RT Journal Article
SR Electronic
T1 Unified interpretation of liver stiffness measurement by M and XL probes in non-alcoholic fatty liver disease
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP 2057
OP 2064
DO 10.1136/gutjnl-2018-317334
VO 68
IS 11
A1 Vincent Wai-Sun Wong
A1 Marie Irles
A1 Grace Lai-Hung Wong
A1 Sarah Shili
A1 Anthony Wing-Hung Chan
A1 Wassil Merrouche
A1 Sally She-Ting Shu
A1 Juliette Foucher
A1 Brigitte Le Bail
A1 Wah Kheong Chan
A1 Henry Lik-Yuen Chan
A1 Victor de Ledinghen
YR 2019
UL http://gut.bmj.com/content/68/11/2057.abstract
AB Objective The latest model of vibration-controlled transient elastography (VCTE) automatically selects M or XL probe according to patients’ body built. We aim to test the application of a unified interpretation of VCTE results with probes appropriate for the body mass index (BMI) and hypothesise that this approach is not affected by hepatic steatosis.Design We prospectively recruited 496 patients with non-alcoholic fatty liver disease who underwent VCTE by both M and XL probes within 1 week before liver biopsy.Results 391 (78.8%) and 433 (87.3%) patients had reliable liver stiffness measurement (LSM) (10 successful acquisitions and IQR:median ratio ≤0.30) by M and XL probes, respectively (p<0.001). The area under the receiver operating characteristic curves was similar between the two probes (0.75–0.88 for F2–4, 0.83–0.91 for F4). When used in the same patient, LSM by XL probe was lower than that by M probe (mean difference 2.3 kPa). In contrast, patients with BMI ≥30 kg/m2 had higher LSM regardless of the probe used. When M and XL probes were used in patients with BMI <30 and ≥30 kg/m2, respectively, they yielded nearly identical median LSM at each fibrosis stage and similar diagnostic performance. Severe steatosis did not increase LSM or the rate of false-positive diagnosis by XL probe.Conclusion High BMI but not severe steatosis increases LSM. The same LSM cut-offs can be used without further adjustment for steatosis when M and XL probes are used according to the appropriate BMI.