Unified interpretation of liver stiffness measurement by M and XL probes in non-alcoholic fatty liver disease

Wong, Vincent Wai-Sun and Irles, Marie and Wong, Grace Lai-Hung and Shili, Sarah and Chan, Anthony Wing-Hung and Merrouche, Wassil and Shu, Sally She-Ting and Foucher, Juliette and Le Bail, Brigitte and Chan, Wah Kheong and Chan, Henry Lik-Yuen and de Ledinghen, Victor (2019) Unified interpretation of liver stiffness measurement by M and XL probes in non-alcoholic fatty liver disease. Gut, 68 (11). pp. 2057-2064. ISSN 0017-5749, DOI https://doi.org/10.1136/gutjnl-2018-317334.

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Official URL: https://doi.org/10.1136/gutjnl-2018-317334


Objective The latest model of vibration-controlled transient elastography (VCTE) automatically selects M or XL probe according to patients' body built. We aim to test the application of a unified interpretation of VCTE results with probes appropriate for the body mass index (BMI) and hypothesise that this approach is not affected by hepatic steatosis. Design We prospectively recruited 496 patients with non-alcoholic fatty liver disease who underwent VCTE by both M and XL probes within 1 week before liver biopsy. Results 391 (78.8%) and 433 (87.3%) patients had reliable liver stiffness measurement (LSM) (10 successful acquisitions and IQR:median ratio ≤0.30) by M and XL probes, respectively (p<0.001). The area under the receiver operating characteristic curves was similar between the two probes (0.75-0.88 for F2-4, 0.83-0.91 for F4). When used in the same patient, LSM by XL probe was lower than that by M probe (mean difference 2.3 kPa). In contrast, patients with BMI ≥30 kg/m 2 had higher LSM regardless of the probe used. When M and XL probes were used in patients with BMI <30 and ≥30 kg/m 2, respectively, they yielded nearly identical median LSM at each fibrosis stage and similar diagnostic performance. Severe steatosis did not increase LSM or the rate of false-positive diagnosis by XL probe. Conclusion High BMI but not severe steatosis increases LSM. The same LSM cut-offs can be used without further adjustment for steatosis when M and XL probes are used according to the appropriate BMI. © 2019 Author(s).

Item Type: Article
Funders: Research grant council of the Hong Kong Sar government (Project ref 14108916)
Uncontrolled Keywords: fatty liver; hepatic fibrosis; liver biopsy; liver cirrhosis; nonalcoholic steatohepatitis
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 29 Nov 2019 03:49
Last Modified: 29 Nov 2019 03:49
URI: http://eprints.um.edu.my/id/eprint/23151

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