Articles

Diagnostic Accuracy of Vibration Controlled Transient Elastography in Noninvasive Assessment of Hepatic Fibrosis in Nonalcoholic Fatty Liver Disease

8/17/2021 3:26:33 PM
Introduction

Liver biopsy is the current gold standard for diagnosing hepatic fibrosis; however, it has some limitations, such as life-threatening complications, low acceptance by the patients, and variations in the related sample. On the other hand, given the epidemiologically considerable number of Non-Alcoholic Fatty Liver Disease (NAFLD) patients globally, it is not feasible to perform the patient follow-ups using liver biopsy. Therefore, there is a need for the development of non-invasive investigations for diagnosing hepatic fibrosis. Vibration-Controlled Transient Elastography (VCTE) is one of these non-invasive methods.

Method

The present study included 73 patients suffering from NAFLD who were older than 18years. The patients underwent VCTE by an experienced physician at the Hospital. Then, they underwent a liver biopsy under ultrasound guidance by an experienced radiologist in the same hospital. ROC curve of different fibrosis stages was used to evaluate the VCTE verification. Then, the sensitivity and specificity of the method were calculated.

Results

VCTE could detect any fibrosis (stage 1 and higher) with an Area Under the ROC curve (AUROC) of 0.381 (95% CI: 0.258-0.517). Moreover, it detected stage 2-4 fibrosis with an AUROC of 0.400 (95% CI: 0.212-0.588), stage 3-4 fibrosis with an AUROC of 0.687 (95% CI: 0.507-0.881), and stage 4 fibrosis with an AUROC of 0.984 (95% CI: 0.9621.00). the area under the curve in advanced fibrosis and cirrhosis is very close to one and the ideal state, which shows the very high sensitivity of the VCTE method in the diagnosis of advanced liver fibrosis and cirrhosis. Also given the 100% NPV in stage 4, VCTE should be considered as a good non-invasive method to rule out cirrhosis.

Conclusion

the VCTE has high clinical validity in diagnosing the advanced stages of fibrosis and can be a suitable alternative to the invasive method of liver biopsy with high reliability.