title: The role of Fibroscan in predicting the presence of varices in patients with cirrhosis.
abstract: OBJECTIVE
  Transient elastography is a relatively new, noninvasive method of measuring liver stiffness. This study aimed to evaluate the diagnostic accuracy of transient elastography and other noninvasive methods for the diagnosis of esophageal varices (EV) in patients with cirrhosis.
  
  
  METHODS
  This cross-sectional study graded EV according to size in 145 consecutive patients with cirrhosis who underwent endoscopy, Fibroscan, and other noninvasive diagnostic methods. The accuracy of these diagnostic methods in diagnosing EV was evaluated on the basis of area under receiver operating characteristic (AUROC) curves.
  
  
  RESULTS
  Elastography was successful in 123 patients. Of these, 54.5% had hepatitis C and 10.6% had hepatitis B. EV were absent in 39.8%, small EV was present in 24.4%, and large EV was present in 35.8% of patients. Fibroscan, aspartate aminotransferase-to-platelet ratio index, and international normalized ratio showed low accuracy in diagnosing EV in non-viral-related cirrhosis patients (AUROCs 0.66, 0.68, and 0.67, respectively). Fibroscan and aspartate aminotransferase-to-platelet ratio index were more accurate in measuring EV with a viral etiology (AUROCs 0.704 and 0.703, respectively). A cutoff value of 16.9 kPa was 83.8% sensitive in diagnosing EV in non-viral-cirrhotic patients, whereas a cutoff value of 19.9 kPa was 83.4% sensitive in diagnosing EV in patients with viral hepatitis. Fibroscan was moderately accurate in diagnosing grade I EV and less accurate in diagnosing grades II and III EV in all cirrhotic patients, irrespective of the underlying etiology.
  
  
  CONCLUSIONS
  Fibroscan might be useful in predicting the presence of EV in patients with cirrhosis with a viral etiology. However, endoscopy remains the gold standard for EV screening.
authors.affiliation: aGastroenterology Unit Department of Medicine, Departments of bMedical Education cPathology, College of Medicine dKing Saud University Liver Disease Research Center, King Saud University, Riyadh eGastroenterology Unit, Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia fDepartment of Tropical Medicine & Gastroenterology, College of Medicine, Assuit University, Asyut, Egypt.
authors.forename: Waleed K
authors.initials: WK
authors.lastname: Al-Hamoudi
authors.forename: Awny A
authors.initials: AA
authors.lastname: Abdelrahman
authors.forename: Ahmed
authors.initials: A
authors.lastname: Helmy
authors.forename: Shirin
authors.initials: S
authors.lastname: Anil
authors.forename: Nehal
authors.initials: N
authors.lastname: Khamis
authors.forename: Maha
authors.initials: M
authors.lastname: Arafah
authors.forename: Khalid A
authors.initials: KA
authors.lastname: Alswat
authors.forename: Youssef M
authors.initials: YM
authors.lastname: Suwefy
authors.forename: Faisal M
authors.initials: FM
authors.lastname: Sanai
authors.forename: Faleh
authors.initials: F
authors.lastname: Al Faleh
authors.forename: Ayman A
authors.initials: AA
authors.lastname: Abdo
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood; D003430:Cross-Sectional Studies; D054459:Elasticity Imaging Techniques / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D019934:International Normalized Ratio; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000097:blood* / Q000000981:diagnostic imaging* / Q000821:virology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D001219:Aspartate Aminotransferases