Accuracy of the ElastPQ® technique for the assessment of liver fibrosis in patients with chronic hepatitis C: A “real life” single center study

Giovanna Ferraioli, Laura Maiocchi, Raffaella Lissandrin, Carmine Tinelli, Annalisa De Silvestri, Carlo Filice, Elisabetta Above, Giorgio Barbarini, Raffaele Bruno, Silvia Corona, Carolina Dellafior, Marta Di Gregorio, Roberto Gulminetti, Paolo Lanzarini, Serena Ludovisi, Antonello Malfitano, Renato Maserati, Giuseppe Michelone, Lorenzo Minoli, Mario MondelliStefano Novati, Savino F A Patruno, Gianluigi Poma, Paolo Sacchi, Domenico Zanaboni, Liver Fibrosis Study Group

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Abstract

Background & Aims: Noninvasive assessment of liver stiffness has been increasingly used to evaluate fibrosis instead of liver biopsy, especially in patients with chronic viral hepatitis. The aim of this study was to assess the performance in staging liver fibrosis of the updated ElastPQ® technique (EPIQ7 ultrasound system, Philips Healthcare, Bothell, WA, USA) in the “real life” setting by using the FibroScan as the reference standard and to understand whether the use of the quality criteria improves the performance of the technique. Methods: This was a cross-sectional study: 278 patients affected by chronic hepatitis C referred for liver stiffness measurement with the FibroScan® 502 Touch device (Echosens, Paris, France) underwent measurements also with the ElastPQ® technique. For the assessment of significant fibrosis (F≥2), advanced fibrosis (F≥3) and cirrhosis (F=4), respectively, we used the cutoffs of 7.0, 9.5 and 12.0 kPa. The diagnostic performance of ElastPQ® was assessed using the area under the ROC (AUROC) curve analysis and was evaluated overall and for cases with (a) 10 measurements and IQR/M≤30%, (b) 5 measurements and IQR/M ≤30%, (c) 10 measurements and IQR/M>30%, (d) 5 measurements and IQR/M>30%. Results: The optimal cutoffs of ElastPQ® for significant fibrosis, advanced fibrosis and cirrhosis were 6.43, 9.54 and 11.34 kPa, respectively. For measurements with an IQR/M≤30%, there was no statistically significant decrease in sensitivity between 10 and 5 measurements (p=0.26, p=0.09, p=0.71, for F≥2, F≥3, and F=4, respectively). Conclusion: The ElastPQ® technique is reliable and accurate for staging liver fibrosis. The number of measurements does not affect the performance.

Original languageEnglish
Pages (from-to)331-335
Number of pages5
JournalJournal of Gastrointestinal and Liver Diseases
Volume25
Issue number3
Publication statusPublished - Sep 1 2016

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Chronic Hepatitis C
Liver Cirrhosis
Fibrosis
ROC Curve
Liver
Touch
Paris
Chronic Hepatitis
France
Area Under Curve
Cross-Sectional Studies
Delivery of Health Care
Biopsy
Equipment and Supplies

Keywords

  • Chronic hepatitis C
  • Liver cirrhosis
  • Liver stiffness
  • Shear wave elastography
  • Transient elastography

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{12215d2f304f4f479ec8c66cde5517a2,
title = "Accuracy of the ElastPQ{\circledR} technique for the assessment of liver fibrosis in patients with chronic hepatitis C: A “real life” single center study",
abstract = "Background & Aims: Noninvasive assessment of liver stiffness has been increasingly used to evaluate fibrosis instead of liver biopsy, especially in patients with chronic viral hepatitis. The aim of this study was to assess the performance in staging liver fibrosis of the updated ElastPQ{\circledR} technique (EPIQ7 ultrasound system, Philips Healthcare, Bothell, WA, USA) in the “real life” setting by using the FibroScan as the reference standard and to understand whether the use of the quality criteria improves the performance of the technique. Methods: This was a cross-sectional study: 278 patients affected by chronic hepatitis C referred for liver stiffness measurement with the FibroScan{\circledR} 502 Touch device (Echosens, Paris, France) underwent measurements also with the ElastPQ{\circledR} technique. For the assessment of significant fibrosis (F≥2), advanced fibrosis (F≥3) and cirrhosis (F=4), respectively, we used the cutoffs of 7.0, 9.5 and 12.0 kPa. The diagnostic performance of ElastPQ{\circledR} was assessed using the area under the ROC (AUROC) curve analysis and was evaluated overall and for cases with (a) 10 measurements and IQR/M≤30{\%}, (b) 5 measurements and IQR/M ≤30{\%}, (c) 10 measurements and IQR/M>30{\%}, (d) 5 measurements and IQR/M>30{\%}. Results: The optimal cutoffs of ElastPQ{\circledR} for significant fibrosis, advanced fibrosis and cirrhosis were 6.43, 9.54 and 11.34 kPa, respectively. For measurements with an IQR/M≤30{\%}, there was no statistically significant decrease in sensitivity between 10 and 5 measurements (p=0.26, p=0.09, p=0.71, for F≥2, F≥3, and F=4, respectively). Conclusion: The ElastPQ{\circledR} technique is reliable and accurate for staging liver fibrosis. The number of measurements does not affect the performance.",
keywords = "Chronic hepatitis C, Liver cirrhosis, Liver stiffness, Shear wave elastography, Transient elastography",
author = "Giovanna Ferraioli and Laura Maiocchi and Raffaella Lissandrin and Carmine Tinelli and {De Silvestri}, Annalisa and Carlo Filice and Elisabetta Above and Giorgio Barbarini and Raffaele Bruno and Silvia Corona and Carolina Dellafior and {Di Gregorio}, Marta and Roberto Gulminetti and Paolo Lanzarini and Serena Ludovisi and Antonello Malfitano and Renato Maserati and Giuseppe Michelone and Lorenzo Minoli and Mario Mondelli and Stefano Novati and Patruno, {Savino F A} and Gianluigi Poma and Paolo Sacchi and Domenico Zanaboni and {Liver Fibrosis Study Group}",
year = "2016",
month = "9",
day = "1",
language = "English",
volume = "25",
pages = "331--335",
journal = "Journal of Gastrointestinal and Liver Diseases",
issn = "1841-8724",
publisher = "Romanian Society of Gastroenterology",
number = "3",

