title: Real-time elastography as a noninvasive assessment of liver fibrosis in chronic hepatitis C Egyptian patients: a prospective study.
abstract: BACKGROUND
  Hepatitis C virus is a worldwide problem. Noninvasive methods for liver fibrosis assessment as ultrasound-based approaches have emerged to replace liver biopsy. The aim of this study was to evaluate the diagnostic accuracy of real-time elastography (RTE) in the assessment of liver fibrosis in patients with chronic hepatitis C (CHC), compared with transient elastography and liver biopsy.
  
  
  METHODS
  RTE, FibroScan and liver biopsy were performed in 50 CHC patients. In addition, aspartate aminotransferase to platelet ratio index (APRI) and routine laboratory values were included in the analysis.
  
  
  RESULTS
  RTE was able to diagnose significant hepatic fibrosis (F ≥2) according to METAVIR scoring system at cut-off value of 2.49 with sensitivity 100%, specificity 66%, and area under the receiver-operating characteristics (AUROC) 0.8. FibroScan was able to predict significant fibrosis at cut-off value 7.5 KPa with sensitivity 88%, specificity 100%, and AUROC 0.94.APRI was able to predict significant hepatic fibrosis (F ≥2) with sensitivity 54%, specificity 80%, and AUROC 0.69. There was a significant positive correlation between the FibroScan score and RTE score (r=0.6, P=0.001).
  
  
  CONCLUSIONS
  Although FibroScan is superior in determining significant hepatic fibrosis, our data suggest that RTE may be a useful and promising noninvasive method for liver fibrosis assessment in CHC patients especially in cases with technical limitations for FibroScan.
authors.affiliation: National Hepatology and Tropical Medicine Research Institute (Lamiaa Mobarak, Ehsan Hassan), Cairo, Egypt.
authors.forename: Lamiaa
authors.initials: L
authors.lastname: Mobarak
authors.affiliation: Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University (Mohammed M. Nabeel, Dalia Omran, Zeinab Zakaria), Cairo, Egypt.
authors.forename: Mohammed M
authors.initials: MM
authors.lastname: Nabeel
authors.affiliation: National Hepatology and Tropical Medicine Research Institute (Lamiaa Mobarak, Ehsan Hassan), Cairo, Egypt.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Hassan
authors.affiliation: Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University (Mohammed M. Nabeel, Dalia Omran, Zeinab Zakaria), Cairo, Egypt.
authors.forename: Dalia
authors.initials: D
authors.lastname: Omran
authors.affiliation: Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University (Mohammed M. Nabeel, Dalia Omran, Zeinab Zakaria), Cairo, Egypt.
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Zakaria
keywords: Hepatitis C virus; aspartate aminotransferase to platelet ratio index; liver biopsy; liver fibrosis; real-time elastography; transient elastography