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Cited by 82Liver Disease Diagnosis and TreatmentUltrasound Imaging and ElastographyLiver Disease and Transplantation

Significant variations in elastometry measurements made within short-term in patients with chronic liver diseases

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Nascimbeni, Fabio, Lebray, Pascal, Fedchuk, Larysa, Oliveira, Claudia P., Alvares-da-Silva, Mario Reis, Varault, Anne, Ingiliz, Patrick, Ngo, Yen +32 more·2015·Clinical Gastroenterology and Hepatology
DOI 10.1016/j.cgh.2014.07.037
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Abstract

Background & aims Transient elastometry is a noninvasive procedure used to measure fibrosis when patients are diagnosed with liver disease; it might be used to monitor changes over time. We investigated whether there are short-term variations in stiffness measurements that are not attributable to changes in fibrosis by studying patients with stable liver disease.Methods We performed a retrospective analysis of 531 paired liver stiffness measurements made by Fibroscan when the study began (LSM1) and at follow-up (LSM2), more than 1 day and less than 1 year apart, from 432 stable (for body mass index, waist circumference, and alcohol consumption), untreated, immunocompetent patients with chronic liver disease (from January 2006 through March 2009). Variations between the first and follow-up measurements were expressed as absolute (LSM2-LSM1, kPa) or relative ([LSM2-LSM1]/LSM1*100) or as changes in fibrosis stage.Results There was >20% variation in 49.7%, >30% in 34.3%, and >50% in 12.2% of paired measurements; this variation was constant across the spectrum of LSM1 values. The variations produced a 1-fibrosis stage difference in 31.5% of pairs and a ≥ 2-stage difference in 9.8% of pairs. Patients with LSM1 >7 kPa had increased probability of having a different stage of fibrosis at LSM2, compared with patients with LSM1 <7 kPa. Factors associated with variation included measurements made by 2 different operators or at least 1 non-senior operator, ratios of interquartile range:median values, significant fibrosis (≥ 7 kPa) at LSM1, baseline body mass index, or a 2-fold difference in level of alanine aminotransferase between measurements. When the analyses were restricted to measurements made by the same operator, the variation was slightly reduced; fibrosis stage differed between measurements for only 34.3% of cases.Conclusions Operator-related and patient-related factors produce significant variations in liver stiffness measurements made by transient elastometry, limiting its use in monitoring patients. These variations are unrelated to disease progression. The lowest levels of variation occur in measurements made in patients with no or early-stage fibrosis or by a single experienced operator.

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  • VCTE measurements are highly variable, with a coefficient of variation of up to 60% in those with cirrhosis.

    “VCTE measurements are highly variable, 188 with a coef fi cient of variation of up to 60% in those with cirrhosis. 189”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [188]

    Our indexed copy contains the article title and a repository navigation page, but no results or measurements. Searches for the 60% coefficient of variation and cirrhosis found no passage that could verify the claim. (LLM, conf=0.72)

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Authors
Nascimbeni, F., Lebray, P., Fedchuk, L., Oliveira, C. P., Alvares-da-Silva, M. R., Varault, A., Ingiliz, P., Ngo, Y., de Torres, M., Munteanu, M., Poynard, T., Ratziu, V., Grimaldi, A., Giral, P., Bruckert, E., Basdevant, A., Clement, K., Oppert, J.-M., Hartemann-Heurtier, A., Andreelli, F., Gombert, S., Jacqueminet, S., Cocaul, A., Fouffelle, F., Moussalli, J., Thabut, D., Lebray, P., Podevin, P., Bonnefont-Rousselot, D., Bittar, R., Benhamou, Y., Bernhardt, C., Boitard, C., Larger, E., Sola, A., El-Etr, M., Gautier, J.-F., Serfaty, L., Housset, C., & Capeau, J.
Affiliations
  • University of Modena and Reggio Emilia (IT)
  • Inserm (FR)
  • Universidade de São Paulo (BR)
Corresponding author
Ratziu, Vlad
ORCID
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2015-04
Volume
13
Issue
4
Pages
763-771.e6
ISSN
1542-3565 (ISSN-L)
DOI
10.1016/j.cgh.2014.07.037
OpenAlex
W2095851283
Cited by
82
References
25
Citations by year
2026: 3 · 2025: 6 · 2024: 7 · 2023: 8 · 2022: 4 · 2021: 8 · 2020: 6 · 2019: 4 · 2018: 3 · 2017: 8 · 2016: 9 · 2015: 14 · 2014: 2
FWCI
8.31
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Ultrasound Imaging and Elastography
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Keywords
transient elastography, liver stiffness measurement, chronic liver disease, liver fibrosis, measurement variability, FibroScan, operator variability, fibrosis staging, disease progression monitoring, alanine aminotransferase, body mass index
MeSH terms
Adult, Aged, Chronic Disease, Female, Follow-Up Studies, Humans, Liver Cirrhosis, Male, Middle Aged, Retrospective Studies, Reproducibility of Results, Elasticity Imaging Techniques

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