title: Factors Associated with the Quality of Transient Elastography.
abstract: BACKGROUND
  Transient elastography is a noninvasive method for the evaluation of fibrosis in chronic liver disease. However, its reliability is variable, and the factors associated with its accuracy have not been identified completely.
  
  
  OBJECTIVE
  To identify the factors associated with the reliability of transient elastography.
  
  
  METHODS
  A total of 2033 transient elastography measurements were taken from March 2009 to October 2013. Reliability was determined according to the interquartile range/median (IQR/M < 0.30 = reliable; IQR/M < 0.10 = very reliable). Other indicators such as the percentage of successful measurements (>60 %), time of performance, and probe size were recorded. Potential factors that could affect the reliability of the procedure were analyzed using multivariate logistic regression.
  
  
  RESULTS
  Slightly less than 5 % of the measurements were unsuccessful, and 83 % of the successful measurements were found to be reliable. Factors associated with an unsuccessful measurement were female gender, incorrect probe size, and the presence of HCV infection. Unreliable measurements were associated with use of the procedure as part of a clinical study and success rate. Very reliable evaluations were associated with >10 measurements, the presence of chronic hepatic disease, and a success rate of >60 %.
  
  
  CONCLUSIONS
  The operator and clinical and anthropometric characteristics are factors that influence the success and reliability of transient elastography. Improvements in the quality of the procedure are needed to provide better diagnostic accuracy in clinical practice.
authors.affiliation: Obesity and Digestive Diseases Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Col. Toriello Guerra, Tlalpan, 14050, Mexico City, Mexico, evajuarezh@hotmail.com.
authors.forename: Eva
authors.initials: E
authors.lastname: Juárez-Hernández
authors.forename: Martha Helena
authors.initials: MH
authors.lastname: Uribe-Ramos
authors.forename: Martha Helena
authors.initials: MH
authors.lastname: Ramos-Ostos
authors.forename: Angélica Yanine
authors.initials: AY
authors.lastname: López-Ramírez
authors.forename: Sofía
authors.initials: S
authors.lastname: Ornelas-Arroyo
authors.forename: Juan Luis
authors.initials: JL
authors.lastname: Romero-Flores
authors.forename: Nahúm
authors.initials: N
authors.lastname: Méndez-Sánchez
authors.forename: Misael
authors.initials: M
authors.lastname: Uribe
authors.forename: Norberto C
authors.initials: NC
authors.lastname: Chávez-Tapia
mesh_terms: D000328:Adult; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies