea.
authors: Soo Young
authors: SY
authors: Park
authors: Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Bundang, South Korea.
authors: Hana
authors: H
authors: Park
authors: Departments of Internal Medicine and Preventive Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors: Eun Uk
authors: EU
authors: Jung
authors: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea.
authors: Byung Seok
authors: BS
authors: Kim
authors: Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Seoul, South Korea.
authors: In Hee
authors: IH
authors: Kim
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University School of Medicine, Daejeon, South Korea.
authors: Tae Hee
authors: TH
authors: Lee
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, South Korea.
authors: Soon Ho
authors: SH
authors: Um
authors: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors: Kwang-Hyub
authors: KH
authors: Han
authors: Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
authors: Sang Gyune
authors: SG
authors: Kim
authors: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors: Soon Koo
authors: SK
authors: Paik
authors: Division of Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
authors: Jong Young
authors: JY
authors: Choi
authors: Institute for Digestive Research, Digestive Disease Center, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, South Korea.
authors: Soung Won
authors: SW
authors: Jeong
authors: Department of Internal Medicine, Division of Hepatology, Inha University School of Medicine, Incheon, South Korea.
authors: Young Joo
authors: YJ
authors: Jin
authors: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea.
authors: Kwan Sik
authors: KS
authors: Lee
authors: Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea.
authors: Hyung Joon
authors: HJ
authors: Yim
authors: Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, South Korea.
authors: Won Young
authors: WY
authors: Tak
authors: Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Bundang, South Korea.
authors: Seong Gyu
authors: SG
authors: Hwang
authors: Departments of Internal Medicine and Preventive Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
authors: Youn Jae
authors: YJ
authors: Lee
authors: Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea.
authors: Chang Hyeong
authors: CH
authors: Lee
authors: Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Seoul, South Korea.
authors: Dae-Ghon
authors: DG
authors: Kim
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University School of Medicine, Daejeon, South Korea.
authors: Young Woo
authors: YW
authors: Kang
authors: Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
authors: Young Seok
authors: YS
authors: Kim
mesh_terms: D000328:Adult; D019540:Area Under Curve; D015415:Biomarkers / Q000032:analysis*; D001706:Biopsy; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D056910:Republic of Korea; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers
keywords: Fibroscan; Transient elastography; chronic liver disease; cirrhosis; liver fibrosis; liver stiffness; performance