Validity criteria for the diagnosis of fatty liver by M probe-based controlled attenuation parameter

Antonio Craxi, Salvatore Petta, Antonino Tuttolomondo, Calogero Camma', Julien Vergniol, Wassil Merrouche, Henry Lik-Yuen Chan, Fabio Marra, Anthony Wing-Hung Chan, Brigitte Le Bail, Vincent Wai-Sun Wong, Jean-Baptiste Hiriart, Umberto Arena, Victor De Lédinghen, Grace Lai-Hung Wong, Umberto Arena

Risultato della ricerca: Article

30 Citazioni (Scopus)

Abstract

Background &amp; Aims Controlled attenuation parameter (CAP) can be performed together with liver stiffness measurement (LSM) by transient elastography (TE) and is often used to diagnose fatty liver. We aimed to define the validity criteria of CAP. Methods CAP was measured by the M probe prior to liver biopsy in 754 consecutive patients with different liver diseases at three centers in Europe and Hong Kong (derivation cohort, n = 340; validation cohort, n = 414; 101 chronic hepatitis B, 154 chronic hepatitis C, 349 non-alcoholic fatty liver disease, 37 autoimmune hepatitis, 49 cholestatic liver disease, 64 others; 277 F3-4; age 52 ± 14; body mass index 27.2 ± 5.3 kg/m2). The primary outcome was the diagnosis of fatty liver, defined as steatosis involving â¥5% of hepatocytes. Results The area under the receiver-operating characteristics curve (AUROC) for CAP diagnosis of fatty liver was 0.85 (95% CI 0.82â0.88). The interquartile range (IQR) of CAP had a negative correlation with CAP (r = â0.32, p <0.001), suggesting the IQR-to-median ratio of CAP would be an inappropriate validity parameter. In the derivation cohort, the IQR of CAP was associated with the accuracy of CAP (AUROC 0.86, 0.89 and 0.76 in patients with IQR of CAP <20 [15% of patients], 20â39 [51%], and â¥40 dB/m [33%], respectively). Likewise, the AUROC of CAP in the validation cohort was 0.90 and 0.77 in patients with IQR of CAP <40 and â¥40 dB/m, respectively (p = 0.004). The accuracy of CAP in detecting grade 2 and 3 steatosis was lower among patients with body mass index â¥30 kg/m2and F3-4 fibrosis. Conclusions The validity of CAP for the diagnosis of fatty liver is lower if the IQR of CAP is â¥40 dB/m. Lay summary: Controlled attenuation parameter (CAP) is measured by transient elastography (TE) for the detection of fatty liver. In this large study, using liver biopsy as a reference, we show that the variability of CAP measurements based on its interquartile range can reflect the accuracy of fatty liver diagnosis. In contrast, other clinical factors such as adiposity and liver enzyme levels do not affect the performance of CAP.
Lingua originaleEnglish
pagine (da-a)577-584
Numero di pagine8
RivistaJournal of Hepatology
Volume67
Stato di pubblicazionePublished - 2017

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Fatty Liver
ROC Curve
Elasticity Imaging Techniques
Liver
Liver Diseases
Body Mass Index
Biopsy
Autoimmune Hepatitis
Chronic Hepatitis B
Adiposity
Hong Kong
Chronic Hepatitis C
Hepatocytes
Fibrosis
Enzymes

All Science Journal Classification (ASJC) codes

  • Hepatology

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Validity criteria for the diagnosis of fatty liver by M probe-based controlled attenuation parameter. / Craxi, Antonio; Petta, Salvatore; Tuttolomondo, Antonino; Camma', Calogero; Vergniol, Julien; Merrouche, Wassil; Chan, Henry Lik-Yuen; Marra, Fabio; Chan, Anthony Wing-Hung; Le Bail, Brigitte; Wong, Vincent Wai-Sun; Hiriart, Jean-Baptiste; Arena, Umberto; De Lédinghen, Victor; Wong, Grace Lai-Hung; Arena, Umberto.

In: Journal of Hepatology, Vol. 67, 2017, pag. 577-584.

