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The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.

Pitfalls of Liver Stiffness Measurement: A 5-Year Prospective Study of 13,369 Examinations

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Castéra, Laurent, Foucher, Juliette, Bernard, Pierre-Henri, Carvalho, Françoise, Allaix, Daniele, Merrouche, Wassil, Couzigou, Patrice, de Lédinghen, Victor·2010·Hepatology
DOI 10.1002/hep.23425
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Abstract

Liver stiffness measurement (LSM) based on transient elastography (TE, FibroScan) is gaining in popularity for noninvasive assessment of liver fibrosis. However, LSM has limitations, which have not yet been thoroughly evaluated. We prospectively investigated the frequency and determinants of LSM failure and unreliable results over a 5-year period, based on 13,369 examinations (134,239 shots). LSM failure was defined as zero valid shots, and unreliable examinations were defined as fewer than 10 valid shots, an interquartile range (IQR)/LSM greater than 30%, or a success rate less than 60%. LSM failure occurred in 3.1% of all examinations (4% at first examination [n = 7261]) and was independently associated at first examination with body mass index (BMI) greater than 30 kg/m2 (odds ratio [OR], 7.5; 95% confidence interval [CI], 5.6-10.2; P = 0.0001), operator experience fewer than 500 examinations (OR 2.5 [1.6-4.0]; P = 0.0001); age greater than 52 years (OR 2.3 [1.6-3.2]; P = 0.0001), and type 2 diabetes (OR 1.6 [1.1-2.2]; P = 0.009). Unreliable results were obtained in a further 15.8% of cases (17% at first examination) and were independently associated at first examination with BMI greater than 30 kg/m2 (OR 3.3 [2.8-4.0]; P = 0.0001), operator experience fewer than 500 examinations (OR 3.1 [2.4-3.9]; P = 0.0001), age greater than 52 years (OR 1.8 [1.6-2.1]; P = 0.0001), female sex (OR 1.4 [1.2-1.6], P = 0.0001), hypertension (OR 1.3 [1.1-1.5]; P = 0.003), and type 2 diabetes (OR 1.2 [1.0-1.5]; P = 0.05). When metabolic syndrome and waist circumference were taken into account in a subgroup of 2835 patients, waist circumference was the most important determinant of LSM failure and unreliable results. Conclusion: In our experience, liver stiffness measurements are uninterpretable in nearly one in five cases. The principal reasons are obesity, particularly increased waist circumference, and limited operator experience. These results emphasize the need for adequate operator training and for technological improvements in specific patient subpopulations. (Hepatology 2010.)

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Metadata

Authors
Castéra, L., Foucher, J., Bernard, P.-H., Carvalho, F., Allaix, D., Merrouche, W., Couzigou, P., & de Lédinghen, V.
Venue
Hepatology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-03
Volume
51
Issue
3
Pages
828-835
ISSN
0270-9139 (ISSN-L)
DOI
10.1002/hep.23425
OpenAlex
W1985442918
Cited by
1,159
References
1
FWCI
34.34
Type
journal article
Language
en
Open access
bronze

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