title: Diagnostic performance of controlled attenuation parameter for predicting steatosis grade in chronic hepatitis B.
abstract: OBJECTIVE
  A novel controlled attenuation parameter (CAP) using the signals acquired by the FibroScan® has been developed as a method for evaluating steatosis. The aim of this study is to assess the performance of the CAP for the detection and quantification of steatosis in patients with chronic hepatitis B (CHB).
  
  
  METHODS
  136 subjects with CHB underwent liver biopsy and FibroScan® within 60 days. CAP was evaluated retrospectively using raw FibroScan® data. Steatosis was graded as follows: S0 (steatosis < 10% of hepatocytes), S1 (10 to < 30%), S2 (30 to < 60%) or S3 (≥ 60%). Performance was evaluated by area under the receiver operating characteristic (AUROC) curve.
  
  
  RESULTS
  Proportions of each steatosis grade (S0-S3) were 78, 10, 9 and 3%, respectively. Using univariate analysis, liver stiffness measurement (LMS) significantly correlated with fibrosis (τ = 0.43; P < 10-10), sex, necro-inflammatory activity, steatosis, age, NASH, and perisinusoidal fibrosis, and with liver fibrosis (P < 10-8) and perisinusoidal fibrosis (P = 0.008) using multivariate analysis. CAP correlated with steatosis (τ = 0.38, P < 10-7), body mass index, NASH, fibrosis and perisinusoidal fibrosis using univariate analysis, but only steatosis (P < 10-10) and perisinusoidal fibrosis (P = 0.002) using multivariate analysis. AUROCs for LSM were: 0.77 (0.69-0.85), 0.87 (0.80-0.95), and 0.93 (0.83-1.00), respectively, for fibrosis stages F ≥ 2, F ≥ 3 and F = 4. AUROCs for CAP were: 0.82 (0.73-0.92), 0.82 (0.69-0.95), and 0.97 (0.84-1.00) for ≥ S1, ≥ S2 and S3 steatosis, respectively.
  
  
  CONCLUSIONS
  In conclusión CAP is a novel, accurate non-invasive tool and may be suitable for detecting and quantifying steatosis in CHB patients.
authors.affiliation: Department of Hepatology and INSERM U773-CRB3, Hôpital Beaujon, APHP, University of Paris 7, Clichy, France.
authors.forename: Ana C
authors.initials: AC
authors.lastname: Cardoso
authors.affiliation: Department of Hepatology, Hôpital Jean Verdier, Bondy, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Beaugrand
authors.affiliation: Department of Hepatology, Hôpital Haut-Leveque, CHU Bordeaux Pessac, France and INSERM U1053, Université Bordeaux Segalen, Bordeaux, France.
authors.forename: Victor
authors.initials: V
authors.lastname: de Ledinghen
authors.affiliation: Department of Hepatology, Hôpital Henri Mondor, Créteil, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Douvin
authors.affiliation: Department of Hepatology, Hôpital Saint Antoine, Paris, France.
authors.forename: Raoul
authors.initials: R
authors.lastname: Poupon
authors.affiliation: Department of Hepatology, Hôpital Jean Verdier, Bondy, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Trinchet
authors.affiliation: Department of Anatomy and Pathology, Hospital Group Paris-Seine-Saint Denis, Hôpital Jean Verdier, AP-PH, Bondy, France and Paris 13 University, Sorbonne Paris Cité, UFR SMBH, Bobigny, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Ziol
authors.affiliation: Department of Anatomy Pathology and INSERM U773-CRB3, Hôpital Beaujon, Clichy, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Bedossa
authors.affiliation: Department of Hepatology and INSERM U773-CRB3, Hôpital Beaujon, APHP, University of Paris 7, Clichy, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Marcellin
mesh_terms: D019540:Area Under Curve; D001706:Biopsy; D054459:Elasticity Imaging Techniques; D005234:Fatty Liver / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D005260:Female; D005602:France; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index