}

TY - JOUR

T1 - Accuracy of the ElastPQ® technique for the assessment of liver fibrosis in patients with chronic hepatitis C

T2 - A “real life” single center study

AU - Ferraioli, Giovanna

AU - Maiocchi, Laura

AU - Lissandrin, Raffaella

AU - Tinelli, Carmine

AU - De Silvestri, Annalisa

AU - Filice, Carlo

AU - Above, Elisabetta

AU - Barbarini, Giorgio

AU - Bruno, Raffaele

AU - Corona, Silvia

AU - Dellafior, Carolina

AU - Di Gregorio, Marta

AU - Gulminetti, Roberto

AU - Lanzarini, Paolo

AU - Ludovisi, Serena

AU - Malfitano, Antonello

AU - Maserati, Renato

AU - Michelone, Giuseppe

AU - Minoli, Lorenzo

AU - Mondelli, Mario

AU - Novati, Stefano

AU - Patruno, Savino F A

AU - Poma, Gianluigi

AU - Sacchi, Paolo

AU - Zanaboni, Domenico

AU - Liver Fibrosis Study Group

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Background & Aims: Noninvasive assessment of liver stiffness has been increasingly used to evaluate fibrosis instead of liver biopsy, especially in patients with chronic viral hepatitis. The aim of this study was to assess the performance in staging liver fibrosis of the updated ElastPQ® technique (EPIQ7 ultrasound system, Philips Healthcare, Bothell, WA, USA) in the “real life” setting by using the FibroScan as the reference standard and to understand whether the use of the quality criteria improves the performance of the technique. Methods: This was a cross-sectional study: 278 patients affected by chronic hepatitis C referred for liver stiffness measurement with the FibroScan® 502 Touch device (Echosens, Paris, France) underwent measurements also with the ElastPQ® technique. For the assessment of significant fibrosis (F≥2), advanced fibrosis (F≥3) and cirrhosis (F=4), respectively, we used the cutoffs of 7.0, 9.5 and 12.0 kPa. The diagnostic performance of ElastPQ® was assessed using the area under the ROC (AUROC) curve analysis and was evaluated overall and for cases with (a) 10 measurements and IQR/M≤30%, (b) 5 measurements and IQR/M ≤30%, (c) 10 measurements and IQR/M>30%, (d) 5 measurements and IQR/M>30%. Results: The optimal cutoffs of ElastPQ® for significant fibrosis, advanced fibrosis and cirrhosis were 6.43, 9.54 and 11.34 kPa, respectively. For measurements with an IQR/M≤30%, there was no statistically significant decrease in sensitivity between 10 and 5 measurements (p=0.26, p=0.09, p=0.71, for F≥2, F≥3, and F=4, respectively). Conclusion: The ElastPQ® technique is reliable and accurate for staging liver fibrosis. The number of measurements does not affect the performance.

AB - Background & Aims: Noninvasive assessment of liver stiffness has been increasingly used to evaluate fibrosis instead of liver biopsy, especially in patients with chronic viral hepatitis. The aim of this study was to assess the performance in staging liver fibrosis of the updated ElastPQ® technique (EPIQ7 ultrasound system, Philips Healthcare, Bothell, WA, USA) in the “real life” setting by using the FibroScan as the reference standard and to understand whether the use of the quality criteria improves the performance of the technique. Methods: This was a cross-sectional study: 278 patients affected by chronic hepatitis C referred for liver stiffness measurement with the FibroScan® 502 Touch device (Echosens, Paris, France) underwent measurements also with the ElastPQ® technique. For the assessment of significant fibrosis (F≥2), advanced fibrosis (F≥3) and cirrhosis (F=4), respectively, we used the cutoffs of 7.0, 9.5 and 12.0 kPa. The diagnostic performance of ElastPQ® was assessed using the area under the ROC (AUROC) curve analysis and was evaluated overall and for cases with (a) 10 measurements and IQR/M≤30%, (b) 5 measurements and IQR/M ≤30%, (c) 10 measurements and IQR/M>30%, (d) 5 measurements and IQR/M>30%. Results: The optimal cutoffs of ElastPQ® for significant fibrosis, advanced fibrosis and cirrhosis were 6.43, 9.54 and 11.34 kPa, respectively. For measurements with an IQR/M≤30%, there was no statistically significant decrease in sensitivity between 10 and 5 measurements (p=0.26, p=0.09, p=0.71, for F≥2, F≥3, and F=4, respectively). Conclusion: The ElastPQ® technique is reliable and accurate for staging liver fibrosis. The number of measurements does not affect the performance.

KW - Chronic hepatitis C

KW - Liver cirrhosis

KW - Liver stiffness

KW - Shear wave elastography

KW - Transient elastography

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EP - 335

JO - Journal of Gastrointestinal and Liver Diseases

JF - Journal of Gastrointestinal and Liver Diseases

SN - 1841-8724

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