7 recent reports on noninvasive fibrosis detection, staging

Recent studies of early liver fibrosis and advanced fibrosis or cirrhosis have analyzed several noninvasive methods to accurately detect fibrosis, stage fibrosis, and improve survival through early detection. Other studies have taken the next step after detection to determine the safety of certain gastrointestinal procedures in patients with fibrosis and hospitalization outcomes.

The following studies include data on elastography point quantification, virtual touch quantification, and deep learning radiomics of elastography for fibrosis staging, as well as survival outcomes based on level of fibrosis or cirrhosis.

Elastography point quantification accurately stages fibrosis

Elastography point quantification displayed good to excellent performance as a noninvasive measurement of liver fibrosis staging among patients with chronic liver disease, according to a recently published study.

“This technique provides similar diagnostic performance compared with (transient elastography [TE]) in identification of all stages of fibrosis but, with respect to TE, is implemented on conventional ultrasound systems and has the advantage of B-mode imaging TE,” Fabio Conti, MD, PhD, from the University of Bologna in Italy, and colleagues wrote. Read more

Bariatric surgery safe in compensated cirrhosis

Patients with nonalcoholic fatty liver disease and compensated cirrhosis who underwent bariatric surgery did not have higher rates of in-hospital mortality compared with patients without cirrhosis who underwent the procedure, according to a study presented at Digestive Disease Week 2018.

“Obesity is associated with NAFLD, which in 20% to 40% of cases leads to cirrhosis,” Abdulfatah Issak, MD, from the Ohio State University, said in his presentation. “There are many behavioral, medical and surgical approaches to the treatment of weight loss for morbid obesity. However, bariatric surgery is the most effective weight loss strategy, and in the U.S. its use has increased from 160,000 cases per year in 2011 to 200,000 cases per year in 2016.” Read more

Cirrhosis biomarker predicts 1-year mortality after hospitalization

Neutrophil-to-lymphocyte ratio as a biomarker correlated with 1-year mortality after nonelective hospitalization in patients with cirrhosis, according to published results of a retrospective study.

“The neutrophil-to-lymphocyte ratio (NLR) is an inexpensive, objective, reliable, and widely available biomarker that we and others have shown to be predictive of mortality in patients with cirrhosis,” Jonathan Rice, MD, from the University of Colorado, and colleagues wrote. “NLR is easily calculated from a routinely available complete blood cell count by dividing absolute neutrophil count by absolute lymphocyte count.” Read more

PAGE BREAK

New virtual touch quantification criteria offer reliable fibrosis detection

Researchers developed new and comprehensive reliability criteria for virtual touch quantification to assess liver fibrosis based on the interquartile range/median ratio and the shear wave speed measurement result, according to recently published data.

“The correct interpretation of elastography results plays a crucial role in ensuring appropriate patient management, but remains a challenge for physicians, as several conditions other than liver fibrosis can increase liver stiffness,” Jérôme Boursier, MD, PhD, from the Hospices Civils de Lyon in France, and colleagues wrote. “We defined new and comprehensive reliability criteria for [virtual touch quantification (VTQ)] examination resulting in ‘very reliable,’ ‘reliable,’ and ‘unreliable’ categories, all with significantly different diagnostic accuracies.” Read more

Fibrosis severity determines cause-specific mortality in NAFLD

New data showed that in nonalcoholic fatty liver disease, patients with cirrhosis were more likely to experience liver-related events while those with bridging fibrosis were more likely to experience non-hepatic cancers and vascular events.

“Taken as a whole, previous and current findings highlight the importance of underlying fibrosis stage in determining clinical outcomes and cause-specific mortality,” Eduardo Vilar-Gomez, MD, PhD, from the Indiana University School of Medicine, and colleagues wrote. Read more

New imaging model provides superior fibrosis stage diagnosis

Deep learning radiomics of elastography demonstrated superior predictive value in assessing cirrhosis and advanced fibrosis compared with 2D shear wave elastography and biomarkers among patients with chronic hepatitis B, according to recently published data.

“Utilizing the data acquired from limited number of hospitals to train and establish the [deep learning radiomics of elastography (DLRE)] model is likely to be sufficient in applying it for assessing liver fibrosis stages in other hospitals with a consistent accuracy,” Kun Wang, MD, from the Third Affiliated Hospital of Sun Yat-sen University in China, and colleagues wrote. Read more

Bi-annual liver cancer screening for cirrhosis improves diagnosis, survival

Compliance with hepatocellular carcinoma surveillance correlated with early diagnosis, better allocation of curative treatment and longer overall survival among patients with hepatitis C- or hepatitis B-associated compensated cirrhosis, according to a recently published study.

“Monitoring for HCC in patients with cirrhosis, based on bi-annual ultrasound examination is recommended by international guidelines,” Charlotte Costentin, MD, from the Hôpital Henri Mondor in France, and colleagues wrote. “Improving compliance with surveillance guidelines should translate into a significant improvement in the prognosis of this deadly cancer.” Read more