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Impact of skin capsular distance on the performance of controlled attenuation parameter in patients with chronic liver disease
Author(s) -
Shen Feng,
Zheng RuiDan,
Shi JunPing,
Mi YuQiang,
Chen GuoFeng,
Hu Xiqi,
Liu YongGang,
Wang XiaoYing,
Pan Qin,
Chen GuangYu,
Chen JianNeng,
Xu Liang,
Zhang RuiNan,
Xu LeiMing,
Fan JianGao
Publication year - 2015
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12809
Subject(s) - steatosis , medicine , gastroenterology , fatty liver , fibrosis , receiver operating characteristic , liver biopsy , youden's j statistic , biopsy , chronic liver disease , cirrhosis , disease
Abstract Background & Aims Controlled attenuation parameter ( CAP ) is a non‐invasive method for evaluating hepatic steatosis. However, larger skin capsular distance ( SCD ) can affect the accuracy. The aim of this study was to investigate the impact of SCD on the diagnostic performance of CAP and liver stiffness measurement ( LSM ). Methods Of 101 patients with non‐alcoholic fatty liver disease ( NAFLD ) and 280 patients with chronic hepatitis B ( CHB ) who underwent liver biopsy were prospectively recruited. CAP , LSM and SCD were performed using FibroScan with M probe. The areas under receiver operating characteristics curves ( AUROC s) were calculated to determine the diagnostic efficacy. The optimal thresholds were defined by the maximum Youden index. Results SCD (B 30.34, P < 0.001) and hepatic steatosis (B 23.04, P < 0.001) were independently associated with CAP by multivariate analysis. The AUROC s were slightly higher for SCD <25 mm compared to those for SCD ≥25 mm for steatosis ≥5% (0.88 vs. 0.81), >33% (0.90 vs. 0.85) and >66% (0.84 vs. 0.72). For SCD <25 mm, the optimal CAP cut‐offs for differentiating steatosis ≥5%, >33% and >66% were 255.0 dB /m, 283.5 dB /m and 293.5 dB /m. However, cut‐offs were elevated by approximately 60–70 dB /m for SCD ≥25 mm. When stratified by fibrosis grade, LSM was significantly affected by SCD ≥25 mm for advanced fibrosis (≥F3) in NAFLD , but not in CHB. Conclusion CAP is a promising tool for detecting and quantifying hepatic steatosis. SCD ≥25 mm may cause overestimation of steatosis. Similarly, SCD ≥25 mm affects the detection of advanced fibrosis by LSM in NAFLD patients.