Risultato della ricerca: Article

Craxi, A, Petta, S, Tuttolomondo, A, Camma', C, Vergniol, J, Merrouche, W, Chan, HL-Y, Marra, F, Chan, AW-H, Le Bail, B, Wong, VW-S, Hiriart, J-B, Arena, U, De Lédinghen, V, Wong, GL-H & Arena, U 2017, 'Validity criteria for the diagnosis of fatty liver by M probe-based controlled attenuation parameter', Journal of Hepatology, vol. 67, pagg. 577-584.
Craxi, Antonio ; Petta, Salvatore ; Tuttolomondo, Antonino ; Camma', Calogero ; Vergniol, Julien ; Merrouche, Wassil ; Chan, Henry Lik-Yuen ; Marra, Fabio ; Chan, Anthony Wing-Hung ; Le Bail, Brigitte ; Wong, Vincent Wai-Sun ; Hiriart, Jean-Baptiste ; Arena, Umberto ; De Lédinghen, Victor ; Wong, Grace Lai-Hung ; Arena, Umberto. / Validity criteria for the diagnosis of fatty liver by M probe-based controlled attenuation parameter. In: Journal of Hepatology. 2017 ; Vol. 67. pagg. 577-584.
@article{56d86a84d737414d82f840d7e6c2d741,
title = "Validity criteria for the diagnosis of fatty liver by M probe-based controlled attenuation parameter",
abstract = "Background & Aims Controlled attenuation parameter (CAP) can be performed together with liver stiffness measurement (LSM) by transient elastography (TE) and is often used to diagnose fatty liver. We aimed to define the validity criteria of CAP. Methods CAP was measured by the M probe prior to liver biopsy in 754 consecutive patients with different liver diseases at three centers in Europe and Hong Kong (derivation cohort, n = 340; validation cohort, n = 414; 101 chronic hepatitis B, 154 chronic hepatitis C, 349 non-alcoholic fatty liver disease, 37 autoimmune hepatitis, 49 cholestatic liver disease, 64 others; 277 F3-4; age 52 {\^A}± 14; body mass index 27.2 {\^A}± 5.3 kg/m2). The primary outcome was the diagnosis of fatty liver, defined as steatosis involving {\^a}¥5{\%} of hepatocytes. Results The area under the receiver-operating characteristics curve (AUROC) for CAP diagnosis of fatty liver was 0.85 (95{\%} CI 0.82{\^a}0.88). The interquartile range (IQR) of CAP had a negative correlation with CAP (r = {\^a}0.32, p <0.001), suggesting the IQR-to-median ratio of CAP would be an inappropriate validity parameter. In the derivation cohort, the IQR of CAP was associated with the accuracy of CAP (AUROC 0.86, 0.89 and 0.76 in patients with IQR of CAP <20 [15{\%} of patients], 20{\^a}39 [51{\%}], and {\^a}¥40 dB/m [33{\%}], respectively). Likewise, the AUROC of CAP in the validation cohort was 0.90 and 0.77 in patients with IQR of CAP <40 and {\^a}¥40 dB/m, respectively (p = 0.004). The accuracy of CAP in detecting grade 2 and 3 steatosis was lower among patients with body mass index {\^a}¥30 kg/m2and F3-4 fibrosis. Conclusions The validity of CAP for the diagnosis of fatty liver is lower if the IQR of CAP is {\^a}¥40 dB/m. Lay summary: Controlled attenuation parameter (CAP) is measured by transient elastography (TE) for the detection of fatty liver. In this large study, using liver biopsy as a reference, we show that the variability of CAP measurements based on its interquartile range can reflect the accuracy of fatty liver diagnosis. In contrast, other clinical factors such as adiposity and liver enzyme levels do not affect the performance of CAP.",
keywords = "Diagnostic accuracy, FibroScan, Hepatic steatosis, Hepatology, Liver biopsy, Liver stiffness measurement, Non-alcoholic fatty liver disease",
author = "Antonio Craxi and Salvatore Petta and Antonino Tuttolomondo and Calogero Camma' and Julien Vergniol and Wassil Merrouche and Chan, {Henry Lik-Yuen} and Fabio Marra and Chan, {Anthony Wing-Hung} and {Le Bail}, Brigitte and Wong, {Vincent Wai-Sun} and Jean-Baptiste Hiriart and Umberto Arena and {De L{\'e}dinghen}, Victor and Wong, {Grace Lai-Hung} and Umberto Arena",
year = "2017",
language = "English",
volume = "67",
pages = "577--584",
journal = "Journal of Hepatology",
issn = "0168-8278",
publisher = "Elsevier",

}

TY - JOUR

T1 - Validity criteria for the diagnosis of fatty liver by M probe-based controlled attenuation parameter

