Utility of transient elastography in the non-invasive evaluation of cystic fibrosis liver disease

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23 Citations (Scopus)

Abstract

Liver disease frequently complicates cystic fibrosis (CF), with CF liver disease (CFLD) a leading cause of death. Liver biopsy is rarely performed because of the patchy nature of the disease. Transient elastography can reliably stage liver fibrosis via liver stiffness measurement (LSM). Aims: To evaluate LSM as a diagnostic tool in adults with CFLD. Methods: Fifty adult patients with CF were prospectively studied: 25 with CFLD and 25 without CFLD. The presence of CFLD and portal hypertension (PHT) was assessed according to strict established criteria based on serial biochemistry and imaging. All patients underwent LSM; APRI, Hepascore? and Forns score were calculated. Results: Median LSM was higher in those with CFLD [8.1 kPa (IQR 6.8-9.5) vs. 5.0 kPa (IQR 4.1-5.6); P <0.001]. On multivariate analysis, LSM was the only variable associated with CFLD (OR 2.74, 95 CI 1.53-4.89; P = 0.001). AUROC for LSM predicting CFLD was 0.87 (95 CI 0.77-0.98) and an LSM =6.8 kPa predicted CFLD with 76.0 sensitivity and 92.0 specificity. Median LSM was higher in those with PHT [15.7 kPa (IQR 9.2-17.2) vs. 5.4 kPa (IQR 4.3-6.8); P <0.001]. The AUROC for LSM predicting the presence of PHT was 0.96 (95 CI 0.92-1.00). An LSM cut-off of =8.9 kPa predicted the presence of PHT with 87.5 sensitivity, 90.5 specificity, 63.6 positive predictive value and 92.9 negative predictive value. Conclusions: LSM is an accurate and reliable non-invasive tool in assessing CFLD and PHT. An LSM =6.8 kPa is highly suggestive of CFLD and an LSM
Original languageEnglish
Pages (from-to)698 - 705
Number of pages8
JournalLiver International
Volume33
Issue number5
DOIs
Publication statusPublished - 2013

Cite this

@article{5a0ad1eeaab24774a66dbba4a65ce638,
title = "Utility of transient elastography in the non-invasive evaluation of cystic fibrosis liver disease",
abstract = "Liver disease frequently complicates cystic fibrosis (CF), with CF liver disease (CFLD) a leading cause of death. Liver biopsy is rarely performed because of the patchy nature of the disease. Transient elastography can reliably stage liver fibrosis via liver stiffness measurement (LSM). Aims: To evaluate LSM as a diagnostic tool in adults with CFLD. Methods: Fifty adult patients with CF were prospectively studied: 25 with CFLD and 25 without CFLD. The presence of CFLD and portal hypertension (PHT) was assessed according to strict established criteria based on serial biochemistry and imaging. All patients underwent LSM; APRI, Hepascore? and Forns score were calculated. Results: Median LSM was higher in those with CFLD [8.1 kPa (IQR 6.8-9.5) vs. 5.0 kPa (IQR 4.1-5.6); P <0.001]. On multivariate analysis, LSM was the only variable associated with CFLD (OR 2.74, 95 CI 1.53-4.89; P = 0.001). AUROC for LSM predicting CFLD was 0.87 (95 CI 0.77-0.98) and an LSM =6.8 kPa predicted CFLD with 76.0 sensitivity and 92.0 specificity. Median LSM was higher in those with PHT [15.7 kPa (IQR 9.2-17.2) vs. 5.4 kPa (IQR 4.3-6.8); P <0.001]. The AUROC for LSM predicting the presence of PHT was 0.96 (95 CI 0.92-1.00). An LSM cut-off of =8.9 kPa predicted the presence of PHT with 87.5 sensitivity, 90.5 specificity, 63.6 positive predictive value and 92.9 negative predictive value. Conclusions: LSM is an accurate and reliable non-invasive tool in assessing CFLD and PHT. An LSM =6.8 kPa is highly suggestive of CFLD and an LSM",
author = "Kitson, {Matthew T} and Kemp, {William W} and David Iser and Eldho Paul and Wilson, {John W} and Roberts, {Stuart Keith}",
year = "2013",
doi = "10.1111/liv.12113",
language = "English",
volume = "33",
pages = "698 -- 705",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell",
number = "5",

}

Utility of transient elastography in the non-invasive evaluation of cystic fibrosis liver disease. / Kitson, Matthew T; Kemp, William W; Iser, David; Paul, Eldho; Wilson, John W; Roberts, Stuart Keith.

