Noninvasive assessment of liver fibrosis in thalassaemia major patients by transient elastography (TE) - lack of interference by iron deposition.

The correlation between liver stiffness, measured by transient elastography,liver fibrosis, using the histological METAVIR score, and iron overload,measured by atomic absorption spectrometry was evaluated in 56homozygous-b-thalassaemics. Liver stiffness increased proportionally toliver fibrosis staging (r = 0Æ70; P > 0Æ001) independently of liver ironconcentration (r = 0Æ01; P = 0Æ932). The area under the receiver-operatingcharacteristic curve for prediction of cirrhosis was 0Æ997 (95% confidenceinterval [CI]: 0Æ925–1Æ000) with cut-off of 13 kPa with 100% sensitivity (95%CI: 69Æ0–100Æ0) and 95% specificity (95% CI: 84Æ2–99Æ3). Transientelastography is a reliable non-invasive tool for diagnosing advanced liverfibrosis in homozygous-b-thalassaemics, regardless of the degree of ironoverload.