Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) has emerged a major challenge and become the leading indication for liver transplantation. We aimed to assess the applicability and performance of real-time elastography (RTE) in diagnosis of liver fibrosis in patients with NAFLD compared with NAFLD fibrosis score (NFS) and FIB-4 index. Patients and Methods: A prospective case-control study was conducted on 260 subjects attended Hepatology, Gastroenterology and Infectious diseases and Internal Medicine departments in Benha University Hospital from Marsh 20, 2018, to September 1, 2019 and divided into group I included 200 cases with NAFLD and group II included 60 healthy control subjects. Results: There was statistically significant increase in FIB-4 scores between two groups (1.39 ± 1.02 and -0.75 ± 0.32 respectively with p Conclusion: Real time elastography could be valuable in diagnosis of fibrosis in NAFLD especially in cases more than F3 score.
Highlights
Non-alcoholic fatty liver disease (NAFLD) has emerged a major challenge because of its prevalence, difficulties in diagnosis, complex pathogenesis, and lack of approved therapies [1]
Diagnostic performance of real-time elastography (RTE) in advanced liver fibrosis ≥ F3 was assessed in comparing with FIB-4 index show sensitivity 90%, specificity 93.3%, Positive predictive value NPV (PPV) 60%, NPV 98.8% and accuracy 93% with AUC0.917 (p = 0.001) and in comparing with NAFLD fibrosis score sensitivity 52.6%, specificity 93.8%, PPV 66.7%, NPV 98.4% and accuracy 86% with Area under the Curve NAFLD fibrosis score (NFS) (AUC) 0.732 (p = 0.002)
The global prevalence of NAFLD diagnosed by imaging is around 25.24% the highest prevalence of NAFLD is reported from the Middle East (31.79%) and South America (30.45% [95% CI, 22.74 - 39.440]) and the lowest prevalence rate is reported from Africa (13.48%) [6] liver biopsy has been the gold standard for diagnosis and staging of liver fibrosis, it cannot be used as a routine screening tool to detect or monitor fibrosis progression in NAFLD as there are many drawbacks of liver biopsy, including variable accessibility, high cost, sampling errors, and inaccuracy due to inter- and intra-observer variability of pathologic interpretations [7]
Summary
Non-alcoholic fatty liver disease (NAFLD) has emerged a major challenge because of its prevalence, difficulties in diagnosis, complex pathogenesis, and lack of approved therapies [1]. Non-alcoholic fatty liver disease (NAFLD) has emerged a major challenge and become the leading indication for liver transplantation. We aimed to assess the applicability and performance of real-time elastography (RTE) in diagnosis of liver fibrosis in patients with NAFLD compared with NAFLD fibrosis score (NFS) and FIB-4 index. Diagnostic performance of RTE in advanced liver fibrosis ≥ F3 was assessed in comparing with FIB-4 index show sensitivity 90%, specificity 93.3%, PPV 60%, NPV 98.8% and accuracy 93% with AUC0.917 (p = 0.001) and in comparing with NAFLD fibrosis score sensitivity 52.6%, specificity 93.8%, PPV 66.7%, NPV 98.4% and accuracy 86% with AUC 0.732 (p = 0.002). Conclusion: Real time elastography could be valuable in diagnosis of fibrosis in NAFLD especially in cases more than F3 score
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