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Validation of the FibroScan‐aspartate aminotransferase score by vibration‐controlled transient and B‐mode ultrasound elastography
Author(s) -
Hirooka Masashi,
Koizumi Yohei,
Yano Ryo,
Sunago Kotarou,
Watanabe Takao,
Yoshida Osamu,
Tokumoto Yoshio,
Abe Masanori,
Hiasa Yoichi
Publication year - 2021
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.13646
Subject(s) - transient elastography , medicine , elastography , steatohepatitis , liver biopsy , ultrasound , receiver operating characteristic , gastroenterology , fatty liver , radiology , nuclear medicine , biopsy , disease
Aim The FibroScan‐aspartate aminotransferase (FAST) score comprises an easy and feasible method for identifying advanced non‐alcoholic steatohepatitis. Recently, shear‐wave elastography and attenuation coefficient measurement on B‐mode ultrasound (US) have become widely utilized. We investigated the diagnostic accuracy of the FAST score as calculated using US‐elastography compared with that using vibration‐controlled transient elastography (VCTE). Methods Patients with chronic liver disease who underwent VCTE, point‐shear‐wave elastography with attenuation coefficient measurement, and liver biopsy on the same day between January 2015 and September 2020 were retrospectively reviewed. Results Of 189 patients, 94 underwent VCTE using both M and XL probes. The C‐statistics were similar for VCTE (0.846) and US‐elastography (0.814; p = 0.251), and for M (0.857) and XL probes (0.833; p = 0.412). Scatter and Bland–Altman plots showed good reproducibility for the FAST score. For VCTE, a cut‐off of ≤0.35 had a sensitivity of 92.3%, negative predictive value of 85.5%, and negative likelihood ratio of 0.14, and a cut‐off of ≥0.67 had a specificity of 90.6%, positive predictive value of 88.1%, and positive likelihood ratio of 6.03, for ruling out and in advanced non‐alcoholic steatohepatitis, respectively. For US‐elastography, a cut‐off of ≤0.35 had a sensitivity of 90.4%, negative predictive value of 83.3%, and negative likelihood ratio of 0.16, and a cutoff of ≥0.67 had a specificity of 91.8%, positive predictive value of 85.1%, and positive likelihood ratio of 4.67, for ruling out and in advanced non‐alcoholic steatohepatitis, respectively. Conclusions The FAST score is highly reproducible, even when different echo equipment or probes are used.