AU - Craxi, Antonio

AU - Petta, Salvatore

AU - Tuttolomondo, Antonino

AU - Camma', Calogero

AU - Vergniol, Julien

AU - Merrouche, Wassil

AU - Chan, Henry Lik-Yuen

AU - Marra, Fabio

AU - Chan, Anthony Wing-Hung

AU - Le Bail, Brigitte

AU - Wong, Vincent Wai-Sun

AU - Hiriart, Jean-Baptiste

AU - Arena, Umberto

AU - De Lédinghen, Victor

AU - Wong, Grace Lai-Hung

AU - Arena, Umberto

PY - 2017

Y1 - 2017

N2 - Background & Aims Controlled attenuation parameter (CAP) can be performed together with liver stiffness measurement (LSM) by transient elastography (TE) and is often used to diagnose fatty liver. We aimed to define the validity criteria of CAP. Methods CAP was measured by the M probe prior to liver biopsy in 754 consecutive patients with different liver diseases at three centers in Europe and Hong Kong (derivation cohort, n = 340; validation cohort, n = 414; 101 chronic hepatitis B, 154 chronic hepatitis C, 349 non-alcoholic fatty liver disease, 37 autoimmune hepatitis, 49 cholestatic liver disease, 64 others; 277 F3-4; age 52 ± 14; body mass index 27.2 ± 5.3 kg/m2). The primary outcome was the diagnosis of fatty liver, defined as steatosis involving â¥5% of hepatocytes. Results The area under the receiver-operating characteristics curve (AUROC) for CAP diagnosis of fatty liver was 0.85 (95% CI 0.82â0.88). The interquartile range (IQR) of CAP had a negative correlation with CAP (r = â0.32, p <0.001), suggesting the IQR-to-median ratio of CAP would be an inappropriate validity parameter. In the derivation cohort, the IQR of CAP was associated with the accuracy of CAP (AUROC 0.86, 0.89 and 0.76 in patients with IQR of CAP <20 [15% of patients], 20â39 [51%], and â¥40 dB/m [33%], respectively). Likewise, the AUROC of CAP in the validation cohort was 0.90 and 0.77 in patients with IQR of CAP <40 and â¥40 dB/m, respectively (p = 0.004). The accuracy of CAP in detecting grade 2 and 3 steatosis was lower among patients with body mass index â¥30 kg/m2and F3-4 fibrosis. Conclusions The validity of CAP for the diagnosis of fatty liver is lower if the IQR of CAP is â¥40 dB/m. Lay summary: Controlled attenuation parameter (CAP) is measured by transient elastography (TE) for the detection of fatty liver. In this large study, using liver biopsy as a reference, we show that the variability of CAP measurements based on its interquartile range can reflect the accuracy of fatty liver diagnosis. In contrast, other clinical factors such as adiposity and liver enzyme levels do not affect the performance of CAP.

AB - Background & Aims Controlled attenuation parameter (CAP) can be performed together with liver stiffness measurement (LSM) by transient elastography (TE) and is often used to diagnose fatty liver. We aimed to define the validity criteria of CAP. Methods CAP was measured by the M probe prior to liver biopsy in 754 consecutive patients with different liver diseases at three centers in Europe and Hong Kong (derivation cohort, n = 340; validation cohort, n = 414; 101 chronic hepatitis B, 154 chronic hepatitis C, 349 non-alcoholic fatty liver disease, 37 autoimmune hepatitis, 49 cholestatic liver disease, 64 others; 277 F3-4; age 52 ± 14; body mass index 27.2 ± 5.3 kg/m2). The primary outcome was the diagnosis of fatty liver, defined as steatosis involving â¥5% of hepatocytes. Results The area under the receiver-operating characteristics curve (AUROC) for CAP diagnosis of fatty liver was 0.85 (95% CI 0.82â0.88). The interquartile range (IQR) of CAP had a negative correlation with CAP (r = â0.32, p <0.001), suggesting the IQR-to-median ratio of CAP would be an inappropriate validity parameter. In the derivation cohort, the IQR of CAP was associated with the accuracy of CAP (AUROC 0.86, 0.89 and 0.76 in patients with IQR of CAP <20 [15% of patients], 20â39 [51%], and â¥40 dB/m [33%], respectively). Likewise, the AUROC of CAP in the validation cohort was 0.90 and 0.77 in patients with IQR of CAP <40 and â¥40 dB/m, respectively (p = 0.004). The accuracy of CAP in detecting grade 2 and 3 steatosis was lower among patients with body mass index â¥30 kg/m2and F3-4 fibrosis. Conclusions The validity of CAP for the diagnosis of fatty liver is lower if the IQR of CAP is â¥40 dB/m. Lay summary: Controlled attenuation parameter (CAP) is measured by transient elastography (TE) for the detection of fatty liver. In this large study, using liver biopsy as a reference, we show that the variability of CAP measurements based on its interquartile range can reflect the accuracy of fatty liver diagnosis. In contrast, other clinical factors such as adiposity and liver enzyme levels do not affect the performance of CAP.

KW - Diagnostic accuracy

KW - FibroScan

KW - Hepatic steatosis

KW - Hepatology

KW - Liver biopsy

KW - Liver stiffness measurement

KW - Non-alcoholic fatty liver disease

UR - http://hdl.handle.net/10447/248083

UR - http://www.sciencedirect.com/science/journal/01688278

M3 - Article

VL - 67

SP - 577

EP - 584

JO - Journal of Hepatology

JF - Journal of Hepatology

SN - 0168-8278

ER -