Assessment of biliary fibrosis by transient elastography in patients with PBC and PSC
Open accessAbstract
Noninvasive measurement of liver stiffness with transient elastography has been recently validated for the evaluation of hepatic fibrosis in chronic hepatitis C. The current study assessed the diagnostic performance of liver stiffness measurement (LSM) for the determination of fibrosis stage in chronic cholestatic diseases. One hundred one patients with primary biliary cirrhosis (PBC, n = 73) or primary sclerosing cholangitis (PSC, n = 28) were prospectively enrolled in a multicenter study. All patients underwent liver biopsy (LB) and LSM. Histological and fibrosis stages were assessed on LB by two pathologists. LSM was performed by transient elastography. Efficiency of LSM for the determination of histological and fibrosis stages were determined by a receiver operating characteristics (ROC) curve analysis. Analysis failed in six patients (5.9%) because of unsuitable LB (n = 4) or LSM (n = 2). Stiffness values ranged from 2.8 to 69.1 kPa (median, 7.8 kPa). LSM was correlated to both fibrosis (Spearman's ρ = 0.84, P < .0001) and histological (0.79, P < .0001) stages. These correlations were still found when PBC and PSC patients were analyzed separately. Areas under ROC curves were 0.92 for fibrosis stage (F) ≥2, 0.95 for F ≥ 3 and 0.96 for F = 4. Optimal stiffness cutoff values of 7.3, 9.8, and 17.3 kPa showed F ≥ 2, F ≥ 3 and F = 4, respectively. LSM and serum hyaluronic acid level were independent parameters associated with extensive fibrosis on LB. In conclusion , transient elastography is a simple and reliable noninvasive means for assessing biliary fibrosis. It should be a promising tool to assess antifibrotic therapies in PBC or PSC. (Hepatology 2006;43:1118–1124.)
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Both enhanced liver fibrosis (ELF) and transient elastography (TE) have, in cross-sectional studies, shown accuracy in determining disease stage as confirmed by biopsy.
“Both enhanced liver fibrosis (ELF)105 and transient elastography (TE)106 107 (eg, FibroScan) have, in cross-sectional studies, shown accuracy in determining disease stage as confirmed by biopsy.”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [106]
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- Authors
- Corpechot, C., El Naggar, A., Poujol-Robert, A., Ziol, M., Wendum, D., Chazouillères, O., de Lédinghen, V., Dhumeaux, D., Marcellin, P., Beaugrand, M., & Poupon, R.
- Affiliations
- Hôpital Saint-Antoine (FR)
- Hôpital Jean-Verdier (FR)
- Centre Hospitalier Universitaire Henri-Mondor (FR)
- Hôpital Beaujon (FR)
- Corresponding author
- Corpechot, Christophe
- Venue
- Hepatology
- Published
- 2006-05
- Volume
- 43
- Issue
- 5
- Pages
- 1118-1124
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2019951467
- Cited by
- 441
- References
- 17
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 9 · 2023: 11 · 2022: 8 · 2021: 16 · 2020: 15 · 2019: 17 · 2018: 21 · 2017: 13 · 2016: 22 · 2015: 25 · 2014: 24 · 2013: 27 · 2012: 31
- FWCI
- 27.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Ultrasound Imaging and Elastography
- Keywords
- transient elastography, liver stiffness measurement, biliary fibrosis, primary biliary cirrhosis, primary sclerosing cholangitis, noninvasive fibrosis assessment, cholestatic liver disease, hyaluronic acid, liver biopsy
- MeSH terms
- Adolescent, Adult, Aged, Biliary Tract, Elasticity, Female, Fibrosis, Humans, Liver, Liver Cirrhosis, Biliary, Male, Middle Aged, Prospective Studies, Cholangitis, Sclerosing
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