In: Liver International, Vol. 33, No. 5, 2013, p. 698 - 705.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Utility of transient elastography in the non-invasive evaluation of cystic fibrosis liver disease

AU - Kitson, Matthew T

AU - Kemp, William W

AU - Iser, David

AU - Paul, Eldho

AU - Wilson, John W

AU - Roberts, Stuart Keith

PY - 2013

Y1 - 2013

N2 - Liver disease frequently complicates cystic fibrosis (CF), with CF liver disease (CFLD) a leading cause of death. Liver biopsy is rarely performed because of the patchy nature of the disease. Transient elastography can reliably stage liver fibrosis via liver stiffness measurement (LSM). Aims: To evaluate LSM as a diagnostic tool in adults with CFLD. Methods: Fifty adult patients with CF were prospectively studied: 25 with CFLD and 25 without CFLD. The presence of CFLD and portal hypertension (PHT) was assessed according to strict established criteria based on serial biochemistry and imaging. All patients underwent LSM; APRI, Hepascore? and Forns score were calculated. Results: Median LSM was higher in those with CFLD [8.1 kPa (IQR 6.8-9.5) vs. 5.0 kPa (IQR 4.1-5.6); P <0.001]. On multivariate analysis, LSM was the only variable associated with CFLD (OR 2.74, 95 CI 1.53-4.89; P = 0.001). AUROC for LSM predicting CFLD was 0.87 (95 CI 0.77-0.98) and an LSM =6.8 kPa predicted CFLD with 76.0 sensitivity and 92.0 specificity. Median LSM was higher in those with PHT [15.7 kPa (IQR 9.2-17.2) vs. 5.4 kPa (IQR 4.3-6.8); P <0.001]. The AUROC for LSM predicting the presence of PHT was 0.96 (95 CI 0.92-1.00). An LSM cut-off of =8.9 kPa predicted the presence of PHT with 87.5 sensitivity, 90.5 specificity, 63.6 positive predictive value and 92.9 negative predictive value. Conclusions: LSM is an accurate and reliable non-invasive tool in assessing CFLD and PHT. An LSM =6.8 kPa is highly suggestive of CFLD and an LSM

AB - Liver disease frequently complicates cystic fibrosis (CF), with CF liver disease (CFLD) a leading cause of death. Liver biopsy is rarely performed because of the patchy nature of the disease. Transient elastography can reliably stage liver fibrosis via liver stiffness measurement (LSM). Aims: To evaluate LSM as a diagnostic tool in adults with CFLD. Methods: Fifty adult patients with CF were prospectively studied: 25 with CFLD and 25 without CFLD. The presence of CFLD and portal hypertension (PHT) was assessed according to strict established criteria based on serial biochemistry and imaging. All patients underwent LSM; APRI, Hepascore? and Forns score were calculated. Results: Median LSM was higher in those with CFLD [8.1 kPa (IQR 6.8-9.5) vs. 5.0 kPa (IQR 4.1-5.6); P <0.001]. On multivariate analysis, LSM was the only variable associated with CFLD (OR 2.74, 95 CI 1.53-4.89; P = 0.001). AUROC for LSM predicting CFLD was 0.87 (95 CI 0.77-0.98) and an LSM =6.8 kPa predicted CFLD with 76.0 sensitivity and 92.0 specificity. Median LSM was higher in those with PHT [15.7 kPa (IQR 9.2-17.2) vs. 5.4 kPa (IQR 4.3-6.8); P <0.001]. The AUROC for LSM predicting the presence of PHT was 0.96 (95 CI 0.92-1.00). An LSM cut-off of =8.9 kPa predicted the presence of PHT with 87.5 sensitivity, 90.5 specificity, 63.6 positive predictive value and 92.9 negative predictive value. Conclusions: LSM is an accurate and reliable non-invasive tool in assessing CFLD and PHT. An LSM =6.8 kPa is highly suggestive of CFLD and an LSM

UR - http://www.ncbi.nlm.nih.gov/pubmed/23432782

U2 - 10.1111/liv.12113

DO - 10.1111/liv.12113

M3 - Article

VL - 33

SP - 698

EP - 705

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - 5

ER -