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Usefulness of virtual touch quantification for staging liver fibrosis in patients with hepatitis C, and factors affecting liver stiffness measurement failure compared with liver biopsy
Author(s) -
Tsukano Natsumi,
Miyase Shiho,
Saeki Tatsuhiko,
Mizobe Keiko,
Iwashita Hirofumi,
Arima Nobuyuki,
Fujiyama Shigetoshi
Publication year - 2018
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13041
Subject(s) - medicine , receiver operating characteristic , fibrosis , stage (stratigraphy) , pathological , liver biopsy , liver fibrosis , cirrhosis , gastroenterology , biopsy , pathology , paleontology , biology
Aim The assessment of liver fibrosis in patients with hepatitis C is important to predict carcinogenesis. In this study, we evaluated the usefulness of virtual touch quantification (VTQ) for staging liver fibrosis, and investigated factors causing discrepancies between the estimated fibrosis stage using VTQ and the pathological fibrosis stage. Methods Patients with hepatitis C ( n = 302) were assessed using VTQ and underwent pathological liver investigation within 1 week before and after VTQ. A receiver operator characteristic (ROC) curve was obtained for VTQ, fibrosis‐4 (FIB‐4) index, and aspartate aminotransferase‐to‐platelet ratio index (APRI), and each area under the ROC curve (AUROC) was compared to predict fibrosis stage. We used univariate and multivariate analyses to investigate the factors related to the discrepancy between the estimated fibrosis stage using VTQ and the pathological fibrosis stage. Results At any stage, VTQ was the most accurate for staging liver fibrosis. The VTQ cut‐off values were 1.33 m/s (AUROC = 0.822) for ≥F2, 1.51 m/s (AUROC = 0.836) for ≥F3, and 1.92 m/s (AUROC = 0.890) for F4. Skin liver capsule distance (SCD) was the most relevant factor for the discrepancy between the estimated fibrosis stage using VTQ and the pathological fibrosis stage. The SCD cut‐off value was 17.5 mm. Conclusions Virtual touch quantification is a non‐invasive, simple method that is more accurate for staging liver fibrosis than the FIB‐4 index and APRI. However, when the SCD is longer than 17.5 mm, there may be measurement failures.