Multicenter prospective study to validate a new transient elastography device for staging liver fibrosis in patients with chronic hepatitis B

J Dig Dis. 2020 Sep;21(9):519-525. doi: 10.1111/1751-2980.12924.

Abstract

Objectives: To validate the operational and diagnostic performances of a new device for transient elastography (TE), FibroTouch, for liver fibrosis in patients with chronic hepatitis B (CHB).

Methods: In this prospective multicenter study, adult patients with CHB and valid liver pathological results were recruited to validate the operational and diagnostic performance of a TE device by FibroTouch for staging liver fibrosis.

Results: In total, 517 patients with histologically proven CHB were enrolled. All had achieved at least 10 successful liver stiffness measurements (LSM), resulting in a success rate of 99.1% and reliable evaluations of 95.2%. Altogether 412 patients were included to analyze the diagnostic performance of FibroTouch. The area under the receiver operating characteristic curve for the LSM was 0.846 (95% confidence interval [CI] 0.808-0.880) for fibrosis stage ≥ F1, 0.850 (95% CI 0.811-0.883) for ≥ F2, 0.908 (95% CI 0.876-0.934) for ≥ F3 and 0.874 (95% CI 0.836-0.903) for F4. The diagnostic accuracy of LSM was superior to that of gamma-glutamyl transpeptidase-to-platelet ratio (GPR), aminotransferase-to-platelet ratio index (APRI), or fibrosis index based on 4 factors (FIB-4) index in staging fibrosis F2-F4 (P = 0.007 to < 0.0001). Optimal LSM cut-off values for diagnosing fibrosis stage ≥ F1, ≥ F2, ≥ F3, and F4 were 5.5 kPa, 7.85 kPa, 10.0 kPa, and 12.7 kPa, respectively.

Conclusion: FibroTouch has a high success rate and good reliability in staging liver fibrosis in patients with CHB.

Keywords: chronic hepatitis B; diagnosis; fibrosis; liver biopsy; transient elastography.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Biopsy
  • Elasticity Imaging Techniques*
  • Hepatitis B, Chronic* / pathology
  • Humans
  • Liver / pathology
  • Liver Cirrhosis / pathology
  • Prospective Studies
  • ROC Curve
  • Reproducibility of Results