The efficacy of measuring liver stiffness for the assessment of liver fibrosis in patients with chronic liver diseases

Kim, Eun Sun; Seo, Yeon Seok; Lee, Kwang Gyun; Park, Sanghoon; Kwon, Yong Dae; Keum, Bora; Kim, Yong Sik; Jeen, Yoon Tae; Chun, Hoon Jai; Kim, Chang Duck; Ryu, Ho Sang; Um, Soon Ho

Abstract

BACKGROUND/AIMS: Accurate assessment of liver fibrosis is very important for predicting the prognosis of patients with chronic liver diseases. Liver biopsy is still considered the gold-standard for assessing liver fibrosis. However, it is an invasive procedure with several limitations such as its questionable outcomes. Recent studies have suggested that liver stiffness measurement (LSM) using Fibroscan is noninvasive and useful for assessing liver fibrosis. This study was performed to evaluate the efficacy of LSM for evaluating liver fibrosis in patients with chronic liver diseases.
METHODS
We prospectively enrolled 93 patients with chronic liver diseases, as confirmed by liver biopsy. The patients underwent liver biopsy and LSM. The METAVIR liver fibrosis stages of the biopsy specimens were assessed by an experienced pathologist. LSM was performed by Fibroscan. The efficacy of LSM and the optimal cutoff values for assessment of the fibrosis stage were determined by a receiver-operating characteristics (ROC) curve analysis.
RESULTS
LSM was well correlated with the fibrosis stage (Kendall correlation coefficient: 0.58; p<0.001). The areas under the ROC curves were 0.871 (95% CI, 0.715-0.924) for the patients with significant fibrosis (F> or =2), 0.874 (0.761-0.929) for the patients with severe fibrosis (F> or =3) and 0.894 (0.792-0.956) for the patients with cirrhosis (F=4). The optimal LSM cutoff values for F > or =2, F > or =3 and F=4 were 6.9, 11.75 and 14.5 kPa, respectively.
CONCLUSIONS
LSM was a simple, effective method for assessing liver fibrosis in patients with chronic liver diseases. Its use for the follow up and management of these patients could be of great interest and so further investigation is required.