Factors That Could Impact on Liver Fibrosis Staging by Transient Elastography.
International Journal of Hepatology
Hindawi Publishing Corporation
This is the final version of the article. Available from Hindawi Publishing via the DOI in this record.
Transient elastography (TE) based on liver stiffness measurement (LSM) is one of the most validated noninvasive methods for liver fibrosis staging in patients with chronic liver diseases. This method is painless, has no potential complications, is rapid (<10 min), and can be performed at the patient's bedside. However, several points should be considered when interpreting TE results. This review aims to discuss the critical points that might influence liver stiffness and TE results. Spectrum bias and the impact of the prevalence of fibrosis stages should be taken into account when interpreting the studies that validated this method using liver biopsy as a gold-standard. LSM might be influenced by nonfasting status, flare of transaminases, heart failure, extrahepatic cholestasis, presence of steatosis, aetiology of liver disease, type and position of probe, and operator's experience. In addition, interobserver variability can impact on the management of patients with chronic liver diseases. TE should be performed by an experienced operator (>100 exams), in a 3-hour fasting status, and its results should be handled by specialist clinicians that are aware of the limitations of this method.
This work was supported by funding from Newton Fund RCUK-CONFAP Research Partnerships Call, Fundac¸ao Car- ˜ los Chagas Filho de Amparo a Pesquisa do Estado do Rio ` de Janeiro (FAPERJ) under Grant E-26/170.021/2015 (Brazil), and Medical Research Council (MRC) Grant reference MR/ M026515/1 (UK); from Conselho Nacional de Desenvolvimento Cient´ıfico e Tecnologico (CNPq)/Bolsa Jovem Talento ´ (BJT) under Grant 301520/2014-3; from FAPERJ under Grant E-26/110.268/2014; and from Fundac¸ao para Desenvolvi- ˜ mento Cientifico e Tecnologico em Sa ´ ude (FioTec), Rio de ´ Janeiro, Brazil.
International Journal of Hepatology, 2015, Article ID 624596
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