Transient elastography for diagnosing liver cirrhosis

Background and objective: Detection of liver cirrhosis has numerous implications because of the potential sequelae of cirrhosis. Transient elastography (Fibroscan (R)), was evaluated as a novel, non-invasive means of assessing cirrhosis by measuring liver stiffness. Methods: 147 consecutive patients with different forms of liver disease and histologically determined stages of liver fibrosis were prospectively studied by transient elastography. 48 patients had liver cirrhosis. Results: The number of transient elastographic measurements per patient was 12 +/- 4 (range 6-30). Valid elastography measurements were available for 135 out of 147 patients (92%). The results of transient elastography correlated positively with the histological score of liver fibrosis (r=0.8; 95% Cl: 0.72-0.85; p < 0.001). Areas under the receiver operating characteristic curve (AUROC) were 0.91 for >= F3 fibrosis (95% Cl: 0.85-0.96) and 0.94 for cirrhosis (95% Cl: 0.90-0.98). Using a cut-off value of 13 kPa for detection of liver cirrhosis a sensitivity of 90%, a specificity of 82%, a positive predictive value of 71% and a negative predictive value of 95% were obtained. Conclusions: Measuring liver stiffness by transient elastography proved to be an easy method to assess liver cirrhosis. in combination with clinical signs, ultrasound and biochemical markers non-invasive diagnosis of liver cirrhosis will be further improved.