Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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A Prospective Blinded Study of Endoscopic Ultrasound Elastography in Liver Disease: Towards a Virtual Biopsy

  • Schulman, Allison R. (Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital) ;
  • Lin, Ming V. (Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital) ;
  • Rutherford, Anna (Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital) ;
  • Chan, Walter W. (Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital) ;
  • Ryou, Marvin (Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital)
  • Received : 2017.06.09
  • Accepted : 2017.10.26
  • Published : 2018.03.30
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Abstract

Background/Aims: Liver biopsy has traditionally been used for determining the degree of fibrosis, however there are several limitations. Endoscopic ultrasound (EUS) real-time elastography (RTE) is a novel technology that uses image enhancement to display differences in tissue compressibility. We sought to assess whether liver fibrosis index (LFI) can distinguish normal, fatty, and cirrhotic liver tissue. Methods: A total of 50 patients undergoing EUS were prospectively enrolled. RTE of the liver was performed to synthesize the LFI in each patient. Univariate and multivariable analyses were performed. Chi-square and t-tests were performed for categorical and continuous variables, respectively. A p-value of <0.05 was considered significant. Results: Abdominal imaging prior to endoscopic evaluation suggested normal tissue, fatty liver, and cirrhosis in 26, 16, and 8 patients, respectively. Patients with cirrhosis had significantly increased mean LFI compared to the fatty liver (3.2 vs. 1.7, p<0.001) and normal (3.2 vs. 0.8, p<0.001) groups. The fatty liver group showed significantly increased LFI compared to the normal group (3.8 vs. 1.4, p<0.001). Multivariable regression analysis suggested that LFI was an independent predictor of group features (p<0.001). Conclusions: LFI computed from RTE images significantly correlates with abdominal imaging and can distinguish normal, fatty, and cirrhotic-appearing livers; therefore, LFI may play an important role in patients with chronic liver disease.

Keywords

References

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