Research Article
Diagnosis of liver fibrosis and cirrhosis using liver stiffness measurement: Comparison between M and XL probe of FibroScan®- Victor de Lédinghen1, 2, , ,
- Vincent Wai-Sun Wong3, 4,
- Julien Vergniol1,
- Grace Lai-Hung Wong3, 4,
- Juliette Foucher1,
- Shirley Ho-Ting Chu3, 4,
- Brigitte Le Bail2, 5,
- Paul Cheung-Lung Choi6,
- Faiza Chermak1,
- Karen Kar-Lum Yiu3, 4,
- Wassil Merrouche1,
- Henry Lik-Yuen Chan3, 4
- 1 Centre d’Investigation de la Fibrose Hépatique, Centre Hospitalier Universitaire (CHU) de Bordeaux, Hôpital Haut-Lévêque, France
- 2 Institut National de la Santé et de la Recherche Médicale U1053, Université Bordeaux Segalen, Bordeaux, France
- 3 Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
- 4 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
- 5 Service d’Anatomie Pathologique, CHU de Bordeaux, Hôpital Pellegrin, France
- 6 Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Hong Kong, China
- Received 20 August 2011. Revised 15 October 2011. Accepted 17 October 2011. Available online 13 December 2011.
Background & AimsUnreliable results of liver stiffness measurement are obtained in 16% of cases and are independently associated with body mass index (BMI) greater than 30 kg/m2. A new FibroScan® probe (XL probe) was designed specifically for obese patients. The aim of this study was to evaluate the accuracy of liver stiffness measurement using M and XL probes of Fibroscan® for the diagnosis of fibrosis and cirrhosis in a large cohort of patients. MethodsConsecutive patients undergoing liver biopsies for chronic liver disease were prospectively recruited. Liver stiffness measurement was performed within 1 week before liver biopsy using both M and XL probes of FibroScan®. ResultsA total of 286 patients were evaluated. A reliable liver stiffness measurement using M probe was obtained in 79.7% of cases. In the other 21.3%, liver stiffness measurement using XL probe was obtained in 56.9% of patients. A strong correlation was found between M and XL values, regardless of BMI. In all groups, median liver stiffness measurement using the XL probe was significantly lower than liver stiffness measurement using the M probe. By multivariate analysis, unsuccessful liver stiffness examination with M probe was independently associated with age >50 years and BMI >30 kg/m2. By univariate analysis, only BMI >30 kg/m2 was associated with unsuccessful liver stiffness measurement with XL probe. No significant difference was observed between the M and XL probes for the diagnosis of liver fibrosis. ConclusionsLiver stiffness measurement with either M or XL probe is possible in 91.2% of patients with comparable diagnostic accuracy. In clinical practice, the M probe could be used as first step for liver stiffness measurement. In case of no valid shot or unreliable measurement, the XL probe could be used. This result could be useful for the assessment of liver fibrosis in NAFLD and/or obese patients.
|