Performance characteristics of vibration‐controlled transient elastography for evaluation of nonalcoholic fatty liver disease

作者：Raj Vuppalanchi, Mohammad Shadab Siddiqui, Mark L. Van Natta, Erin Hallinan, Danielle Brandman, Kris V. Kowdley, Brent A. Neuschwander‐Tetri, Rohit Seth Loomba, S Dasarathy, Manal F. Abdelmalek, Edward C. Doo, James Tonascia, David Erwin Kleiner, Arun Jayant Sanyal, Naga Chalasani · 发表于：Hepatology · 年份：2017 · DOI：10.1002/hep.29489 · 被引用次数：263 · 研究领域：Liver Disease Diagnosis and Treatment、Ultrasound Imaging and Elastography、Hepatocellular Carcinoma Treatment and Prognosis

Vibration‐controlled transient elastography estimates liver stiffness measurement (LSM) and controlled attenuation parameter (CAP), which are noninvasive assessments of hepatic fibrosis and steatosis, respectively. However, prior vibration‐controlled transient elastography studies reported high failure rates in patients with nonalcoholic fatty liver disease. We examined the performance characteristics of the FibroScan 502 Touch with two probes, medium (M+) and extra large (XL+), in patients with nonalcoholic fatty liver disease in a multicenter setting. A total of 1,696 exams were attempted in 992 patients (body mass index, 33.6 ± 6.5 kg/m 2 ) with histologically confirmed nonalcoholic fatty liver disease. Simultaneous assessment of LSM and CAP was performed using the FibroScan 502 Touch with an automatic probe selection tool. Testing was conducted twice in patients by either a single operator (87%) or two operators (13%). Failure was defined as the inability to obtain a valid examination. An examination was considered unreliable if LSM interquartile range/median was >30%. Significant disagreement between two readings was defined as >95% limits of agreement between two readings. A total of 1,641 examinations yielded valid results with a failure rate of 3.2% (55/1,696). The proportion of unreliable scans for LSM was 3.9%. The proportion of unreliable scans with operator experience in the top quartile (≥59 procedures) was significantly lower than that in the lower three quarter...