title: Comparison between real-time tissue elastography and vibration-controlled transient elastography for the assessment of liver fibrosis and disease progression in patients with primary biliary cholangitis.
abstract: OBJECTIVE
  Assessing disease progression in patients with primary biliary cholangitis (PBC) is necessary in order to evaluate therapeutic effectiveness. Therefore, the aims of this study were to evaluate both the diagnostic accuracy of both real-time tissue elastography (RTE) and vibration-controlled transient elastography (VCTE), and the usefulness of hepatic and splenic elasticity as predictive markers for the progression of symptomatic PBC.
  
  
  METHODS
  The study participants were 44 patients with PBC. We assessed hepatic and splenic elasticity using RTE and VCTE and measured serum markers related to fibrosis and hepatic and splenic blood flow using Doppler ultrasonography. We then compared RTE and VCTE for diagnostic accuracy. Patients with asymptomatic PBC were followed every 1-3 months.
  
  
  RESULTS
  Both RTE and VCTE performed well and had superior diagnostic accuracy compared with biochemical markers. The areas under the receiver operating characteristic curve for RTE and VCTE were 0.92 and 0.92, 0.95 and 0.91, and 0.97 and 0.91 for F ≥ 2, F ≥ 3, and F = 4, respectively. During follow-up, nine patients (25.0%) developed liver-related symptoms. Multivariate analysis revealed that splenic elasticity assessed using RTE was a significant independent factor for the development of liver-related symptoms (odds ratio, 2.19; P = 0.024).
  
  
  CONCLUSIONS
  Real-time tissue elastography offered better diagnostic accuracy for severe fibrosis and cholangitis than VCTE. Splenic elasticity determined using RTE is a useful parameter for evaluating liver-related symptoms and an effective predictive marker of disease progression in patients with asymptomatic PBC.
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Koizumi
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirooka
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tokumoto
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Yoshida
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Imai
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yukimoto
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Teru
authors.initials: T
authors.lastname: Kumagi
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Takeshita
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Yoshiou
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiasa
keywords: biliary fibrosis; elastic ratio; primary biliary cholangitis; real-time tissue elastography; splenic elasticity; vibration-controlled transient elastography